Permit MECHANICAL PERMIT
' � "; � "' CITY OF TIGARD
14 r;i �t Permit #: MEC2010 -00219
1T , , COMMUNITY DEVELOPMENT Date Issued: 05/12/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 25111 DB09900
Jurisdiction: Tigard
Site address: 15495 SW OAKTREE LN
Subdivision: Lot: 0
Project: Littlefield
Project Description: Replace A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
LITTLEFIELD, ALLAN Description Date Amount
15495 SW OAKTREE LN
TIGARD, OR 97224 Air Conditioning 05/12/2010 $46.75
12% State Surcharge - Mechanical 05/12/2010 $10.80
PHONE: 503 - 670 -9262 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.
rift
Issued By: / / .1 , A �P Permittee Signature: A li(/ �/c L- / C� •�-�/C
/t 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 09:10a Columbia Heating /Cooling 503 -598 -0270 p.2 I
Applic � ` t
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Mechanical Permit � �" � � • `� '" �`� ��� � ,���� �. � � * F
v„n�t { � t r Received 1w,a, City of Tigard 1 2010 Daleigy t5 /6ij_ //0 irtr Permit > /1cc /0 ' 00 g 19
a a 13125 SW Hall Bled. - Tigard, OR 9 ?2 Plan Review
,r' '. ° Phone: 503.639 -4171 Fax: 503.598.1'' PA� Date113y: Oth er Permit:
s il .G - ' Ittspe Line. 503.639.4175 �p Dale Ready /By: Jura: El See Page 2 for
� FdG A R'D Fl
roinika wal Internet: www- tlgard- or.gov r 1 ( OF T117 Notif.ed.`Meihod: /(6" Supplemental Information
: DIVIS � l f • TYPE .WORK •• • ...: COMMERCIAL FEEL" SCHEDULE — USE CHECKLIST •
El New construction e[]'Addlfi0ni31tcralion/replacement Medtanical permit tees* arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mcc'uanical materials. equipment. labor, overhead, and profit.
- CATEGORY OF..CONSTRUCTION -- value S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
2<and 2- family dwelling ❑ Commercialiindustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description ! Qty- Fa. , Total
JOB SITE INFORMATION AND LOCATION - - - Heating/cooling
/fq�� r1� F I EF Air conditioning
i pl an
Job site address: .Ai r con site pla showing placement) 46.75
Cit /•LIP: ri 6p ed Furnace 100,000 BTU (ducts/vents) 46.75
� ^ Furnace 100.000+ BTU (ductsveuts) 54.91
Suite!bldg.;apt.no.: Project name: Aue L_i Heat pump 61.06
Cross street /directions to job sitc: Duct work 23.32
1-ivdronic hot water system 23.32 _
Residential boiler (radiator or
jdronic) 23_32
Unit heaters (fuel -type. not elcctric)-
in -wall, in -duct- suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.:
• Other. 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK . . Water heater _ 23.32
� 7� Gas fireplace 33.39
A VG ` P
CE/I e/-7r- Flue vent for .cater heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Woorl'pellet stove 33.39
_Wood fireplace /insert 23.32
Chimney /liner /flue /vent i 23.32
® PROPERTY. OWNER - ❑ TENANT - • Other: 23.32
Name: A L ./ Environmental exhaust and ventilation
�Z/
Range hood /oilier kitchen
Address: 16 �tr 5 W K T ZEE equipment ment 33.39
City /Statc/ZIP: '7", 6A. g Clothes drver exhaust 33.39
? Sin :le -duct exhaust (bathrooms,
Phone: (ffO j 1 6770._ q 'a../c-, Fax: 1 ) toilet compartments, utility rooms) j 2132
® APPLICANT • . - CONTACT PERSON Atticicrawlspace fans 23.32
Other: 23.32
Business name: COLUMBIA HEATING AND COOLING Fuel tin
P g
Contact name: MARLENA 514.15 for first four; S4.03 for each additional
Furnace- etc.
Address: PO BOX 230397 Cas heat pump
City/State/71P: TIGARD OR 97281 WalUsuspendeditmit heater
Phone: (503) 624 - 2704 fax:: (503) 598 - 0270 Water heater
Fireplace _
E -mail: COLUMBHC @TELEPORT.COM Range •
CONTRACTOR - - Barbecue
Clothes dryer (gas)
Business name: COLUMBIA HEATING AND COOLING 1 Other:
Address: PO BOX 230397 . MECHANICAL PERMIT FEES*
Cily TIGARD OR 97281 Subtotal
Minimum permit fee (S90.00) ) t 07)
/hone: (503)624 Fax: (503) 598 - 0270 Platt review (25% of permit fee)
Cal Iic.: 16359 State surcharge (12 %ofpermit fee) fd ,,
y /A
TOTAL PERM FEE AO , 0
A
, applicati on it pi t a acc d is ax u
Authorized signature ' � 4 Jays ex Acc cont mobtaple ile. ned within 180
Print name: RIARLENA MEED0.�9 l ) Date: ' 1 — � Q This permit Fee melhodnbey set by'Tri- County Building industry Service Beard
c.. I,u_...p- ,rr- p...,:, A',, am 1an! 4 a ? - 4617TH IrC2iCO11:1VE9)
May 11 10 09:10a Columbia Heating /Cooling 503 - 598 -0270 p.3
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