Permit CITY OF TIGARD MECHANICAL PERMIT
il
1 o COMMUNITY DEVELOPMENT Permit #: MEC2010 -00444
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/07/2010
Parcel: 1 S 133AD04200
Jurisdiction: Tigard
Site address: 10860 SW SUMMER LAKE DR
Subdivision: Lot: 0
Project: Bogle
Project Description: Furnace replacement.
Owner: FEES
BOGLE, JOHN J AND JUDITH L Description Date Amount
10860 SW SUMMER LAKE Furnaces < 100K BTU 09/07/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/07/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 09/07/2010 $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: ` Cl Permittee Signature:
If if ``` ,'
CaII 50 . 39.4175 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.
Sep 0710 08:37a Columbia Heating /Cooling 503 - 598 -0270 p.1
Mechanical Permit Annlica
tRECEIVED ioi 0,:, l('I: t. l: (1N1.1'
City of Tigard " ed if 7 � � Permit xa.
!L "' 13125 SW Hall Blvd, Tigard, OR 97223 E P 0 7 2 010 (T7' : M1 t-�vt� – 4010144 �+
�1 P lat Review
Phone: 503.639.4171 Fax 503.598.19 0 Dacr/By. Other Permit:
1 C. t t: D Inspection Line: 503.639.4175
Internet vrww.tigard-or.gov CILD1NG DIVISION Not Date ifie&t? Ready/By: cdtod: � !. l ®See Page 2 for
Su pplemental Information
BUILDING DIVISION / ( J� 111 •
l .. •.TYYPE'OF WORK ' . ' .. COMMERCJAL *_ SCHEDUI E USE CHECKLIST
l ❑ Ne w cons truction [:1' Addition /alteraiion/replacement Mechanical permit fees• are based on the value of the work
i performed. Indicate the value (rounded to the nearest dollar) of all
' ❑ Demoiition 0 Other. mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION- • .. Value: $ •
RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 1
�- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special injermorion use checklist.
0 Multi- family ❑ Master builder ❑ Other. Description I Qty. I Ea, I Total 1
JOB SFIE INFORMATION•AND LOCATION H Air Heating/cooling
LAKE:. conditioning • •
Job site address: /C., / ` p S� ..SQ,'1» e LAKE o z Air (reauires site Dian showine placement) 46.75
City /State/21P: T J CA I4 0E 9..72 3 Furnace 100,000 BTU (ducts/vents) x, 46.75
Furnace 100,000+ BTU (duos/vents) 54.91
Suite /bldg./ apt. no.: Project name: �1 U G,L E Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system , 23.32
Residential boiler (radiator or
hydronic) , 23.32
i • Unit heaters (fuel -type, not electric),
i in -wall. in -duct, suspended, etc. 46.75
' Flue/vent for any of above 23.32
Subdivision: • Lot no.: Other: 23.32 •
Tax map /parcel no.: , Other fuel appliances _
DESCRIPTION OF WORK .. • .. - • Water heater 23.32 •
Gas fireplace 33.39
l U�Z N'�C6 C/-44/‘) 6 E – U c1 Flue vent for water heater or gas
fireplace 23.32
Log tighter (gas) 23.32
Wood/pellet stove , 33.39
Wood fireplace/insert 23.32
Chimney /liner /flue/vent 23.32
2ROPERTY OWNER • .. 1 • ❑ TENANT Other: i 23.32
Name: T rl /TOG LC Environmental exhaust and sendlation I
'fir r2- Range hood/other kitchen
Address: i G b6 0 �i;, ...3-1,„,,„, i.,A K E D . equipment , 33.39
City /State /Z1P: T iGA OR Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (� b ) 3 , ,„ Fax: ( ) toilet compartments, utility rooms) 23.32
• ❑ APPLICANT ': ❑ CQNTACT PERSON .
Attic/crawlspace fans 23.32
Other. _ 23.32
Business name: Fuel piping
Contact name: / / /0 Y / /7 _n r}) PP�6rn 514.15 for first four; 54.03 for each additional
`� l e Furnace, etc.
Address: Gas heat pump '
City/State/ZIP: Wall/suspended/unit heater 1
Phone: a 3) (pQL, a70 LI. Fax :. 6 5518 - 0D.70 Water heater 1
Fireplace ,
E -mail: Range •
/�
CONTRACTOR l/, `t- ) 6 . r .,
Barbecue
•
_ t ,7}� f l l� AST Clothes dryer (gas) .
Business name: Q e t h er:
Address: J 1 k 33 C) 7 MECHANICAL PERMIT FEES' • _
C ity /StateiZIP: "�7r kf) c l7ci?, Subtotal
Minimum permit foe ($90.00) efe.. vd
Phone: 603 ) r,. ti -Q- ` Fax: • 4 5` j -O__ Plan review (25 °.6of permit fee)
CCB tic.: 7(0 La9 State surcharge (12% of permit fee) iv", rte
TOTAL PERMIT FEE O( )
Authorized SI
/ . ii / This permit application expires if s permit is not obtained within 180
8tW ' '� J days after it has been accepted as complete.
Print same —(t,Aa 677) 1 Date: -'6:— 1 • Fee methodology set by Tri- County Building Industry Service 3. a d
..: v.. a, I:... ..- .,..w. , MC r_o.....;.. ... A.v 1 nmamo 440-4617r ‘ I Ii32/CONLVEB)