Permit n CITY OF TIGARD MECHANICAL PERMIT
• • - COMMUNITY DEVELOPMENT Permit #: MEC2010 -00526
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/26/2010
Parcel: 1S134CA00503
Jurisdiction: Tigard
Site address: 11205 SW 119TH AVE
Subdivision: PANORAMA NO. 2 Lot: 14
Project: Stricker
Project Description: Install air handler and heat pump. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
STRICKER, PAUL Description Date Amount
11205 SW 119TH
TIGARD, OR 97223 Fumaces < 100K BTU 10/26/2010 $46.75
Heat Pump 10/26/2010 $61.06
PHONE: 503 - 516 -1000 12% State Surcharge - Mechanical 10/26/2010 $12.94
Contractor:
COLUMBIA NW HEATING
PO BOX 622
SCAPPOOSE, OR 97056
PHONE: 503 -543 -3624
FAX: (503) 543 -6285
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $120.75
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: Permittee Signature: Q� i 9 - 7 �D L % e.,42--770"/
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
10/22/2010 11:40 5035436285 PAGE 02
Mechanical Permit Application r
�® r> r. O, F= 1 c r I F ()%1
`� Received
City of Tigard Received
Permit No.- O
13125 SW Half Blvd, Tignil, OR 97223 ` � c1 01 / / 1 / /I I F �/ OQJ - Pine ReVieW
' Phase: 503.639.4171 Fax 503.598.1960 0 0 p u Data/By OntQ.Pernoc;
t i ■ : !, i; ;, lnspediatl Lin- 503.639.4195 PR Hate tteady/tip See z Rr
Ldeanct wwvai a r' e0 rtdl �o d
hO tto° r\ � I GQ \ �‘ S \I CQ Seppknrmml larbrmeflw
T YPE :OF WOWS � • . MMIii(tC1iAr� F$F;a t?Di7tf: — rfSE'FF.CKLi57'
Q New won VAddi tionialte18Ih01 tr pl ens Mechanical.
pert fees* are based on the value of the work
performed. indirate the value (rounded to the new dollar) of ail
. o Demolition ❑ Othen medmnie al matmtsia, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION , valaa S
• 2 and 2- family dwelling El commerciandustriai ❑ Accessory ;� RP,sI�DZN [ lent>:t�QIJIPMP.fd'f t 5YS"[' MS'F!!1±S
❑ Molli ttmily [{ Master builder ❑ Other: For speclai information rise checklist • Description J Qty. I FA L Total ,
' JOB TE ORM TION AN LO He�Meoon
D CATION
lob site address: /i :S so) ii 4 zi AO Air conditioning
at e n z 46.75
City /State/ZIP: Z Q . '+� et/v. ,� Furnace 100))00 SfU (delve es) 1 46.75 .. 46, 15
Project e i tm orx+ BTU (d ) • 54.91
- Suitc/MdgJapt reo : Pt /'1 trjcct rwriec: - Heat vamp_ p j 61.06 0.4
Cross stree /din:chaos to job site: Duct work 23.32
Hydronic hat water system 2332
Residential boiler (ra.b asor or
hydronic) 23.32
Unit beaters (fuel -type, not dcetric),
in -wall, m-dn etc. • 46.75
Subdivision: Lot no.:
Flue/sent for any of above 23.32
Other. , , 23.32
Tax map /parcel no.: Other Ibel appliances • SON or won . Water heater , 2332
- rill& i97.4 eAU/Y-.Fie 4 17GATJVIY1P
Flue fireplace =air heater or gm 33
Breplacc • 23.32 ,
Log lighter (gas) 2332
Wood/pellet stove _
Wood fireplace/insert t _ 2332
t P OPERTY OWNER 0 TENANT • Chimw,/fineNDue/vea* _ 2332 •
2332 _
, //rp Other; m
Name: / S7��� / -Cr- l \ Rnvirarerdal exhaust and ve on ,
it
Mdre_ 3: 1�" 5 p(o'�`'I q / J( other kitchen V 3339 '
equipment
City/State/ZIP: 7 i ca 41773 Clothes dryer exbamt , 3339
Singleduct exhaust (bathrooms,
Phone: () 516_ t /�� fJo Floc( ) toilet con ertmaFq ntilityrooma) 23.32
APPLICANT CI CONTACT PERSON . Attieleaawlspacotans _ 23.32
• Other 2332
F)ruincvs name: Sante as Contractor piping
, Feel Contact name: 814,15 tier first fowl $4.03 for each ndditkan l
Pomace, etc.
Gas heat vamp
City /State/ZIP: Wall/stispendedhavit hater
Phone: ( ) I Fax:: ( ) Water heater - .
Fireplace
E -mail: Range .
.. CONTRACTOR • Barbecue _
Business note: Cmn
olbia NW Resting Clothes )
Other.
llddres: PO Box 622 11Thk1HiCA PER114D P Np[+,6*
City/State/ZIP: Seappoose, OR 47656
Subtotal 0.37.-81
Phone: (503) 543-3624 I Fa1c (503)5434735 Minimum permit fix ($90.00)
. ken
di/CC review (25% of permit fee)
lie.: 674M /OM /'L State surcharge (1246 amnia fee) _ fee
1 , TOTAL PERMIT vEF, / j, ?5 ✓
'/ 11'hls pev ak application ire stn pmma b bet obtained *Mtn tan
Authorized signature: it dips after It has boa) as:acted me complete_
f Print name: Get Jacobson I Date: /4). 1 * Pee enthedolegy act by 1}i -Cmmty Sodding Industry Service Roan,
In PmmroVNac-P nctacodee 10/O11/09 140-461 TM imic MIwm,
•
10/22/2010 11:40 5035436285 PAGE 03
.1.TS0221-1 ...
STRICKER, PAUL
11205 SW 719TAvE
TIGARD, OR 97223
503 - 5 16 -1000
Installation Property Information
PIREC_TION:
Prope Line
FT: ti O
1
FT: n ,) / sg �� Fr: vs.
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1
FT: 9 U
Property Line
(F= FURNACE)
(X=OUTSIDE UNIT) STREET
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Columbia NW Heating, Inc.