Permit MECHANICAL PERMIT
, . CITY OF TIGARD • ° , # . � COMMUNITY DEVELOPMENT Permit MEC2010 00041
13125 SW Hall Blvd., Tigard OR 97223 503:639.4171 Date Issued: 01/27/2010
T1 GARI Parcel: 2S110BD00901
Jurisdiction: Tigard
Site address: 12035 SW BULL MOUNTAIN RD
Subdivision: Lot: 0
Project: Whitney
Project Description: Install a /c.
Owner: FEES
WHITNEY, PAUL Description Date Amount
12035 SW BULL MOUNTAIN RD
TIGARD, OR 97224 Air Conditioning 01/27/2010 $46.75
12% State Surcharge - Mechanical 01/27/2010 $10.80
PHONE: 503 - 620 -3502 Minimum Fee Adjustment - Mechanical 01/27/2010 $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:
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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. Ys ay obtain a copy of the rules
or direct q • o OUNC`by calling 503.246.6699 or 1.800.332.2344.
� _ .7/
Issued By: ij� ! Permittee S'- •
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.
• Jan 26'10 01:01p Columbia Heating /Cooling 503 - 598 -0270 p,2
Mechanical Permit Application - :.4 ',.. "'
.4' ' , �Ol tOt•_F' I ( , f I n , '1'. , ° ,t: .
t 1 4 , 4 12 ' Cat Of 1 i and ®. Received
cEJVED No: p U • 13125 SN r'
/ Half Blvd., Tigard, OR ' . Plan Re yew Pen"
.' ^ Phone. 503.539.4.171 Fax: 503 .598.1960 Date/By: Other Permit:
TIG "AtR'D Inspection Line 503:639.4175 Data Ready/By: furs: Rd Sec Page 2 for
r k " "" Interact: www. tigard - or.gov JAN 26 2010 Nonhed:'Method: ; t. S upplemen[al Information
• TIGARI3 `�
TYP .� • . COMMERCIAL FEE* SCHEDULE USE CHECKLIST
p
, Mechanical permit fees` are based on the value of the work
❑ New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of a :I
❑ Dcmolitior ❑ Other: mechanical materials, equipment, labor, overhead, and profit. -
Value:
CATEGORY OF CONSTRUCTION '
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For .special inforrnahon.:4.7 checklist.
• ❑ Multi- l ❑ Master builder ❑ Other: Description Qty. Fa 1 Tntal _
JOB SITE INFORMATION AND LOCATION Heafing /cootinR
--� Air conditioning — T
. �S
sire address: / 245, 3- SL�.. I .1u 1( ti,( • , t (, u i i it_ (requires site plan showing. p.acement) + 16.i
}' .5tattJI..IP: ��� 2.-7-5 l Furnace 100,000 BTU (duels/writs) ' 46.75
Cit
T Q rr �/ S? Furnace 100,000+ BTU (ducishcnts) I 54.91
Seiletlldg.iapt. no.: 1 Project name: • Heat pump 61.06 _
( street/directions to job site: Duct work 23.32
--- Hydronic hot water system 23.32.
Residential boiler (radiator or
hydronic' , 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended. etc, 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other 23.32
Fax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.3'_
� �� Gas fireplace 1 33,39
-
,;frt , t � OrVi CeXel �-eA Flue vent for water heater cr gas
fireplace 23.32 j
Loe lirhtcr (gas) 23.32
—i
Wood /pellet stove - _ . 33.39
Wood fireplace /insert 23.32
Chimney /liner /fluc/vcnt •3.32 1
❑ PROPERTY OWNER ❑ TENANT Other: 23,32
Environmental exhaust and ventilation
Name . ClUI �, r� - p • Range hood/other kitchen
1
Address: ! vv j f f' v /r-r, equipment 33.39
C ir. •'Stale %U : Clothes dryer exhaust 33.39
_ ' f ( C� c�i /)st' 7 7 2Z r
T — Single -duct exhaust (bathrooms.
l':nonc: ( 5 ) tej2O— . Fax: ( ) toilet compartments. utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32 i
Other: , 23.32
Business name: ; I Fuel piping •
L i nta ct dame: m(7 i t,- /,a /7a f ! eP( $14.15 for first four; $4.03 for each additional
1 I Furnace, eta
Address: Gas heat pump
I City: /State /7,IP: ; Wall/suspended/unit healer
Phooc: a3) i ,9 . c.70 Fax :: • J �9 U - 70 Water place heater
Fireplace
1r. -mail: Range -
CONTRACTOR 1 Barbecue
- Clothes d cr (gas)
33 usincss name: ////��'� // 1' I!� � -
j-y y 7 (g
l �� t l m �� ! JT� .i �lT} 1 i Other: I
Address . '' MECHANICAL PERMIT FEES*
City/Stare/ZIP: 776i /2 06_ j 7,—)F1 I _ Subtotal
Phone: -3) /2j 11 ; (17 / s 1 Fax: (.5-231 L _ )0�i1 Minimum permit fee ($90.00) � J Q
I / 1 C CJ Plan review (25% of permit fee) L 8
�, , 9 _ State surcharge (12% of permit fee) /C. fa
• TOTAL PERMIT FEE (09 .VC)
Authorized signatur 1, " - , A This permit application expires if a permit is not obtained within 180
i Print nanie� r
/J �J�; -- /„ .�, ADO Date: . 2,q / days after it has been accepted as complete.
/a Fee method ology set by Tr-County Building Industry Service Boarc.
,' J l■■: ;ninyPcrn 10.'0 tAIQ
. dap 28-10 01:03p Columbia p.1 •
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HEATING & COOLING, INC. •
P.O. BOX 230397 . TIGARD, CR 9728'
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(543)624-2704 . .
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