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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 -00343 T1GARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2010 Parcel: 2S111DC13100 Jurisdiction: Tigard Site address: 15925 SW OAK MEADOW LN Subdivision: Lot: 0 Project: Carlson Project Description: Replace existing A/C. Unit must meet 3' minimum rear and side yard setbacks. Owner: FEES CARLSON, EDWARD Description Date Amount 15925 SW OAK MEADOW LN TIGARD, OR 97224 Air Conditioning 07/16/2010 $46.75 12% State Surcharge - Mechanical 07/16/2010 $10.80 PHONE: 503 - 684 -5730 Minimum Fee Adjustment - Mechanical 07/16/2010 $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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: / 69) 4 1;4117 Permittee Signature: cy;iv-- _ /OL jC/I720A/ 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 04:17p Columbia Heating /Cooling 503 - 598 -0270 p.2 Mechanical Permit RECEIVED ` role orr ':,"4••,i'''''. s r ;t , E n�1 i City of Tigard R axived ' Permit l'l0- tC,_.! i -Do9 • i " ) 3125 SW Hull Blvd,, Tigard, OR 97223 JUL _ 1 4 ',con ° Plan Retirees Other Permit: Phone: 503.639.4171 Fax: 503.598.1460 DateBy: Inspection Line 503.639.4175 CITY OF T1GARD Dare Readyf3y: Iuri • H See Page 2 for T i G A El D., Internet: www.tigard- or.gov Notified/Method: 6 Supplemental Information BUILDING DIVISIO TYPE OF WORK COMMERCIAL FEE` SCHEDULE — USE CHECKLLST Mechanical permit fees' are based on the value of the work ❑ New construction ❑'74 ddition /alterationireplacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value: $ CATEGORY OF CONSTRUCTION ; RESIDENTIAL EQUIPMENT /SYSTEMS FEES* i 1- and 2- family E3 ildi ily dwelling ❑ Commercial /industrial Accessory building For srmciol information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling , ,' Air Job site address: 1 S IS c �W tti Air ing Condi conditt ion oning hats'inl placement) 1 46.75 —_ Furnace 100,000 E3TU (ductslvents) 46.75 City/State/ZIP: ( l z.., � -1� Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: _ Duct work 23.32 _ Hydronic hot water system 2332 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in-wall, in -duct, suspended, etc. 46.75 Flueivent for any of above 2332 Subdivision: l Lot no.: Other: 1 23.32 Tax map/parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater , 23.32 Gas fireplace 33.39 Pteed-f _9 J 4 E L. Ni 6, A l ( Flue vent for water heater or gas fireplace 23.32 Lop lighter (gas) 23.32 , Wood/pellet stove ; 33.39 Wood. fireplace/insert 23.32 Chimney/liner/flue/vent ,(4. PR_ QPERTY OWNER ' ❑ TENANT Other: 23.32 Name: / +(f r ��� Environmental exhaust and ventilation +c Range hood/other kitchen Address: 'r _� te(l 1 ,�? I' equipment 33.39 City /Statc/Z1P: T , . t Clothes dryer exhaust 33.39 _ Single -duct exhaust (bathrooms, Phe• on S K + g , .✓ - 73 0 Fax, ( ) toilet compartments, utility rooms) 23.32 APPLICANT 0 PERSON Attic/erawlspace fans 23.32 [] _ Other: 2:.32 Business name: Fuel piping C ontact name: mn r k P p a... _ ) eec? 514.15 for first four; 54.03 for each additional / , Furnace, etc. Address: . . Gas heat pump _ City/State/ZIP: / � Wall/suspended/unit heater Phone: (513) , ' a.70 Li Fax : .3 5, 78 -(D 70 aterhater Fireplace _ E -mail: Range CONTRACTOR Barbecue } . Clothes dryer (gas) Business name: a « „ t ...a 5 , _ OA- . _ Other X l ; ��3 1 7 MECHANICAL PE is Subtotal . City/State/ZIP: I' �_', viinimum permit fee ($90.00) �� / P1oae:3) - 7 ') , Fax: ( L!- 1 Q I 8 ` O D Plan review (25% of permit fee) CCB lie.: '7 w 35-9 i State surcharge fee) TOTAL PERMIT FEE , Q , Q �,( ,( This permit application expires if a permit is not obtained within 180 Authorized signatun ,Q 67/ days after it has been accepted as complete Print name;� l©f � 7) Date: , i p j —t ! 1 �.( • Fee methodology set by TO -County Building ng Industry Servn a Hoard ++ 1� ∎.,o .. ,...au..,,,t ,'.MPr .PmnitAmf.doc 10/01/09 440 - 4617T (I 1 /02/COM/WEB) Jul 14 10 04:17p Columbia Heating /Cooling 503 -598 -0270 p.3 69 , t F / /, HEATING & COOLING, INC. P.O. BOX 230397 • TIGARD, OR 97281 (503)624 -2704 SITE PLAN i 1 i if 3 I .AD RESS r 59 CARA2-&-/-45-0