Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00399
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/09/2010
T[ G A R L? 9 Parcel: 2S 111 CA05500
Jurisdiction: Tigard
Site address: 9450 SW LAKESIDE DR
Subdivision: Lot: 0
Project: Meek
Project Description: Replacing existing A/C.
Owner: FEES
MEEK, JANICE F & ANN J Description Date Amount
9450 LAKESIDE DR
TIGARD, OR 97224 Air Conditioning 08/09/2010 $46.75
12% State Surcharge - Mechanical 08/09/2010 $10.80
PHONE: 503 - 352 -5241 Minimum Fee Adjustment - Mechanical 08/09/2010 $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:
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.
Aug 06 10 03:14p Columbia Heating /Cooling 503 - 598 -0270 p.2
\;\ .
Mechanical Permit Application 9 :1- of t) i. i.i1 1 1 si O)I. ,
City of Tigard Received Date/By: al
. • 13125 SW Halt Blvd., Tigard, OR 97223 "' 6 Pl Rev
Phone: 503.639.4 (71 Fax: 503.598.1960 ! Di t ejt t Other Pcrn it:
l
Inspection Line 503.639.4175 ti re
t - MUD Internet: vvww.tigard- or.gov `J� ' 1 Nodified/M had: r S ppkmentatinformation
r-S ..,‘&.:, . •
TYPE F WORK • _` ,, COMMERCIAL. FEE* .SCHEDULE - USE CHECKLIST
❑ New construction ddition/alteration/replace Mechanicel 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.
CATEGORY or..CONSTalICTION.. ...... : :. . ,. . ...
Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
! 12' - and 2- family dwelling ❑ Commercial/ ❑ Accessory building .
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFO TIO A LOCATION . .. . : Heating,/cooling
Job site address: (� Air con ditioning
1 ��. // ��� "`-- ��' (requires site plan showing placement) I 1 46.7:
City /State /ZIP: " — I - 7 (.,,,/.3/(2. - Furnace 100,000 BTU (ducts/vents) 46.75 Suite/bldglapt. no.: Project name: ,c..... / r 0 �
Heat 100,000+ BTU (ducts/.ents) 54.91
I_A . Hea[ pump 61.36
Cross street/directions to job site: Duct work 23.32 _
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit healers (fuel -type, not electric),
•
in -wall, in -dud, suspended, etc. 46.75 '
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other. 23.32
• fax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 23.32
/ap.e.,01--<e. Gas fireplace 33.39
_ a o S / / AI 6 / &_ _ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fueplacelinsert 23.32
,PR PERTY OWNER• �] Ot v/linerlftue/vent 23.32
other
Name: Le-e� / L ` I 1 f .r t /1/ T i O Environmental exhaust and ventilation
4 Range hood/other kitchen 23.32 1 I
Addres . ' _ ' J P_ a! ± 't equipment 3:.39
City/State/ZIP: e t I Clothes dryer exhaust 33.39
I to• ingti• l ' Single-duct exhaust (bathrooms,
Ph, • 'j) -524. } Fax: ( ) toilet compartments, utility rooms) , 23,32
1:1 APPLICANT [[ { . [] CONTACT PERSON Alt c/crawlspace fans 23 32
Other. 23.32 • •
Business name: Fuel tin
PP R
Contact name: /n r /-f' I , ,„ /7' eto(in-in S14.15 for first four; $4.03 for each additional
Fumace, etc.
Address:
Gas heat pump
City; StateiZIP: Q a g WalVsuspended/unit heater i
Phone: 6}3) (nay - (nay - Q702.4 Fax::'�3 5- ! -O�70 Wa r h 1
E-mail: Ran
• CONTRACTOR..> Barbecue
Business name. Cpu j rn jP J-y �' 1 � Clothes dryer (has j
other: L
Addre ,, 3 3 9 7 • MECRANICAL PERMIT FEES*
• Ci yfStatetZ1P: / ' O � 7� g J Subtotal
I ' + Q Minimum permit fcc (S90.00) • 4 0. ( p
Phone: ( ) r _ �7 1 ' 1 8 _ ��� Plan review (25% cf permit fee) 1
CCI3 lie.: 71 da 9 State surcharge (12% cf permit fee) f V
fI TOTAL PERMIT FEE I
j This permit application expires if a permit is not obtained within 180
Authorized sigttatu days after it bas been accepted as complete.
Print name: Da te: • Fee methodology set by Tri - County Building Industry Service Bond
1' Builain41PermitAMEC- PerraitApt.doc 10101109 440.46lrr(11i 02!COM.'WE13)
Aug 06 10 03:43p Columbia Heating /Cooling 503 - 598 -0270 p.1
_ , /
Cr. .. `,
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
COQ
0 �
L
61 l cE) %-L.) it\12.)
ADDRESS: