Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT permit #: MEC2010 -00305
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/06/2010
TIGARD g Parcel: 2S103BA00141
Jurisdiction: Tigard
Site address: 11965 SW LYNN ST
Subdivision: LERON HEIGHTS NO. 2 Lot: 31
Project: Marchese
Project Description: Replace gas furnace and add A /C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
MARCHESE, MARK Description Date Amount
11965 SW LYNN ST
TIGARD, OR 97223 Air Conditioning 07/06/2010 $46.75
Furnaces < 100K BTU 07/06/2010 $46.75
PHONE: 503-590-0223 12% State Surcharge - Mechanical 07/06/2010 $11.22
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: Natural Gas
Gas Pressue:
Total $104.72
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: ) Permittee Signature: ny0/06
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.
Jul 01 10 04 :02p Columbia Heating/Cooling 503 -598 -0270 p.2
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Mechanical Permit Applica i,p �1 ° l 1, <)IZ,<)1 r ICI tlt�l 1) � ti; , i t 'lh ,
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, ` 1 1312.5 SW Hall Blvd., Tigard, OR 9 y � �O Plan Ravi.
r ;'d t Phone 503.639.411 Fait '503:59 U 1 Datefay:.. Other.Permu:
�'iun:lEUl fns ection,Line 503.639.4175
t, R . Date Ready,By: See Pg e,2 for
Pape `� ti �.w+ '.i' , . Intcmet; www.tlgend -0r;gav CITY OF TIGARD Nodfred1Method: 1 S Info rmation
BUICrarir l'Ul /iotlu. _ _ -
TYPE.;OF.WORK.. . • ,. • COMMERCIAL, + ',:SCIIEDULE — .USECHECKEIST
❑ New construction 0�qq Addi _ion /alteration/replacement Mechanical permit fe are base l`un the value" uf'tlie work
i/� performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, . labor, overhead „ and brotit
CATEGORY OF .CONSTRUCTION •' Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS -FEES*
.,Iii. an d 2- family dwelling ❑ Commercial /industrial El Accessory building
+ For special:nfor,na(iorr use checkiis;.
❑ Multi - family ❑ Master builder ❑ Other: Description '. Qty. I Ea. I Total
JOB SITE INFORMATION AND .LOCATION ' i :'. Heating/cooling
Job site address:- Air conditioning t [, JAB - ∎`_ „ 1 (requires site plan showing placement) 1 46.75 7� , 75
City /State /ZIP: L� Furnace 100,000 BTU (duotstvents) E 46.75 4 7S
i ' '`' f ` Furnace 1OO.O0» BTU (ducu/vents) 54.91
Suite/bldg./apt. no.: Project name: Ada + '"~ �/� Heat pump 61.06
1 Cross streeddirecbons toj site: a� f! Ductwork 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
Su'odivision: Lot no.:
Other: 23.32
Tax map /parcel no,: Other fuel appliances
DESCRIPTION OF WORK.. ..... W'atcrheater I 23.32
r .. . Gas fireplace 33.39
, - £ 5 H Ufl & 1 Flue tent for water heater or gas
�r Ci'f 1
�,[�,f� �• � fireplace 23.32
r'Tl [/� -,l/ Lo lighter ) 1 23.32
Log g �
Woad pellet stove ; 33.39
Wood fireplace/insert 23.32
"(PROPERTY OWNER • ' • I ' • 0 TENANT' Chimney/liner/flue/vent 23.32 1
Other: 23.32
Name: ! /la a r e Q,, Environmental exhaust and ventilation
•
Address: I i g y' " °'� - ddd +_ Ro hood/other kitchen
equipment 33.39
City/State/ZIP:
r "� `� Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms, •
Phone a i • Fax: ( ) torlet •compartments; utility rooms) 23.32 1
❑ APPLICANT . ❑ PERSON Atticicrawlspace fans 23,32
Other: j 23.32
Business name: Fuel tin
P P� g
Coti name: (7 , / l f� . / 524.t5 for first four: $4.03 for each additional
Furnace, etc. I
Address: r [ ' !
Gas heat pump
City/ State /"LIP: �] 7 q - a 70 �^� 'WalUsuspcndcd/unitheater 1
Phone: a3) ( ,Q1�..,7bV Fax: / 8 Water heater .
Q Firepl ace i
E -mail: Range
COYI'RACIOR . Barbecue _
•
Business name: ` Clothes dryer (gzas) -
.. �� ► .twutiai�t i . _ so.. . Other:
Address AD z 3 C '7 1 • MECHANICAL PERMIT FEES*
CitytStateiZII 716
f ' 1Jf ! 0. 0 7� f r , Subtotal 95, SC)
' Q( //�� Minimum permit fee ($90.00)
P One: ) 7 t) Fax: ( .� [ ti � ! - ea7 (0 Plan review (25% of permit fee)
/ •
■ COB lic.: a State surcharge (12% of permit Lee) //. ,:,?„2,. TO'I'AL PERM IT FEE /0y, 'f.,
Authorized si atur�: /J / ! �J j, / This permit application s been accepted as complete.
till name: Date: r '
P Fee methodology set by Tri-County Building 4tdustry Service Board
tuui'.d. niacrmitsWIEC- PermtApp.ccc 1 X I /o9 44c1-4617t (11 /02 /CCM/WEE)
Jul 01 10 04:02p Columbia Heating/Cooling 503-598-0270 p.3
HEATING & COOLING, INC.
1 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
1
11
ADDRESS: (t 5 . 111"