Permit p CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2010 -00392
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2010
TIGARD ' 9 Parcel: 2S111CC20700
Jurisdiction: Tigard
Site address: 15650 SW GREENLEAF CT
Subdivision: Lot: 0
Project: Krouse
Project Description: Replacing existing A/C.
Owner: FEES
KROUSE, TIM Description Date Amount
15650 SW GREENLEAF CT
TIGARD, OR 97224 Air Conditioning 08/05/2010 $46.75
12% State Surcharge - Mechanical 08/05/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 08/05/2010 $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: Permittee Signature: • . i
1 II
Cal 03.639.4175 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.
Aug 03 10 01:00p Columbia Heating/Cooling 503-598-0270 p.1
..- .-
Mechanical Permit App1icati�
..,. .r,1-.: - 0 1 OH 01 Flt '1: I SI. ON1.1
city of Tigard t '. Received
(.... 6 1 ' L P
DakiBY: T j/tr) rip- ermit Ne.:
i iii .....„ 13 I25 SW Ilan Blvd., 'figard, OR 97223 Plan Review
: I Phone: 503.639.4171 Fax: 503.598,1960 1\\-\ . 'k Datc/B • Other Pernit
Inspection Line: 503.639.4175 - c' '' - : ''''' ° ' Date R /B kris: r 0 See Page 2 for
(ICl/UM ^ i - '1 • ' . , earlY Y'-
Internet: www.tigard-or. gov ,*' ,
1 ',, ' ' r" `-- :NJ' Notified/Method: Suppleme ni
ntalinrorarion
'i.._, t k 00C V
:4■11■":10111 ,. , . .
1 ..=.::,AF ::....got*.pow60.4,;:),:i..km:..;;,,:i..:::.q-:4:6::', US
Mechanieal pemtit fees. are based on the
0 New construction Addition/alteration/replacement value of the work
performed. Indicate the value (rounded to the nearest dollar; of all
0 Demolition 0 Other. mechanical materials, equipment, labor, overhead, and profit.
Value: $
- . - ' • -- ., . . ,•••• civrgpoRyr ;....• ; . • .. .. - . . .: .. .
' 1 - find 2-family dwelling 0 Commercial/industrial E Accessory building
l .': 1 ::. ' #0.0?)0- 1 4.400ER. iili4 FEES
E
i *
For special informatfon we checklisr.
0 Multi-family 0 Master builder D Other: Descripton 1 Qty. Ea. 1 'rota; 1
'. • JOB SITE • INFORMATION , AND LOCATION ,•....'. • .' ..,- '..- .::.:..;:. • Heating/cooling
i ..---- Air conditioning
Job site address: /)ff 51) Gga.", c cr-. :requires site plat sbowing placement) / N. 46.75
City/S:ate/Z: P: 7-7 az 9 2,,Ili Furnace 100,000 BTU (ducts:vents) 46.75 .
. . 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
Hydranic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. cu... 46.75
' Fluchent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map/parcel no.: Other fuel appliances
- '..- - ' .. • • ' . ..... Dt.ScliXr.tle$:::0r;,1*00W"*.j.41`!„;;;;.0i.''..1(0,4,S,..,ii,,O? Water heater I 23.32 „
' • Gas fireplace 1 33 39 , ...
A/c. gek-ACEAFAJF , Flu: vent for water heater or gas ,•
fireplace , 21.32
1
Log lighter (gas) . 23.3?
Wood/pellet stove . [ 33.39
Wood limplacclinser. 23.32
Chimney/liner/flue/vent , 23.32
421 OWNER. • :1 ,...:. 1' ,'...-.:.....: .
;. .. ....- 0 TENANT'. •I'• : ,..'..'.. 23
•
Other .32 --;
Name: Ti Al Kg 0 U Se. Environmental exhaust and ventilation
Range hood/other kitchen .
Address: /5 ... s,_) (5,06 Cr. , equipment 33.39 i '
City/State/Z1P: 7 --,,,,, d oz._ ql q • Clothes dryer exhaust 33 39 --I
Single-duct exhaust (bathrooms.
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 _
0..APPLIcA11ti.'.''-.;:::*....410.414143-0040.4*-***1415?4 - Ar-icicraviisPa" fan3 1 • 23.32 ■
Other: 23.32
Business name: • Fuel piping
Contact name: Tr) a r /..ey)(1 .._/7)e(ool577') . I
.. S for first four; 34.03 (or each addicional
Fwmucc,
Address:
Gas heat pump ,
City/StateJZIP: Wallisuspended/unit heater
Phone: 503; 0 g4. Q- 4. Fax: 663 Ei3 a -OD-70 Water heater
- Fireplace .
E-ftlai I: Range
.. . .
CONr.4 s.? . • .-- •: -,..,-:,- H.:: Barbecue
,. .
. . . ..
Clothes drier (gas)
Business name: 0 , 4 urn j a i 1) ___i_4,rr+ i . 1 & crok ...t
Addressy V 23?3 3 • 7 .:-..,,-.-: ,4411,1311CAL rERIVIIT •
C:ty/StateiZIP: 7 0.0 T7(-Y? / Subtotal I
Minimum permit fcc ($90.00) 1
Phone: 3 ) tc, 6 4 . ..._Q_ 8 Fax: 0 (. 5 • ir. _ /1 • .--i
__ Plan review (25% of permit fee) I
CCB lit .: 712L5-9 State surcharge (12% cf permit fee) 1 1 . cr-0
-- TOTAL PERMIT FEE WO. 4c
Authorized signatuaigill This permit application expires if a permit is not obtained 1 t30
days after it has been accepted as complete.
, ?riot name:frni-•(tyldi ../7 - 6 - 7)-) Date: ../..z., ,,,7 ` Fee methodology set by Tri-Coinry Build; iN Industry Srn icc 3Gan.:
1A13uildini0ermits \MEC. -Penilit App.doc 10/01/09 440-4617T (I 1)0VCOMAVEZ)