Permit '
b n ' CITY OF TIGARD MECHANICAL PERMIT
ip
. ` ., .. COMMUNITY DEVELOPMENT Permit #: MEC2010 -00156
Date Issued: 04/09/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 110DD06800
Jurisdiction: Tigard
Site address: 10525 SW GREENLEAF TER
Subdivision: Lot: 0
Project: Fuegy
Project Description: Replace air conditioner. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
FUEGY, BILL Description Date Amount
10525 SW GREENLEAF TER
TIGARD, OR 97224 Air Conditioning 04/09/2010 $46.75
12% State Surcharge - Mechanical 04/09/2010 $10.80
PHONE: 503 - 639 -5391 Minimum Fee Adjustment - Mechanical 04/09/2010 $43.25
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: () , /- / c .,1_ /
Ot Call 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 0710 02:30p Columbia Heating /Cooling 503- 598 -0270 p.2
Mechanical Permit ApplicafiogEC " { ( ` �,�=; la1210F ,lc r, s nN,:a .y e. : r `;
Y ®7 r�1
it. y, City of Tig ard APR c IG Dan!: QL/ ee 0 i Pc- "W6 -CO /s
a 13125 SW Hall Blvd., Tigard OR 97223 Plan Review / /
%y7t' Phone: 503.639.4171 Fat: 503.598.1960 a Datc/B�: Other Permit: •
Inspection Line: 503.639.4175 CITY OF 11
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IGAI , By: -llurk Page 2 for
InlcrInternet: 1cww Tigard -0r -gov BUILDING DIV�� ® � Netified'Mcthod: 1� 0 Sec Supplemental Information
TYPE OF WORK COMMERCIAL FE SCHEDULE — USE CHECKLIST
0 New construction Addition /alteration /replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
n Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION vat"
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
X I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I I:a. Total
JOB SITE INFORMATION AND LOCATION Healing,/cooling
Job site address: /0526 Air conditioning
5 J -. / f J "T (recuires site plan showing placement) t I. 46.75
C it_siStatc.rliP: J aid-- 9722-4
�-- Furnace 100,000 BTU (dueislvcnts) 46.75
1 Furnace 100.000-i- BTU (ducts/vents) ! 54.0:
Suite/bldg./apt. no.: Project name: Heat pump t t 61.06
Cross street directions to job site: Duct work 23.32
I-lydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32 •
Unit heaters (fuel -type. not electric). !
in -wall, in -duct. suspended. etc. 46.76
Flue /vent for any of above 23.32
S•.thdlvision: Lot no: '
Other: 1 23.32 ,
Ta.s inapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 1 1 23.32
Azit- ad �� e � � Gas fireplae 31.39
Flue vont for water healer or gas
• ! fireplace 23.3'' •
Log lighter (gas) 23.32
Wood/pellet stove ,
Wood fireplace/insen 23.32
Chimnev,9iner /flue /vent 1 23.32
❑ PROPERTY OWNER ❑ TENANT
Other: 23.32
Nano; r— g ; # a - e �(, �Y y - Environmental exhaust and ventilation
Range hood /other kitchen I
Address: equipment t 33.39 •
Cit):'State;ZL'• Clothes dryer exhaust I 33.39
Single -duct exhaust (bathrooms,
Phone: 5(Ji ) 639-539 Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT 0 CONTACT PERSON Atticfcrawlspace fans 23.32
Other:
23.32
Business name: Fuel tin
p�P t; _
Cnntaci narne• 4/70 rr / t2<••" r ._, t )) e& 7 77) 314.15 for first four; S4.03 for each additional _^
Furnace, etc.
Address:
Gas heat pump —_
City/Stater/ ,�rr•�� Wall lsuspended/unit heater
Phone: ( , ( ,„,Q 4. x704- Fax: : j 'S) 55, E _ D 7rj Water heater
Fireplace
F.-mail: Range
CONTRACTOR Barbecue
Abu u i f7l �A-> A .6-ti. rk Clothes dryer (gas)
13usincss name:
Other:
Address:; '/0 , = , ! __ dpiL • ' • MECHANICAL PERMIT FEES*
Citv,'StatelZlP:� �7��1 Subtotal 9
1 ' [� ,� Minimum permit fee ($90.0C) c ,
Phone: 3 ) 6 , 4 __c J / Fax: 18, /^ Plan review (25% of permit fee) l
An ✓l.'(:Fi tic.: t , 1/ State surcharge (12% of permit fee) Q , 0 V,, (1 1
TOTAL PERMIT FEE /0 , f
/i( /1^ 7 `
This permit application expires if a permit is not obtained within 1 R0
Authorized signatu 4 X /J ( y i days after it has been accepted as complete.
Prin nameni-I M Date: , 4/7 w ' Fee methodology set by Tri- County Building Industry Ser:icc Board
1:'- .auildinq,Per 4s',MEC- P= nniinpa.doc IO,,O1/06 440.461 Tr( 11021COP4 /Wi:a)
co Q u 1 IT SITE PLAN
FEET TO BACK OF PROPERTY LINE
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FEET TO
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SIDE PROPERTY LINE
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FEET TO FRONT P LINE
- A;PDRESS: - 0 1
PL REFAX APPLICATIONJWITH SITE PLAN '
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