Permit ''' n CITY OF TIGARD
MECHANICAL PERMIT
'
IN ' COMMUNITY DEVELOPMENT Permit #: MEC2010 -00122
Date Issued: 03/25/2010
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 25111 DB02800
Jurisdiction: Tigard
Site address: 15395 SW ALDERBROOK CIR
Subdivision: SUMMERFIELD NO.8 Lot: 487
Project: Boyer
Project Description: Replace a /c.
Owner: FEES
BOYER, ANELLA Description Date Amount
15395 SW ALDERBROOK CIR
TIGARD, OR 97224 Air Conditioning 03/25/2010 $46.75
12% State Surcharge - Mechanical 03/25/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 03/25/2010 $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: e t i t ` ` 1 �, Permittee Signature:
Q Q M
CaII 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.
Mar 2510 10:32a Columbia Heating /Cooling 503 -598 -0270 p.2
Mechanical Permit Application r „, , ^'r
R� n. � #h GAL , ., ' ' .. ... i : , 4 If•N :I 51� li , v t a kt `.;" '
I!} � t'. $ 1,l i! a: 46eeivcd Pe Nn.
City of Tigard Dare.rily: rtveq on -en 0
y " 13125 SW 1 tall Blvd.. Tigard, OR 97223
1 a MAR 2 5 ; �8T
'' Prone, 503.639,/• 171 Fax: 50+ "59&.1960 3 Plan Rcvi ^u
Dato.03y;
'
7J
Other Permit)
'" Inspection Line: 503,639.4175 _ p
G :N D; Dale Readyl8y. ti , RI Sec Page 2 for
rata,, i I n :cruet', www-trgard- or.gnv CITY OF p IGARD Noli icd/Melhnd: I \
DIVISION
c � Jupplemental la[orma
RI 111 PING DI`f!SION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Li e construction - Addit :al /alteration /replacement i Mechanical permit fees* are based on the value nfthc work
performed. Indicate the vaiue (rounded to the nearest dollar) of all
❑ 1)c:mn1 iron ❑ Other: I mechanical materials, equpmcnt- labor, overhead. and profit.
CATEGORY OF CONSTRUCTION... . . Value: A
and 2- .'anvil dwelling n . . RESIDENTIAL EQUIPMENT' /SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building For snecio(rnrnrmarinn use chcn,rl..rr.
❑ Multi - family ❑ Master builder ❑ Other: -
__ - Description. Qtv 1 Ira Total I
JOB SITE INFORMATION. AND LOCATION Heating/cooling 1
c ^ y
.�j �f Air conditioning / 3 �
.ton site address: /j j 95 c J f) AL. k Cfc C1 C. irequires site p showirg placement; ' / 4 6. / ��
Ci :v''Slatc /7.1P: Furnace 100.000 BTU (ducts'vcnl i 46.7.5 /F Furnace 100,000+ HT1.1 (decisive nts; '4.91
Suite /blde.%apt. r:n.: Project name: /�1
„ ct Or) ,YG Oy - Heat pump r,t.06
Cross street/directions to inh silt: r-r C Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
:iydronic) 1 23.32
Unit heaters (fuel- type, not elec:riz). ' .
in- wall, in -duct, suspended, etc. t 46,75
•
Flue/vent for any of ahnvc 1 2 3.32
tihdit ision: Lot no.: t7thcr. 23.32
r. map parcel no.: Other fuel appliances
•
DESCRIPTION OF WORK •• Water heater 23.32
Gas fireplace 33.39
A i / Co i Ii if N F!a- (C/4 Jf f 04- . Flue vent for water heater or gas I
fireplace 1 23.32
1
Log lighter (gas) 23.32
Wood/peliet stove 3 ±.3P • , PR Wood ftreplacdinsert -�
1: - -i
2 OPERTY OWNER ❑TEN Ara Chimne /nueivent 1 23.32 1
I I Otter: t : 23.32
' hanl� tekA EY( ITL ' v Environmental exhaust and ventilation l
Address ` Ran9c hood other kitchen
/0 r ��: J9 tor ecuipmenl 33.39
I.'ity %ctate.7.IP, -/ic / 19'CuC4/ clothes dr'r exhaust 53.39
/ / Single -duct exhaust (bathrooms,
;'hone: ( ) Fax_ ( ) toilet compartments, utility rooms) 23.32
[] APPLICANT . ❑ CONTACT PERSON Atticierawlspace fans 23.32
Other: 23.32
` Wisi-)css name: I Fuel piping
,. 'ntart name: r . 1 () , - /� f"'� /2-) et ocy n a $14.15 for first four; $4.03 for each additional
' / Furnace, etc.
ridress:
Gas hear pump
C itviSlatcltP: Wall /suspended/unithcaler
Phone: f 31 (,{)q-- . QL7C Fax:: - j�1 q _b�7O water heater
7 Fireplace
I. -mail: Range 1
CONTRACTOR ' Barbecue
i
Rosiness name: ' / Cleihesdner aj
t vcr
. - I1 i on it A a - �a ..... i Other:
. 2dress: � \i �.�ah� 9 7 MECHANICAL PERMTT FEES* i
C.tOtate,'ZIP: C -/ 1 7a i Subtotal
Minimum permit fee (59,1.00)
Phone: ,..6:11_ 3 } � 7() _Pax: X9 1 _ 0 D Plan review (25 %of permit fee) - --
CCT3lic: 160 9 State surcharge(l2' /o of permit fee)
/ /' TOTAL PERMIT FEE IQc5. O
,Authorize :: sirrlatur /( /J ji 1 v
This permitappticftion b if a permit is not t . within IAf�
- f_: n ` f t f` : A
v" � - -"-`l days after y has been accepted pr mica ac s n ust y complete.
t
f'in :n / it 0 411•11 411•11 Datc. Fee methodology, set M� 'rri -Coumv Rnild�nt Industry Service Board
1. R -iiid,nr.Pcrniit : .1EC- .icrmb. App.doc tO'�' 4a(�a$ITr (II O2'CO \L'WF.ti)
Mar 2510 10 :32a Columbia Heating /Cooling 503 - 598 -0270 p.3
es
HEATING & COOLING, INC.
P 0. BOX 230397 • TIGARD, OR 97281
(503)6242704
SITE PLAN Z
4. L .,
i _J
ADDRESS.