Permit "�la C ITY OF TIGARD MECHANICAL PERMIT
` ' � ; COMMUNITY DEVELOPMENT Permit #: MEC2010 -00374
'' Date Issued: 07/29/2010
T 1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112CA07000
Jurisdiction: Tigard
Site address: 15385 SW 79TH AVE
Subdivision: ASHFORD OAKS Lot: 24
Project: Britton
Project Description: Heat pump installation. Unit must meet minimum 3' rear and side yard setbacks.
Owner: FEES
BRITTON, WILLIAM & LORRAINE Description Date Amount
15385 SW 79TH AVE
TIGARD, OR 97224 Heat Pump 07/29/2010 $61.06
12% State Surcharge - Mechanical 07/29/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 07/29/2010 $28.94
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: Z. - - - Permittee Signature: 8 .e..r.... „ ,
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 26 10 10:07a Columbia Heating /Cooling (Kra 503 598 -0270 p.2
k :
T r i 1 OIZ O I 1 1( t r F: O\ LA Mechanical Permit Apnli�: ,I���
Received ^armit tic.:
s °City of Tigar Date/By: 7A7 I0 677 f '06 - ■ 1p "� C �10
• 13 125 SW Nall Rlvd., Tigard, OR 97R 2 Plan Review Daher Permit:
C Phone SO i 6;4.41 ? 1 Fax: Date/fly:
' lnspcct,on I-ine: 501 639A175 aRD Dale RcadyiF v luris El Fire Page 2 for
TIGAFD' Interne www.,I6drd- or,gov V,1 , Nctificd 1cthvd: or Supplemental Information
Supp
pFTI
.,., �.v,... D1V1 ®� •
BUILDIN -
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST 1
j { Mechanical permit fees` are based on the value of the work
0 New construction Addition/alteration /replacement 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*
6 I - and 2- family dwelline ,] Commercial /industrial ❑ Accessory building Forspec:a! information use checklist
Multi - family ❑!master builder ❑Other: Description 1 Qty. Ea. ' Total .-
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: / 5 3 (g. 5, 9 of /4y(}-{_ (requires site On showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46 -75
Cim%Stater/1P: , DA_ 9-72-2-y Furnace 100.000+ BTU (ducts /vents■ 54.91
Suite.'hidgJ pl no.: 1 Project name: 641710 Heat pump , F 6.06 -(411,0i Duct work j 23.32
Crass street/directions to job site:
Hydronic hot water system 23.
Residential boiler (radiater 01 1
hydronic) 2463:73-5' yl
Unit heaters (fuel -type, not electric).
in -wait suspended, spended, etc. •
Flue/vent for any of above I 23.32
Subdivision: l Lot no " Other: 1 2 3.32
TeX map /parcel no.: Other fuel appliances
Water heater 2132 DESCRIPTION OF WORK • Gas fireplace 33.39
� . ii _ 7_ J`� /�
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert t 23.32 _ •
Chimney/liner/flue/vent , 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23,32
Name : ,L,2) Environmental exhaust and ventilation
l r). f / 1J ! �r�'7 .. i /"'� Range hood/other kitchen
Address: /53ff J-4/ 7 c/4 equipment 33.39
Clothes dryer exhaust 33.39
(.'it }!State,ZIP: )—G,_,✓ l ?ZZ% - Single -duct exhaust (bathrooms,
Fax: ( ) toilet compartments, utility rooms) 32
Plume. t ! 3' tf ' `t537 v.32
CONTACT PERSON Attic:rawispacc fans
❑ APPLICANT Other: 2332
Business name: Fuel piping
i
/ 17 J - /-P & / e& �,f, S14,15 for first four; $4.03 for each additional
Contact name: f //
Furnace, etc.
.Address: Gas heat pump -
City/State/ZIP: Wall/suspended/unit heater 1 I
1 ,r� Water heater
Phone: 31 (pay.. - Q7011 Fax:: J 59 $3 CJ Fireplace -
E -mail: Range
CONTRACTOR Barbecue
. Clothes dryer (gas) I
Business name: a .. 1a jt, .: r�L L : _ Ike, k _ Other: 1 1
Address: - X 1zy,;,3 9 7 MECHANICAL PERMIT FEES*
O r 7c) g i
� Subtotal f
CityiStatGL1P: f minimum ptaTtil fee ($90.00) ek),Q(�
?honer ) r f f ` �r,�L7 n Fax: 1 �9 - o�o Plan review (25% of permit fee
c
State surcharge (12% of permit fee) U, t�
CCR tic.: 76 Syr / TO'T'AL PERMIT FEE ;
� ��� D This permit a pplication cicpiraifapermitisnOtobtaine wtthinl50
Authorized signatui .0 A days after it has been accepted na complete.
/� b I • Fee methodology set hy Tri-County Building lndusry Scrvbcc !loud
Print name: • 1 d - '► / !j/ Date: , i `
n,.: 1.1.. ,.,;n,,,.,In17,41 PermitA+n. form 09 440 - 46177 I/0?JCOMIM'EB)
Jul 28 10 08:28a Columbia Heating/Cooling 503-598-0270 p.1
,
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97261
(503)624-2704
SITE PLAN
7
1 0
-E1 •
- -1
ADDRESS: