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Permit CITY OF TIGARD MECHANICAL PERMIT . COMMUNITY DEVELOPMENT Permit :: MEC2010-00561 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/04/2010 Parcel: 1S135DD03600 Jurisdiction: Tigard Site address: 11600 SW 90TH AVE Subdivision: Lot: 0 Project: Olsen Project Description: Replace gas furnace. Owner: FEES OLSEN, ERIK Description Date Amount 11600 SW 90TH AVE TIGARD, OR 97223 Furnaces < 100K BTU 11/04/2010 $46.75 12% State Surcharge - Mechanical 11/04/2010 $10.80 PHONE: 503 - 758 -9951 Minimum Fee Adjustment - Mechanical 11/04/2010 $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: Natural Gas 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 Notif ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or dire questions to 11NC calling 503.246.6699 or 1.800.332.2344. Iss d By: Permittee Signature: CaII 503.639.4175 by 7:00 a.m. for an inspection that busine 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 03 10 04:22p Columbia Heating/Cooling 503-598-0270 p.2 Mechanical Permit Application Fo It 01:Fic1 t st: ()Nt,y City of Tigard VVD Received /0 k I Penn" No. w ed.joi . do .3 / , • 13125 SW 1.iall Atsfdigard, OR I et- Plan Review ' a :--hone 503.63 17 1 Fax 503.59M9 Da:eel. Other Penni: TIGARD .nsxetior Line 503.639.d 175 % '1 Date Ready/By: Serj ' 0 See rage 2 fur :11cruct w N4 gard \\\Ci\i Notified:Method: :•ilaai, Supplement2 . ti,..." . .. TYPE OF all , s to %MO c NINA, COMMERCIAL:FEE* SCHEDULE - USE CHECKLIST • j Mechanical permit fecs• arc based on the value oldie ....or, New Ainstruction AAdd it ionlaitiOlgialacemen1 performed. :ndicate the value (rounded to Vie nearest do:;./, • El I.k1:10IiiiCE D Other: mechanical materials, equipment, labor, Qv:If:cud, and,: - _. it --- \Jake: $ CATEGORY OF CONSTRUCTION . • .. ' • . • :•:: .*:' . ., '. ..• RESID ' .- . , E ., • NTIAL EQUIPMENT / FEES' and 2-fi.u dwelling 3 Commercial/industrial ID Accessory building For 3pecia! mformar• on use cneckksi 1 Ej toJili-ram.i 3 Master builder 0 Other: Dtscription I Qty nti. I 1 JOB SITE INFORMATION AND LOCATION . • • ••••,• • • •••• . : Ileating/cooling • — Air conditioning „Lib site .t.....tLess: ALAI ar i h 1 (7equires site plan showing ph:em t:ew) 9 46.7j , ---,----.- - (.it■,'SLate.'ll:': ... - _re:- aa . Furnace 100,000 BTU (ducts.%enis) 1 ,I 4(., 75 1 _________.__. • , r— • , Furnace 100,000+ BTU tdectsrvents) • 54 , ,;1 i 'u r' •io : ?reject name: Qi sfyia. lieat pump 61 '.:0 r,.,..„„,,t.„„,„ ... i,.....(..,.,,,h,,..,: Dcct work ■ , , . .:_ ! Hydronic hot water s'Stem • 1 23 2.2 • -4--- Resider.tial boiler :rad iator or hydron:c) 23 32 ------ - - - • I. Unit heaters (fuel-type, not electric), in-wall. in-duct, suspended, etc. 4o 75 ' 1 -- Flue/vent for any of above i • Schiliv:sion• 1 Lot no.: Other: : 23 3: ..... Env/parcel m... : Other fuel appliances DESCRIPTION OF WORIC • - - . •. . • , Water heater 7 - 23 I i • . .... . Gas fireplace ., 3 ...1 9 ater heater --.- - Flue vent for W ur gas ______ fireplace 23 32 _____ ____........_ ... , Log lighter (gas) 2332 -- Wood/pellet stove T3 3 1---- i Wood fireplace/insert 23 32 . ........... I --. C/hinineyfliner/flueivent 23 32 _ . ..._1( PROPERTY OWNER 0 TENArrr - • Other: 1 __ 1.1 Name: 6,0*/ IC r '10 .... A •i Environmental ex ba ust and ventilation .vldre .s: i iippa6LO 4 ii- Range hood/other kitchen equipment 3).1-) ; Cm/State:IF' (Zit/ di t • • _ 4 , Clothes dryer exhaust I -• • • .. - , Single-due: exhaust (bathrooms, r 1 i'liotte: :M e.qq5 / Fax: ( I / , toilet compartments, utility NOillij I , ; ;' 0 APPLICANT 0 CONTACT PERSON • ' Atticicrawlspace fans 1 23 32 , Other. • 23 32 i. BUSLit:SS liant,:: Fuel i pipng — ____ ..._____ ____ . _ ..... !tante: /7 70 1 .-1!--e /020,,.. ri ._ /27 een1 514,15 for first four: S4.03 fur cacti eckfirii. (Ia. ____— Furnace, etc. I A...dres. Gas heat pump r . .... .... L...ty.'S:.deiZIP: I FP 1;503: (,) 4. Q 704 Fax: : ,s7 8 _og.70 Wall/saspendedfunit heater Water heer I i 4 , Fireplace at li-mail: i e - . [. . T • - - - . . CONTRACTOR. - • Barbecue ' • Clothes dryer (gas) m nosiness nae: (1 ' . d u 4 ... . NMI •:.-,_ : ..a.adgi IL • 1 *II ■. ■ _ Other: 7- Addrossfb . • 1 \ c ;; ; .v... - ks:.:5. 9 • MECHANICAL PERMIT FEES* CitsiState12.11 4 ”6 7 0 7 12 . r 0 a7c j )? I Subtotal I ---0.- ) j Minimum permit let ($90.1b.1) I Pluirte:&•=, ) i I __..) . EI„: (5q3 L _5 - (38 -0,1,70 .1 ___.........oa, , - Plan review (25 °II permit Ito (IC.13 11c. .r, • --. r _._... 9 /(6,..,._i i State surcharge I, i 2% of permit feet i TOTAL PERMIT VLF. 1 --- - - • This prmit a epplication {pem expires if a rit .s 001 utile met; riWirt I N.. AuLtunzed b!kl:iliay 411) rt days after it has been accepted as cuertylete. 1 Fnr.t :ittine:Trai- /nee ( . 5 - 27 . I Date: tb.g_10 . Fee methcdology set by Tri-Couni: Huildirg '.r.it.iti 1,...".1 : I 1..0,r, v■ urn