Permit " CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00521
Date Issued: 10/22/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102CA00210
Jurisdiction: Tigard
Site address: 13235 SW ASH DR
Subdivision: VIEWCREST TERRACE Lot: 8
Project: Packer
Project Description: Replace heat pump system. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
PACKER, PAUL Description Date Amount
13235 SW ASH DR Heat Pump 10/22/2010 $61.06
TIGARD, OR 97223 Other, Heating /Cooling 10/22/2010 $23.32
PHONE: 503 - 806 - 8668 12% State Surcharge - Mechanical 10/22/2010 $10.80
Minimum Fee Adjustment - Mechanical 10/22/2010 $5.62
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: / (C791 1-fe___ Permittee Signature: o 0 /o�L' /7 - 770 /J
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.
Oct 21 10 10:35a Columbia Heating/Cooling 503-598-0270 p.2
Mechanical Permit ApplagIVED .. ...,
1.1)„ ()Iu( .1. i s II ttNl.1
City of Tigard
1 7010 Received ii) pi A / o „ :954 1
Datehly: -/ Permit No/LW o w /0 .... 0 a 5
• 1112s sw Hall Blvd., Tigard, OR 99S3 2 - -
"I ' Phone: 503.639.4171 F. $03.598.1960
NI Plan Review
Date.12.y: Other Permit i
lnspee:icn Line: 503.639.4175 CITY OF TIGARD 1
1 IC,AF.D Date Ready,I3y: Ir 1 :1 See Page 2 fur
Internet: VAVW.ligard-or.gov
BUILDING DIVISION Notified/Method: pplementak Information
..t, s. :`. i'.7'!:,.",,:-!:.%:";:;'''''''::::.1,-...V::... '; .: . POititiiiis0 7''. iiiaktik USE CHECKLIST
Mechanical permit foes* arc based on the value of the work
CI New construction El Additionieherationireplacemcnt performed. Indicate the value (rounded to the nearest dollar) or all
0 Demolition 0 Other: mechanical materials, equ:pment, labor, overhead, undroli:.
_
- .. - • ..'' . .• • ::: CAtEPQR16' , . ,. ‘ • Value :5
..**ti05.0.1"..*..V$9137,r41.447r;IW6TEMS FEES*
0 I- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special Information use cheekhsr.
0 Multi-family 0 Master builder 0 Other: 1 Qty. ' Ea ' Tutal
i . .
. - 40B:SITE'INFORMATIONAia.LOCA.Ii0.N.',..-;::'...;-,::.:,..:.. ;::',::::,* D H es er I ti ri ng/ Pti° coo n ling
Air conditioning
Job site address: /32 3 _r/.434. /).,- _ (requires site plan showing p)acernent) 1 46 75
City/StateiZ1P:
' - 7 - 11-4.,-,/ 4 "-- 9? 2-e-L3 Furnace 100,000 BTU tducts/vents) 46.75
r Furnace 100,000+ BTU (ducts'vents) 54.91
Suite/bldg./apt. no.: I Project name: Heat pump 1 1 61.06 1 .
Cross svectidirections to job s .te* Ductwork 23.32
' Hydronic hot water system l 23.32
•
. ,
Residential boiler (radiator or •
hydronic) 2 3.1 2
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.
. _ .
' Flue/vent for anv of above 23.32
Subdivision: ' Lot no.:
Other ritl) Co ': %-- 1 1 23.32
Tax map/parcel no.: Other fuel appliances
• ' : ''.' .. - . . • . • ' 0*•SPigrAIQN.: Wale heater 23.32
/ Gas fireplace 33 39
- / ._.....-..4...• . .,Z.,.....t.,,,-'... Flue vent for water heater or gas
fireplace 23.32 1
i
Log lighter (gas) 1 23.32
Wood/pellet stove 33.39 '
■
. Wood fireplaceinsen 1 , 23 32
' • . aPROPERTY OWNER .: . ...._:•::: .. ....,.........i.. Chimney/liner/flue/vent 23.32.
Other: I
NE-me: - p c , u ( i c k Environmental exhaust and ventilation •
Address. / 34 3. ft... ,„ h. /2., Range th
hood/oer kitchen
equipment 3 3 .39
City/State/ZIP: 4 Clothes dryer exhaust _ 3".: 39 '
1 4 .. d / 5, 2 - 2. - 3 Single-duct exhaust (bathrooms, i
Phone: ( ) ) Se)6 -gt ,F' I Fax: ( ) toilet comparunenls, unlity rooms) 1 . 23 32 I
—4 .
•••::::....', . . 0 APPLICAN1:-...:,:.. Atli dcrawlsPar fans , 1 3.22 1
Other I 23 32 I .
Business name: .
Fuel piping
Contact name: irk] /,- / j,7 A / / 1 ry--) ee d S14.15 for first tour; S4.03 for each additional
C
Furnace, etc. 1
Address:
Gas heat pump
City/StateiZILP: Walt/suspended/unit heater
1 i —
Phone: i 6 , Q i.."„ c; 7 4 Fax: :60 55/8 _nD.70 Water heater
Fireplace
E-mail: Rang , r
coNT4c10*,.;' :: .:::•'.,:::::::.::::.......:y.:,..., Barbecue I: .
• .
Clothes dryer (gas)
Business name: (...,( lin jaif944r_r+-71106...„i_e_noLdi,. )6_,
Address: cit
t r2.: 7„,, n ,... : . ci 7 , ••;:f•-).:;'•:,,..:...F.:,‘.1,gcrptilICALTERltilr FEES* i
;
i
City/StalLatri 716 0 i Mi i f Subtotal I
O . Phone:613 ) & :_a_ (") Fax: Li) L 59p ) ._ 0.70 nmum permit ee (S90.00; cM , rd
Plan review (25% of permit fee,
1 I CCH lic.: 70) 359 of 2--/i z- State surcharge (12% of permit fee)
TOTAL PERMIT FEE /0,0.1.1 ..,/
Authorized signatur,,,y This permit application elpires if a permit 13 no: obtained within 180
days after it has beta accepted as complete.
. ,
I Print nameirCi---(iii-Ki (57) Date: 14.Wije • Fee methodology set by In-County Bt. ;Jai ng Induvy Service B oaf d
1:113uildinaermitsWBC-PernitArip dot I WO ItC6 440 (I /C2ICOWWEB),
Oct 21 10 10:36a Columbia Heating /Cooling 503 - 598 -0270 p.3
ar aznz a z
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
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ADDRESS: /3z35- sWmd-pr-