Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 00552
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/2010
Parcel: 1S135CD01701
Jurisdiction: Tigard
Site address: 11650 SW 98TH AVE
Subdivision: GREENBURG HEIGHTS Lot: 2
Project: Vezey
Project Description: Replace existing furnace and heat pump.
Owner: FEES
VEZEY, CHERYL ANN Description Date Amount
PO BOX 230299 Furnaces < 100K BTU 11/02/2010 $46.75
TIGARD, OR 97281 Heat Pump 11/02/2010 $61.06
PHONE: 503 -620 -4778 12% State Surcharge - Mechanical 11/02/2010 $12.94
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97281
PHONE: 503 - 624 -2704
FAX: 503 - 598 -0270
Type of Use: COM
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.
l '
Issued B y : di `L.L../ i Permittee Sign / l�4
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.
Nov 01 10 04:06p Columbia Heating /Cooling 503 - 598 -0270 p.2
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Mechanical Permit Applicati
III City of Tigard ECE IUED per. // eft- /0 Permitt+io.. tree,e /0 -005
13125 SW Hall Blvd., Tigard, UR 972 3 I Plan Review
Phone: 503 639.4171 Fax: 503.5913.1960 NOV 2 2010 paze/By' Other Permit:
- f I t; A I; a Inspection Line: 503.634 pate Ready/By: kuir 1 R
- or. ov to See e e 2 for
Internet: www.ti
� g CITY OF TIGARD Notified/Method: � Supplemental Information
• TYPE OF ilkiti DIVISION COMMEBCIIAI;.FT,E' SCHEDULE - USE CHECKLIST
❑ New construction 4dditiort�alteCdtion /replacement : Mechanical permit fees' are based on the value of the work
' i pafortned. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: , mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION , Value: S
RESIDEN77AL EQUR'MENT / SYSTEMS FEES*
V1 - and 2- family dwelling ❑ CommerciaLindustrial ❑ Accessory building
For special information use checklist .
❑ Multi- family ❑ Master builder 0 Other: Description
I Qty. I La. ] 'Total
JOB SITE .INFORMATION AND LOCATION Heating/cooling
Job site address: 11 _G ) �g Air conditioning i
�, (requees site Man shoainR ptaccmcol) L 5.75 City /Statet'LlP: q 7Furnace 100,000 BTU (ducuiveats) 1
Furnace 100,000+ BTU (ducts'vents) _ 54.91
Suiteibldg ✓apt. no.: Project name: V.e Heat pump 61.06 ' N.
Cross s :'eetAiirections to job site: Duct wort: 23.32 i
' Hvdronie hot wafer system 23 32 i
I— Residential boiler (radiator or 1
hydronic) 23 32 I
Unit heaters (fuel -type not electric),
in -wall, in -duct, suspended. etc. 46.75
Subdivision: Lot no.:
Flueivent for any of above 23.32 i
Other. 23.32
Tax map /parcel rw.: Other fuel appliances
DESCRIPTION OF ,WORK . • - Water heater 23.32
/, .- ....---.7---. Gas fireplace -
/ ,!' ! ' y ..y . j ;"' /f`:- .. �,' i•'.; j Flue vent for water heater or gas
fireplace 23.32
/�' Log lighter (gas) ( 23.3
Wood/pellet stove 33.39
Wood fireplacelinsert 23.32
PROPERTY OWNER I • ❑ TENANT Chimney/liner/flue/vent 23.32
Other: _ 23.32
Name: a Environmental exhaust and ventilation
Address: / ep 5 l Range hood/other kitchen
s equipment 33.39
1, City!StattJZIP e x_ 97 3 Clothes dryer exhaust 33.39 .
LNbd1 ) � Fax: ( ) Single duct exhaust (bathrooms,
V^'• toilet compartments, utility rooms) • _ 23.32
❑ APPLICANT 0 CONTACT PERSON . Attic /crawlspace fans . 23 32
Other: 23.32
Business name: Fuel piping
Contact name: 'd ; . i _ 1, ' .. , oft 514.15 for first four; S4.(13 for each additional
Address: Furnace, etc.
Gas heat pump
City(Sta/te�2IP: n I ^� 7 . Q a Vdallisaspended/unit heater
Phone: X5)3) ( ' n , J( 1L . oC/0 I F ax: :66 51 U -d D.7( W�taheater
E -mail: Range
• CON'IRACrOR. .. . Barbecue •
Business name: 4. /a . ` r p /'� 1 • A )6 Clothes dryer (gas)
J r r I I ` W , `� �J� / ` V Oth
Address: , A tk .� 3 9 7 • MECHANICAL PERMIT FEES'
City /State/ZIP: 1 1 ` 04 7C 8/ Subtotal /07. $t i
qQ _ Minimum pemlh fee ($90.00) i
6 t
Phone: )' ) Fax: ( /t �
Plan review (25% of permit fee) �'�
CCB tic.: r7(n a State surcharge (12% of permit fee) /a.94
! TOTAL PERMIT PEE Mo. !
/ This permit indication expires if • permit is not obtained within 180
Authorized s:gnat / / ` pp days after it has been accepted as complete.
Print name :A / ` -474. a la i Date: ip : e - , . • Fee methodology set by TO- Counry Budding industry Service Board
I \ auilding \PtxriiteMEC- PernslApp.dce 1001 440-4;17T (1 0721COMAVE8)
Nov 01 10 04:06p Columbia Heating/Cooling 503-598-0270 p.3
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HEATING & COOLING, INC.
P.O. BOX 23C397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
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ADDRESS: