Permit CITY TIGARD MECHANICAL PERMIT
I^ DEVELOPMENT SERVICES PERMIT #: MEC2006 -00534
164 1 $ , DATE ISSUED: 11/1/2006
=- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 11066 -04800
SITE ADDRESS: 12297 SW CHANDLER DR ZONING: R -3.5
SUBDIVISION: ARLINGTON RIDGE LOT: 025 JURISDICTION: TIG
Project Description: Add to existing duct work.
CLASS OF WORK: ADD FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KREMIDAS, THOMAS G + LETITIA J Description Date Amount
12297 SW CHANDLER DR
TIGARD, OR 97224 [MECH] Permit Fee 11/1/200E $72.50
[TAX] 8% State Surcha 11/1/200E $5.80
Total $78.30
Phone: 503- 968 -7137
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: 4.4.1-0.-A--ak--. Permittee Signature: : L.
CaII 503 - 639 -4175 by 7:00 a.m. for inspections 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.
1
4
Mechanical Permit Applica ng , O I'OR OFFICE I. Sl: 0\1.1
City
Ci of Tigard �vl GG Recei ved �! /,,
0
l � Ha f 7e,b /3 h Permit No.: Y%( GI�eCOb V _oa
13125 SW Hall Blvd., Tigard, OR 97 C Plan Review ' \
Phone: 503.639.4171 Fax: 503.598.1960 . 20 * , A q y Other Permit:
Inspection Line: 503.639.4175 � Q V Date , .1. Re
Internet: www.Ci.tigard,otus IGpFI : iv �� I -• Nate ady.By: 3 El See Page 2 for
CI i o G IVISI� Notified/Method: ' / Sappremeabl Iaformatioa
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. .. .'=L CONIIi�IERCIA.L; E ... DUIt:, - )E' , vsE Ca>cIKrAsi
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition /alteration/replat ment
performed. Indicate the value (rounded to the nearest dollar) of al
❑ Demolition 0 Other
mechanical materials, equipment, Tabor, overhead, and profit.
; -• CAT'EGORV F , CONStAUc 1bl iai;:t,a ., # . - f i + Value $ •
❑ 1- and 2- family dwelling ❑ Commercial/industrial ,RES. .... .. iEN1.'78YS . . .. FEES',
❑ Accessory building
❑ Multi- family El Master builder ❑ Other
For special irrfo,rrrarrorrust'chec4lisr.
Description Qty. 1 Ea. I Total
_.. JOB SIT ,Il AND_ '.LOCATION: Heating/cooling
Job site address: /a.Z. q S I Air conditioning or heat pump
f ���7'lU�l� (requires site plan showing placement) 14.00
City/State/ZIP: Furnace 100,000 BTU (duets/vents) 14.00
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg./apt. no.: I Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work , ! 14.00 ,
Hydronic hot water system 14.00 _
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot Flue/vent for any of above 10.00
Other. , 10.00 _
Tax map/parcel no.: Other fuel appliances
y��}
D 9 -+ �•' rb. ;:: ..
• .._ .. .%6 �, Water heater 10.00
eV — Gas fireplace 10.00
G/ / 42,....L! Flue vent for water heater or gas
fireplace 10.00
Log tighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimneyfliner/flue/vent 10.00
oITY.6 ��,� C7,�rEAii ,. I 10_(10
Cnh�:
Name:
1 / .iii � _ _ i
Environmental ezhanst and ventilation
.
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -dud exhaust (bathrooms,
Phone ) 5 3 Fax ( ) toilet compartments, utility rooms) 6.S0
-. .: , Er APPLICANT . .. i•> 45e§.: yirtO014.rAc t$R$Oltttlalt.. Anic/crawlspace fans 10.00
Business name:
Other: 1 0.00
Fuel piping
Contact name: f Ai i /2 //V 55.40 for first fourzS1.00 for each additional
Address: ��77 !C1 Furnace, etc.
Gas heat pump
City / Stale/ZIP: Wall/suspended/unit heater
Phone j 3 ) ‘02 ..7/709 Fax: a3) 9g, D„Vry . Water heater
E -mail:
Fireplace
Range
. CONTRACTOR iss + , `: ,r r, n Barbecue
n ' / / _ Clothes dryer (gas)
Business name:
a /il.4l b/ d lire 44JQ - WD/ aI �` Other:
Address: Pe joy 3 3_91 / ` s ll - *, > 4 0,41I1v i C' 3Aki ,``1t' R7 F1tS "nu ,r'.,f
/"/ e9 ql a$ ?
City / State/ZIP:
�J L}fL0 /r � Subtotal
` �i7 Minimum permit fee (S72.50)
phone:
(ryj 3 ) Ga ({ 0 l . {� �
Faxz) 9g �
Plan review (25% of permit fee)
CCB lic.: 7/ 35 9 State surcharge (8% of permit fee) ?r• l � TOTAL PERMIT FEE
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: /14 /A 4 ( a t': / /// / b C / * Fee methodology set by Tri- County Building industry Service Board
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