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Permit q CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit#: MEC2010-00084 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/24/2010 Parcel: 2S1120007100 Jurisdiction: Tigard Site address: 15785 SW 82ND AVE Subdivision: LANGTREE ESTATES Lot: 3 Project: Alexander Project Description: Replace gas furnace and a/c. Owner: FEES ALEXANDER, SALLY Description Date Amount 15785 SW 82ND AVE Furnaces < 100K BTU 02/24/2010 $46.75 TIGARD, OR 97224 12% State Surcharge - Mechanical 02/24/2010 $10.80 PHONE: 053-624-2604 Minimum Fee Adjustment - Mechanical 02/24/2010 $43.25 Air Conditioning 02/24/2010 $46.75 Contractor: 12% State Surcharge - Mechanical 02/24/2010 $5.61 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: Natural Gas Gas Pressue: Total $153.16 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: ( Perm ittee Signature: 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. p I' 503-598-0270 p.3 Feb 23 10 02:01 Columbia Heating /C Mechanical Permit Applicati t r 'f , s ; w u oRio •T:.,:'.."' l 4 fwii i ,4t 4 �9 , : ;1' ti , Cray o Tigard. Recerve11 . • n�a N�M r l l c l; (is .,° FEB 2 3 2 Date it . 010 .By. Permit Noe 13125 Hall Blvd. T OR 97223 C'7 t� I V` l } r Q G . I C Phone: 503.639.4171 Fax: 503.598 196 Plan Review , 2 `" ' I ns eciion Line: 503 639;41 , CITY OF TIGARD DataBr o:hE Permit 7«� n p g BU DIVISION. Dale.ReadycBy ,uns S See Page '2 for i 9 in1 in Nrnel: www.tigard-or.gov 3rd -o ov VIS. Noii(ediMet6ad: Supplemental Information • TYPE. OF WORK • . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 1c" construction NtAddition /alterationtreplacemenl Mechanical permit fees' are based on the value oldie work performed. Indicate tare value (rounded to the nearest dollar) of 'all Demo]ition ❑ Other: mechanical materials, equiamcnt. labor, overhead. and profit. CATEGORY. OF :.CONSTRUCITON,., Value: $ • . RESIDENTIAL EQTlIPMENT / SYSTEMS FEES* 1 • and 2 family dwelling ❑ Commerciallindustral ❑ Accessory building For special rnjormnrirn use checklist ❑ \luiti -Camil ❑ Master builder ❑ Qther: Description I Qty. Ea. Tatal JOB SFFE INFORMATION AND LOCATION' Heating/cooling 1 �} " 7 � Q y Air conditioning ,fob a s address ` irequires site plan showing paccment) ' i 46.75 City/State/ZIP: Tr Q 7 7 Furnace 100,000 13T1J (duets/vents: / +1.75 T Furnace 100,00(1 BTU (ducts/yenc } 54.91 S rtc'hida /apt. no Project name: .e,�xcj O Q - : -scat pump P GL06 Cross strce'Jci to Job site: Ductwork I 23'32 Hydronic hot water system 23.32 Residential boiler (radiator or l hydrontc) 1 23.32 Unit heaters (fuel -type. not electric), in -wall. in -duct, suspended, etc. 46.75 Fluelvent for any of above / 23.32 .i ht`. % isirsc: Lot no.: Other ' 23,32 J Tax neap /parcel ro.: Other fuel appliances DESCRIPTION OF WORK ' Water heater 23.32 Gas; fireplace 33.39 f . ` 0� ( L L _ l Flue vent for water heater or gas — n . 1.1 / y C I' \'� ,- fireplace 23.32 Log lighter (gas) 2 , Weod /pclle, stove 33?9 'Wood fireplaceiinscn 23.32 Chimney /liner /flue /vent 23.32 '® PROPERTY OWNER ©TENAYf I Other: 23. Name. / / ! ' �,R Environmental exhaust and venfitation � A � �+ `� � �� Range hood/other k; when v • ° V equipment 33.39 '1—try/State/ZIP. ` _,At - �Zca--: : Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, ]'hone' .. Fax: ( ) j toilet compartments, utility moms) 23.32 • 0 AdPPLLCANT 0 CONTACT PERSON Attic /eravvlspace fan; t 23.32 • Business name abet l 23.32 Fuel piping ct ' Con,a name I $14.15 for first four; .$4.03 for each additional ___ C'�PCcS Iddress: Fumace, etc. Gas heat pump 1 Gity /State /"l,lP: Walt /suspended/unit heater j I icnc: �'3) Q a 70L Fax:: C9 -d 70 blazer heater Fireplace I mail: Range CONTRACTOR 1 .: Barbecu e • i rn urines; Wae: �D m f1 i LL_f +:.Ti� C'_ v � Other: Dryer (gas) , — ,� idress: k � � �{ 7�� r Q ' -7 ST l MECHANICAL PERMIT FEES* . .. • `CitviState/7.,1F: • (�,� / 7s i Subtotal r Minimum � �rnit fee $90.00) Phone: . 7j ( / Ot i' 'c.7 _ t� Fax: ( - -`-0J' �9{) - C Plan review (32 � 5 °o ofpetmit fee) CCB tic.: '7(n 13-- State surcharge,(12 %ofpermit • TOTAL PERMIT FEE ' li t / I � � This permit application expires ifa permit is not a htained within n Authorized si atur -: \ 5 i 1 `E' a _ days after it has 6eenaccepted ss complete Print name' i l & - /'y7) Dale: 1( ' Fee methedclogy ;et by Tri- Court. Bcitding Industry Service E.s '0.1 di r @`.P crm y i s \MEC -:^ crmit A � p.dos ' 0/0 E 1)9 4• P-461 iT (l t!02 /COM/1i' EB) (�1u- b Acne CM