Permit CITY OF TIGARD MECHANICAL PERMIT
r'.a,` -- COMMUNITY DEVELOPMENT Permit #: MEC2010 -00344
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2010
TIGARD; Parcel: 25111 CC07000
Jurisdiction: Tigard
Site address: 15905 SW GREENS WAY
Subdivision: SUMMERFIELD NO. 2 Lot: 97
Project: Bowman
Project Description: Replace existing furnace and NC. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
BOWMAN, DONALD M & JUDITH L Description Date Amount
15905 SW GREENS WAY
TIGARD, OR 97224 Air Conditioning 07/16/2010 $46.75
Furnaces < 100K BTU 07/16/2010 $46.75
PHONE: 503 - 639 -2096 12% State Surcharge - Mechanical 07/16/2010 $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:
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: f f. Permittee Signature: d'/V / Dz.,/( - •
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 1410 04:57p Columbia Heating /Cooling 1')IS) 503-598-0270 p.2
Mechanical Permit Application 4 I aR OEF IC'L 015 O \Elt
' City of Tigard , (1% ,,e ateBy- i 4, i -� , Permit No. / Received � p /�� 6 -ee,_ ,,.. " _/ /
A
13125 SW Hall Blvd., Tigard, OR 97223 1
;; C :, Phone' 503.639.4171 Fax: 501598.1960 � \.) " �Gs e Other Permit:
1 I G h [i I nspection Line: 503.639.4175 (��{ 4 Date lteadyBy : 0 See Page 2 for
_ Internet: www.hgard or.gov C �� �� •AC Notified/Method: EM Supplemental Information
TYPE OF WORK ■-• I COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
' Mechanical permit fees* are based on the value of the work
❑ New construction ■Addition /alteration /replacement i i performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
� RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
- 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special irprormation use checklist.
Q Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Rea ting/cooling
/ � 7 2 ��, Air conditioning e
Job site address: _542 �- oo �..._.. ��
(requires site plan showing placement) £ 46.75
City /State /Z1P: 77 -r2 -12 6A ErN,5 kl y Furnace 100,000 BTU (ductsivents) / 46,75
/ Furnace 100,000+ BTU (ducts /ve nts ) 54.91
Suiteibldg. /apt. no.: Project name. . / �iyJ y + H eat pump 61 06
Cross street/directions to job site: J Duct work I 23.32
Hydronic hot water system I 23.32
Residential boiler (radiator or
hydronic) i 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
Tax mapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
• � Gas fireplace 33.39
�(�_ _ 7$'^1 YS y ���'�J' / `-Y/ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Woodipeliet stove 33.39
Wood fireplace/insert 23.32
Chimney /liner vent
Other: 23.32
PROPERTY OWNER I ❑TENANT 23.32
Name: L x.67 et
.....•- Environmental exhaust and ventilation
` / Range hood/other kitchen
!
Address: equipment 33.39
City /State/ZIP: t Ven,„.,,,,T Cl othes dryer exhaust 33.39 '
2 �
M o exhaust (bathrooms,
Phwtd ) 103C Fax: ( ) toilet compartments, utility ity rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32 _
Business name:
Fuel piping
Contact name: 514.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater ,
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range _
CONTRACTOR .. Barbecue
Neat) Clothes dryer (gas)
e � Business name: e a LL / Q, Other
Address: s ��, w ry , MECHANICAL PERMIT FEES*
City /Statc /ZIP: J j 4 4 ? I Subtotal 93 , so
4 9 .. . ��' 7Q Minimum; permit permit fee ($90.00;
hone Z A «� Fax: 1 Plan review 25% of fee
CCI3 tic,: ci State surcharge (12% of permit fee) f/- 0
TOTAL PERNIIT FEE Ad / zz
Authorized signature: k.- .4 This permit application expires if a permit is not obtained within 180
days ys after r it has been accepted as complmpl ete.
I Print name: r l-n , Q 'n Date: 7//4/ 1� ' pee methodology set by Tri- County Building Industry Service Board
1PButdingYcamits\MEGPermitApp.doo 10/01;09 440 -4617T (1 1/o v O 4/wEB)
Jul 1410 04:57p 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
SITE PLAN
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ADDRESS: 1 61,0