Permit CITY OF TIGARD MECHANICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: MEC2010 -00218
Date issued: 05/12/2010
TIGARD`; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S110DD04800
Jurisdiction: Tigard
Site address: 15630 SW OLD ORCHARD PL
Subdivision: SUMMERFIELD NO 3 Lot: 151
Project: Propes
Project Description: Replace furnace.
Owner: FEES
PROPES, CARL Description Date Amount
15630 SW OLD ORCHARD PL Furnaces < 100K BTU 05/12/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 05/12/2010 $10.80
PHONE: 971- 340 -9001 Minimum Fee Adjustment - Mechanical 05/12/2010 $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: '9 'z�' j fir
/� 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.
May 11 10 08:22a Columbia Heating /Cooling 503 - 598 -0270 p.2 D
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Mechanical Permit Applicatio i , ; �' "'� v �F0R.oFFIC 'sE'ov r „A ,( i )
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13125 SW Halt Blvd.. Tigard. OR 97223 L. r�
MAY 1 1 Dan Review
, �^ 1 .{ Phone: 503.639.4171 Fax: 503.598.1960
� 10, o Dare,'i3s: Outer Permit
w1'n'" � Inspection Line: 503.639 4175
11TIG':4RD DatcReadv'Br Ju (/ /�ScePagc2far ormatian
4ut� a 2 Internet: «ww.tlgard or.gov hiatified /Merlind' Supplemenh+l lnf
(�fC]]OTY 0� TI GARD • TYPE OF WORK .. NG .P . .. ' • COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction dition /alterationfreplacement Mechanical permit fees' are based on the value oldie work
performed. indicate the value (rounded to the nearest dollar) of' all
❑ Demolition ❑ Other: mechanical materials- equipment, Tabor. overhead, and profit
CATEGORY OF CONSTRUCTION• Value: 2-family d $
ant1 svcllin RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
g ❑ Commercial /industrial ❑ Accessory building
For special nrfornratian use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description j Qty. I En. 1 Total
JOB SITE INFORMATION AND LOCATION • Heating /cooling
PL Air conditioning
loh site address:
/5 - 6 . 3 0 SC..) OW 0LCHA�Z PL. trequires site plan snowing placemem) 46.75
City'State/7_IP: 77 c A. v , OL/ 6/ZC#9Zb n_ Furnace 100.600 BTU (ducts/ veinal / 46.75
Furnace 100.000+ BTU (dm:Ls /sews) 54.91
Suite'bldg.lapt. no.: Project name: Coq R L. mope. 5- H eat pump j 6106
Cross street/directions to job site: _ Duct work 23.32
I— dronic hot water , vstem 23.32
Residential holler (radiator or
hvdronic) 23.32
Unit heaters (fuel -type. not electric),
• in -wall, induct, suspended. etc. 46.75
Subdivision: Lot no.: Flue(vent for any of above 23.32
Other: 23.32
Tay m apipateel no,: Other fuel appliances
• DESCRIPTION OF WORK 'r1•' heater 1 23.32
Gas fireplace 33.39
ru , 4tc;e CiAA) (TE — 0 fr Fleet vent for water healer or gas
fireplace 23,32
- --- ---- - - - - -- — Log lighter (gas) 23,3
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chininey/liner /flue /vent 23.32
® PROPERTY OWNER + : 0 TENANT
/Rap Other: 23.32
Name: CARL E f Environmental exhaust and ventilation
Address: )51,1 c1 (•„> OL RM O AO Range hood/other kitchen
equipment 33.39
City /State!ZIP: n i Clothes dryer exhaust 33.39
— " Single -duct exhaust (bathrooms,
Phone: (503 )6-9a - ya -/15
(Fit '(o7) );jtj -- `tool
toilet compartments, utility rooms) 23.32
® APPLICANT . C CONTACT PERSON Attic'crawlspace fans 23.32
Other: 23.32
Business name: COLUMBIA HEATING AND COOLING Fuel piping
Contact name: MARLENA 514.15 for first four; 54.03 for each additional
Address: PO BOX 230397 Furnace. eta
Gas heat pump
City(State /ZIP: TIGARD OR 97281 • Wall/suspended'unit heater
Phone: (503) 624 -2704 Fax: : (503) 598 -0270 Water heater __-
Fireplace , •
E -mail: CO Li! MBHC@TELEPORT.COM Range
.. CONTRACTOR..: . • .. Barbecue
Business name: COLIA HEATING AND COOLING Clothes deer (gas)
Other
Address: PO BOX 230397 MECHANICAL PERMIT FEES"
Cit■'State,'ZIP: TIGARD OR 97281 — Subtotal
Minimum permit fee ($90.00) 7 /, , t
Atv l' on e: (503) 624 2704 Fax: (503) 598 0270
/ Plan review (25 °roof permit fee)
CCB tic.: 76359 ,/ State surcharge (12 %ofpermit tee) 70 - to
TOTAL PERA1IT FEE 1a , ed ,/
This permit application expires ifa permit is not obtained within IRO
Authorized signature: clays after it ha, been accepted as complete.
Print name: MARLENA MEEDOAII Date: 0 //- /Q Fee methodology set by Tri County Raildiug rnduitry Service Boxed
1 - Riildino•.Perm'.IS'W - Perari:Anr doe 10 ;01 44C' - o,i T (11'O1:COit,WFR)