Permit n CITY OF TIGARD MECHANICAL PERMIT
i
-- 0 COMMUNITY DEVELOPMENT Permit #: MEC2010 00172
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 04/19/2010
Parcel: 1 S 134AD07700
Jurisdiction: Tigard
Site address: 10603 SW WINDSOR PL
Subdivision: WINDSOR PLACE Lot: 14
Project: Hashmat
Project Description: Replace existing gas furnace
Owner: FEES
HASHMAT, ABDUL WAHEED Description Date Amount
10603 SW WINDSOR PL
TIGARD, OR 97223 Furnaces < 100K BTU 04/19/2010 $46.75
FlueNent For Any of Above 04/19/2010 $23.32
PHONE: 12% State Surcharge - Mechanical 04/19/2010 $10.80
Minimum Fee Adjustment - Mechanical 04/19/2010 $19.93
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97281
PHONE: 503 - 624 -2704
FAX: 503- 598 -0270
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. .
•
Issued By: ,� Permittee Signature: t/ / p isL_.
Cali 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Apr 16 10 12:28p Columbia Heating /Cooling 503- 598 -0270 p.1
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Mechanical Permit Ai pl i ` E ED tit ' l �m FO ° !c E n r ` � !� �` '
,;, ice` 74 and Rece ived
City of Tigard
eq 13125 SW Hal{ Dlvd., Tigard, OR 97223 APR 1 6 V 2010 Plau Review Permit No. l.t�i(�p�I (] Dt�i7a-
Phone:
5036394171 Far 503.59 D ate; B y . Other Permit:
1G ' Ins Line: 503.639.4175 OF G uns t3 Se Page 2 for
TIG A'RD; TI A Date
Rrcal iitiandi Internet: www.ligard-or.gov B UILpI N Nolified,Method: Supplemental Information
G p IVIS10N Datc By
N
- ::. TYPE. OF. WORK . . • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
•
1I1 New construction il5 Addition /alteration /replacement Mechanical permit fees* are based (in the value [Idle work
performed. [udicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment. labor, overhead, and profit.
CATEGORY OF CONSTRUCTION • • . • • • Value: $ (FOv/
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special injormarion use check rsr.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 6a. Total
• JOB SiTE INFORMATION AND .LOCATION . • • Heating /cooling
q Air conditioning
Job site address
Il9(0 O 3 Si,. t1J i'iL 5 02 PL . (requires site plait showini: placement) 46.75
CitylState /ZiP: iii At q 11'23 Purnace 100,000 BTU (dttctvvents) / 46.75 4 4, 7,E
1' Furnace 100,000 + [3TU;(1ucts:vents) 54.91
Suite bldg./apt. no.: Project name: A% Doi. ( 4 A -CH0.4 Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hvdronic hot water system_ 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wali. in -duct, suspended. etc. 46.75
Flue/vent for any of above ( 23.32 Z 3
Subdivision: 1 Lot no.:
Other: 2332 1
Tax map'parcel no.: Other fuel appliances
DESCRIPTION .OF WORK Water heater I 23.32
• -- - Gas fireplace 33.39
it ty)L t' 1 S 77 44 F7.424)// 4 a' Flue vent for water healer or gas
fireplace 23.32
Log lighter (gas) 23.32
Woad/pellet stove 33.39
Wood fireplace /insect 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER . • 0 TENANT
Other: 23.32
Name: 0 60 L f 4A Cu u,.I 4- r Environmental exhaust and ventilation
` Range hood /other kitchen
Address:
l t 0,3 S (,>.) Lc)Is. iso''Z �C. equipment 33.39
City/State /LIP: 71( f, 0,1_ 7 223 Clothes dryer exhaust _ 33.39
Single -duct exhaust (bathrooms.
Phone: (' ?! ) ti ZQ - 42 / / Fax: ( ) toilet compartments. utility rooms) 23.32
® APPLICANT • 0 CONTACT PERSON • _ Attic; crawlspace fans 23.32
Other: 23.32
Business name.: COLUMBIA HEATING AND COOLING
Fuel piping
Cou.act name: MARLENA S14.15 for first four: 84.03 for each additional
r Furnace, ctc.
! Address: PO BOX 230397
Gas heat pump _
City!State(ZlP: TIGARD OR 97281 Wall /suspended /unit heater
Phone: (503) 624 -2704 Fax:: (503) 59B -0270 Water heater
- Fireplace
E -mail: COLIN BHC@TELEPORT.COM Range ,
CONTRACTOR • . • •• Barbecue _
Business name: COLUMBiA HEATING AND COOLING Clothes dryer (gas)
Other.
Address: PO BOX 230397 . MECHANICAL PERMIT FEES
CitylState /Z1P: TiGARD OR 97281 Subtotstl 7 a 02
- Minimum permit fee (590.00) qp, (y?
Phone: (503 ) 624 -2704 I Fa. t3) 59B -0270
Plan review (25 %ot permit feel _
.1 CCH Iic.:76359 State surcharge (1 2% o permit fee) i 0. C t � ,
TOTAI. PERMIT FEE /(10 , p V
/ This permit application expires if a permit b not obtained within 180
Authorized signature: ttayc after it has been accepted as complete.
Print mime: MARt.ENA HEED ! %;� Date: t, l�/� .. Fee methodology set by Tri -Cut my Rocking ]ndustr, Service Board
-140-451i ■ I P72‘COM,'\VE13I