Permit CITY OF TIGARD MECHANICAL PERMIT
1c. COMMUNITY DEVELOPMENT Permit #: MEC2010 -00359
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/23/2010
T1G'ARD Parcel: 2S111AD15100
Jurisdiction: Tigard
Site address: 14814 SW 91ST AVE
Subdivision: MALLARD LAKES Lot: 17
Project: Garcia
Project Description: Replace existing furnace and A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
GARCIA, OCTAVIO & CATHRYN M Description Date Amount
14814 SW 91ST AVE
PORTLAND, OR 97224 Air Conditioning 07/23/2010 $46.75
Furnaces < 100K BTU 07/23/2010 $46.75
PHONE: 503 - 684 -8219 12% State Surcharge - Mechanical 07/23/2010 $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: Permittee Signature: Q /97 / G, / Cg j / cm,"
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 21 10 02:54p Columbia Heating /Cooling 503- 598 -0270 p.2 • Mechanical Permit Application g�, � l; 1 O1 1 I 1 ' 1 ( � , .
C� ,
City of Tigard � �/ � R eceived .
{� g PermitNo.' •
` DelelBy / /v dirt-- i ,io 'DoJ
i llg • 13125 SW Hall Blvd., Tigard OR 9722? Plait Revie
, ..2.I. ••; ®•, Phone: 503.630.4171 Far: 503.598.1960 JUL 21 2010 Dnr&By: Other Permit. .
T
l C A. t p Inspection Line: 503.639.4175 Dale l d mri.. 1;6 Sec,Pabe 2 for
a + i. l ntemet: www.tigard- cr.gov CITY OF TIGARD Notified/Method: -�!(- Sneeleteentat information
RI III DING DIVISION •
. TYPE. OE WORK ..: tC0 1' ygE',SC IEDULE - USE CHECKLIST
[] New construction ti Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: S
CATEGORY OF CONSTRUCTION '.. >: .
I RESIDENTIAL EQUIPMENT. / SYSTEMS FEES*
l and 2- family dwelling ❑ Commercial!industrial ❑ Accessory building For special information use checklist.
❑ Multi - family C Master builder 0 Other: Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND. LOCATION Headng/cooliug
Job site address:. r . \ i s+. Air n site plan showir� placement)
1 t�3 ,( Air ir conditioning ( ' •
• 46.75
City /State/ZIP: 7 j cit. Furnace 100,000 BTU (ducts/vents) C 46.75
/-1 Furnace 100,000+ BTU (duc�Jvents) . 54.91 •
Suite./bldg./apt. no.: V Project name: 0 t " Heat pump 61.06
Cross street/directions to job site: Ductwork ! 23.32
'; Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit beaters (fuel -type, not electric),
in -wales in -duct, suspended, etc. 46.75
Flue:vent for any of above 23.32
Subdivision: Lotno.: 2 32
Other. •
Tax map /parcel no.: , Other fuel appliances
DESCRIPTION OF WORK Warm heater 23.32
Gas fireplace 33,39 1
' Q/y 5T't4rp ` ^.) R.hl,6•_.,G ,4( (. Flue vent for water heater or gas
� j I fireplace 23.32
' Log lighter (gas) 23.22 '
Woodpellet stove _ 33.39
Wood fireplace/insert 23.32 •
Chimney /liner /fiue/vent _ 23.32
PROPERTY OWNER ' D. TENANT Other: 23.32 •
Nam: 1 / Environmental exhaust and ventilation
! e Range hood /other kitchen 1
Address: /4 �� r gist equipment , 33.39
City /State /ZIP: Clothes dryer exhaust _ 33.
Single -duct exhaust (bathrooms.
Phone:6A 6 sa,,1i Fax: ( ) toilet compartments, utility rooms) t 23.32
❑ APPLICANT. D CONTACT PERSON <"
Attic/erawlspace fans 23.32
^
Other: 23.32
Business name: ,
Fuel piping
i / ^ i
Contact name: m ! "2t� /7') e'C/ S14.15 for first four; $4.03 for each additional
Furnace, etc 1
Address: Gas heat pump '
Ci tylStateiZIP: Wall/suspended/unit heater
� . a70 4 Fax 3 5q 8 - 0;70 Water heater
Phone l, 3 ) /
W Fireplace
E -mail: Range -
CONTRACTOR Barbecue
. Clothes dryer (gas)
Business name: i t� i asr ,,zI i � , 0.i_ Other:
Address: k c.. • . • MECUAIVICAL PERMIT FEES*
City /State/ZlP: 77 Q ` 7 . ' / Subtotal I r13 .50
1 ` q Oval. Minimutm permit fee ($90.00) �
One: ) & - � _ 9 Tax: Q J F3 - D Plan review (25% of permit fee) _
C CI3 lit.: (76) q State surcharge (12% of permit fee) �/ r� 2_
1 TOTAL PERMIT FEE 19', 7-
This permit application expires if a permit is not obtained within 18U
Authorized sigtatur 1 ` days after it has been accepted as complete.
Print name f- 0/76 �� (Tf'�
Date: i '1-- /() • Fee [methodology set byTn -County Building Industry Service;3ca
. a.. :ie,,...:n...f ;.d.nwr- Drnni•A hoc 10/DI/09 440 -9617T (11/C21CCMAWEB)
Jul 21 10 02:55p Columbia Heating /Cooling 503- 598 -0270 p.3
o r,
., # _,
,,,,': ,,, , .. 4/ 11 RECEIVED
HEATING & COOLING, INC. .10L 2 1 7-M5
P.O. BOX 230397 • TIGARD. OR 97281
(503)624 -270a OF TIGRD
CITY NISI ®N
BUILDING D
SITE PLAN
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ADDRESS: 1"21 4- 11 rLi>