Permit T it ;, f ai' : CITY OF TIGARD MECHANICAL PERMIT
a
` COMMUNITY DEVELOPMENT Permit #: MEC2010 -00332
T t G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/14/2010
Parcel: 2S111 CCO3000
Jurisdiction: Tigard
Site address: 10330 SW CENTURY OAK DR
Subdivision: SUMMERFIELD NO. 1 Lot: 53
Project: Phipps
Project Description: Replacing existing A/C and furnace.
Owner: FEES
PHIPPS, FRANK E & WANDA L FAM TR Description Date Amount
BY PHIPPS, FRANK E/WANDA L TRS, 10330
SW CENTURY OAKS DR Air Conditioning 07/14/2010 $46.75
Furnaces < 100K BTU 07/14/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 07/14/2010 $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.: r .. - .
■
Issued By: Permittee Signature:
Ca 1 503.639.4175 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 12 10 04:42p Columbia Heating /Cooling 503 - 598 -0270 p.2
Mechanical Permit Appli r`�i � �' - 1 c)l °l F lc I i S I 13 )1.1 , ,
Ci ty of Tigard � � t G�� 7 •
..: ; , Pefrnil No.:
m 13125 SW Hall Blvd., Tigard, OR 97241311 3 't �O plan Review L GSA •
' Phone: 503.639A171 171 Fax: 503.598`l9b'L+ Other Permit:
Date/By:
TIG7IRD Inspection Line. 503.639.4175 _ _,, , Date Notified/Met y: r ® See Page 2 for
•. r +� ,. r.' Interne); tvuw.ti�+azd- or.gov CITY i �" ii�l?'tfSU Notificd/Methed: ( Suppkmental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USECHECKLLST
❑ New construction Addition /altcration/replacement Mechanical permit fees* are based on the value of the work
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*
g 1- and 2-family dwelling ❑ Commcrcialiindustrial ❑ Accessory building
For special information use checklist.
❑ m ti.ti - fancily ❑ Master builder ❑ Other: Description Qty. Ea. 'Total
JOB SITE INFORMATION AND LOCATION Heating/cooling _
Air conditioning • oh site address: /0 33D 1 5;- r ,,,. / ,,,...., t ' (requires site plan showine placement) 1 i 46.7' i
i
CitylStateiZlP: 1 i S crx ^ (l 0 it 5; 7 2,LA7, Furnace 100,000 BTU (duets/vents) ' 1 46. 75
Furnace 100,000 - + BTII (duetUVCn:<) 54.91
I Suite/bldg./apt. no: Project name: Ph 1 pp$ Heat pump 61.06
Cross succtldirections to job site: / Duct work 23.32
i Hydronic hot water system 23.32
I Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 46.75 i
' Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
J Gas fireplace 33.39
aim. 4 ' v , % _ 1 t ' _ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23 32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /fluelvent 23.32
Other: 23.32 I
\ amc: • r' Environmental exhaust and ventilation
t-:-/..a,„)‹ � }J / l �l J Range hood/other kitchen
Address: /033D S7 J C - 1 a e equipment 33.39
CitylStatc' /_1P: "7 4 u J , Q �ZZy Clothes dryer e exhaust , 33.39 I
Q Single-dduct exhaust (bathrooms,
Phor.c: ( s33 ) �� �z5 0 Fax: ( ) toilet compartments, utility rooms) 23.32 ,`: 1
—
�
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32: .
Other: 23.32 1
Business name:
Faei piping
Contact name: /)---)a Y k et30 7'7 eer 'S14.15 for first four; 54.03 for each additional
dd ress: � / Furnace, etc
A
Gas heat pump
Ci: 1Sta: :c /LIP: Walt /suspended/unit heater
; Phone: f 3) 06/214. a7n L7/ Fax: : 5 � 8 _ Water heate
eF' Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name: > , l� _; )6- Cl othes dr (ras)
Other:
. m �" 1 tiJtJ"T �(
liv 4ddress: MECHANICAL PERMIT FEES*
Cit /Slate /7.1P: _ 0 �7 , Subtotal
7� 3 V-96 _ O J� /a Minimum permit fcc r q `
Phone: '663 - ) a �; Fax: L Plan review (23 of permit i! f fee)
C.CR I :u. r76 3 ,Q State surcharge (L2% of permit fee) L
J TOTAL PERMIT FEE 1y 72
llulhori7,Cd s: nature �i�f p rhis permit expires if a mit is obtal ed within 180
• g days application after it has been acce as no c omplete.
Print name J7 �g7 Date: ^ ��� yh � Fcc methodology set by Tri- County 3uildicg Industry Service Board
1 el PermOApp.doe 0/01!0`) 443 -46I7T (1 IiON.COM.'WF..B;
CV . It 6 1/c/( A'.-47..
Jul 12 10 04:42p Columbia Heating/Cooling 503-598-0270 p.3
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JUL 1 3 2010 t
CITY OF TiGARD
i BUILDING. DIVISION
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