Permit µ ' l
CITY OF TIGARD
MECHANICAL PERMIT
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$ COMMUNITY DEVELOPMENT Permit #: MEC2010 -00386
Date Issued: 08/03/2010
T tGA RI? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
qr z- Parcel: 2S103DB08800
Jurisdiction: Tigard
Site address: 11225 SW MORGEN CT
Subdivision: GENESIS NO. 3 Lot: 87
Project: BREWIN
Project Description: Heat pump replacement.
Owner: FEES
BREWIN, SHARON F & MICHAEL K Description Date Amount
11225 SW MORGEN CT
TIGARD, OR 97223 Heat Pump 08/03/2010 $61.06
12% State Surcharge - Mechanical 08/03/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 08/03/2010 $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: .. 'ermittee Signature �
Call 503.6 -. 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 3010 03:50p Columbia Heating /Cooling 503- 598 -0270 p.2
Mechanical Permit Application ' , t'i W I l OR (_ I(1 � �F O\ I \ •
>% t / il Received Prcmil N u..
111 City of Tigard - . .:Datc/By.. i 3() iJ /3 77 - / (0 -0 03
• 1 3125 SW Hall Blvd., Tigard, OR 97223 JUL 3 0 ?Ian Review
Phone: 503.639.4171 lax: 503.598.1960 ZOO DateiB otne Perm it.
rIGAI`S7 lnspection 503.639.4175 ` Date Ready/By: Juts. H See Page 2for
• .
Internet: w w.tigard- or.gov C� 1 OF 7 tCiWR• 1 Nouficd/Method: T(4 Supplemental Information
BUUU imp, rillleler '
F WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees` arc based an the value of the work
1 0 New' constriction ddition/altcration/replacement performed. Indicate the value (rount ed to the nearest dollar) of all
i ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit. _
CATEGORY OF CONSTRUCTION value: R
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
I - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ` For special inJormoricn use checklist.
Q Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. ( Total
JOB SITE INFORMATION AND LOCATION ! Heating/cooling
A, Air conditioning •
Job s address: / Z z j �(,c.i m ma/pm •s r • (requires site plan showing placement) 46.75
City /State/Z.1P: . 1jc, G /e ,. dt- 9 2, ? C_ Fumacc 100,000 BTU (d cts/vcntsl 46.75 •
Furnace 100,000+ BTU r,ductJverus) 54.91 •
•
Suitelbldg. /apt. no.: Project name: rei A/ I Heat pump ( 1 FLOE
Cross sireetldirections to job site: D uct work 33.32 l
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 46.75
Flue/venifor any of above 23.32 _ i
Subdivision: Lot no.: Other. 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK - Water heater 23.32
Gas fireplace 33.39
1` — _al ` .. , l� - G.r• w Flue vent for water heater or gas
fireplace 23.32
Leg lighter (gas) 23.32
Wood/pellet stove 33.39 1
Wood fireplace/insert 23.32
Ch
imncy/liner /flua'vcnt 23.32
'PROPERTY OWNER ❑ TES Other. . 2 3. 32 1 i
i Name: 141 �n 1„,:v.\._ Environmental exhaust and ventilation
i Range hood /other kitchen
Address: 1 t 2,-LA- c-6., v..--i Gf 1 if k -r r- equipment 33.39
City/State/ZIP: ( e •1 Clothes dryer exhaust 33.39
�( - �� O vL 7 7 . Z / Single -duct exhaust (bathrooms.
Phone: (� 5 � - J F ax: ( ) toilet compartments. utility rooms) 23.3
S � - 1
❑ 4PpT1� 0 CONTACT PERSON Attic /craw'Ispace fans 23.32
Other: • 23.32
Business name: � Fuel piping
Contact name: /)'20 Q p. ).ee f / (�m 514.15 for first four; S4.03 for each additional i
/ , , Furnace, etc. 1 I
, Address: : 1
Gas heat pump f j
1 (:ite :State /ZIP: Wall/suspended/unitheater i
( c 7 7 C Water heater
Phone: 3) 1,C. 0 F ax:: , 5 q� 0 a Fireplace
E-mail: Range 1 G
CONTRACTOR Barbecue ,
Clothes dryer (gas)
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Business name: l l fn/A (C � /� O ther:
Address: ` k , 2.....a , 33±7 MECHANICAL PERMIT FEES*
City /State/ZIP: `716.4,0 1t Q D' Subtotal 1
� Q l P) O7 Minimum permit fee (590.001 1 et 0 0
Phone: ` .� t
) /0� rl cO_7 �u-CJ
Fax: C ' � Plan review (25% of permit fee)
CCBlie.: �7/^ State sufcharge (1 2% ofpennit fee) (U, 1rd
/ 1 Q TOTAL PERMIT FF.E , NO, A
''//�� This permit app expires if a permit is n obtained within 180
Authorized sigaatur / j r r days after it has been accepted a complete.
Print namc��Q �( { Date: / �n ee methodology set by Tri- County' B�itdin5 IM retry Service Board
I:'ale,ildinq.Pertnic fE:- Perm :App.doc 10 �� / 440 -4617r r, I I/02 /CO'WWER)
Jul 3010 03:51 p 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
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