Permit CITY OF TIGARD MECHANICAL PERMIT
1' COMMUNITY DEVELOPMENT Permit #: MEC2010 -00288
�sx ; Date Issued: 06/24/2010
7!G`ARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111DB03900
Jurisdiction: Tigard
Site address: 9195 SW SUMMERFIELD CT
Subdivision: Lot: 0
Project: Moore
Project Description: Replace existing a /c.
Owner: FEES
MOORE, HENRY V TR & PATRICIA Description Date Amount
9195 SW SUMMERFIELD CT
TIGARD, OR 97224 Air Conditioning 06/24/2010 $46.75
12% State Surcharge - Mechanical 06/24/2010 $10.80
PHONE: 503 - 620 -0550 Minimum Fee Adjustment - Mechanical 06/24/2010 $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 qu =: • • OUNC b calling 503.246.6699 or 1.800.332.2344.
Issued B . Perm ittee Sign.. ure:
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.
Jun 23 10 11:47a Columbia Heating/Cooling 503-598-0270 p.2
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Mechanical Permit Anplicatior 1"` .!' i w r- 1 ,....1, 1, 1 sr ,,,,..N
City of Tigard Received / _ ,..
Didc/Br LI W .
Permit No.: Wie ir 1
il
' 13125 SW Hall Blvd„ Tigard, OR 97223 JUN 2 3 2010
Platt Review
: • Phone: 503.639.4171 Fax: 503.598.1960 /Byi Other Permit:
., ..., ,... Date
1 . i (.., A 11 ., Inspection Line: 503.639.4175 CITY c I PJAHD Date Ready/By: lunri,.....- 0 Sec Page 2 for
Internet: viww.tigard-or.gov BUILDING DiVISION NaifiedlmaiKe: t „...--7 i al, Supple= en ta I Info cm alio.'
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— USE CHE CKLIST
Mechanical permit fees* are based on the value of the work
0 New construction &i
performed. Indicate the value (rounded 10 the nearest doliat) JC ail
E Demolition E Other: mechanical materials, equipment, labor, civet and profit
Value: 5
. - , . • • ... • '.: ..1 CA.WGORY"..0? n : .. . . . . .____.. ..._... .
.-.,-. 1q,.)..?.ig.m.p FEES-
E'{ anc. 2 dwelling E] Commercialiindustrial 0 Accessory budding
For specrcl informalion use checklist
E Multi-family E Master builder 0 Other: Description 1 Qty 1 E. fulai -,-,
, . • JOB SITE INFORMATION . AND LOCATION .'• .. • - ..- .?..,:::,. • .. ,-. • . Heating/cooling
Air conditioning
Job size address. q I . c: Sc.,, SZ)ft/n 6 //CI li Cr crequ.,e, site plan showing pl &lc' merit) PS 45
City/State/21P: 7-i gio ok 9 t72.2 q , FUME= 100,000 BTU (ducts/vents) 46.75
,,, Furnace 100,000'- B ',.cluctsivenis) 54 91
Suite/bldg./apt. no.: i rroject namei M00ee ArrgiC1/3 Heat pump 61.06
Cross su-eetidirecrons to job site: Duct work _ 23.32
liydronic hot water system . 23.32
Residential boiler (radiator or
•
hydronic; 23.32
Unit heaters (fuel-type, not electric), 1
in-wall. in-dttet, suspendec, etc. 1 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.3
Tax map/parcel no.: Other fuel appliances
111.ESPREPTIOK.ORe..WO00.1.0.:.,..-.,:.,:-::,....::....: - . ...,......!.../,.:,..:,..,;;i;;R:•:; , - ;.::. Water heater I 23.32
i Gas fireplace 33 39
A / r, 1ZE itACEm eAlr Flue vent for water heater or gas
fireplace 23 32
Log lighter (gas) 2332
Wood/pellet stove 1 33.39
Wood fireplace/insen 23.32 ;
Chimney/liner/flue/vent 1 23.32
... . PROPERTY OWNER : .. .:,.. • .. • Other I 1 23.32
Naln: PArti C(01 MC70 fZE Environmental exhaust and ventilation _........
Range hood/other kitchen
Address: q[15 SC-"i J n E1,F7 EL-13 Cr. I equipment i 33 3Y ,
City1State/Z1P: ' Ti tat) Ole 9712,02 ii Clothes dryer exhaust 33 33 —1
Single-duct exhaust (bathrooms,
Phone: 6 ,., ac ,...0,, ) Fax: ( ) toilet compartments, utility rooms) 2332 _..1
0 AppuoiNt,....,..,1..i::.;,:::.,..",iV.:' :, -,1y , i4i0a,:, , ,iti-iiltic.FJEria§;114.,64i;j4if i :, Attickrawlspace farts
1 23.35
Other: 23.32
-- - '
Business name: .
Fuel piping
Contact name: itiafikej.,)(2_/7.7 LeEci271 Furnace 514.15 for first four; S4.03 for each additional
I
, fi etc.
Address: Gas heat pump
1 City/State/ZIP: waiususpendediunit heater
Water heater
'Phone: 3) i.,5:) ( ,V,c, 9_ Fax: ,E6 5.1'78 _na7a _ -
Fireplace ,
:3-mail: Range
.... ... „ .
.• . COINTRAc .:,::: ..... :',, ,.. ii.,. ..-'.....:..,- Barbecue
Clothes dryer (gas)
Business name: / . ii .S. 'I -.dal A A a■ 1 1/0■ ■ _ Other: 1 :
Address ir,..0 , go zs..- ci 7 H
CANICAL PERMIT FEES*
• .. .,•—• ••••• •.• •••• ..
•
City/StAti4ZIP: 7164gn 0 T7 g i Minimum 9 Oa
Subtotal
one: 6; ) (0()ft Q-7 n .,,..r . Fax: C -5 - Ca-70
permit fee (590.00) 6
Ph '
Plan review (25% of permit :e,e) - (::9 --
CCB lie.: 1 7(0 a5.9 State surcharge (12% of permit fee) /O. eCi
TOTAL PERMIT FEE /00 . 1C,
Authorized signature r
This permit application expires if a permit is not obtained .ittnn
days after it has beco accepted as complete
Print nameinbj- 6-7 In'
Date: ( .":r- id ' fee methodology set by Tr-County Butldin industry Senile Iiogre
i:V3u:14:402ertrics\MEC..PerreitApploc 10/01/09 44G
Jun 23 10 11:47a Columbia Heating /Cooling 503 -598 -0270 p.3
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
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