Permit CITY OF TIGARD MECHANICAL PERMIT
e COMMUNITY DEVELOPMENT Permit #: MEC2010 00577
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2010
Parcel: 1 S 136CA90471
Jurisdiction: Tigard
Site address: 10900 SW 76TH PL 47
Project: Camera Subdivision: TIGARD WOODS CONDOMINIUMS Lot: 47
Project Description: Furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: CAMERA, GEORGE NICHOLAS
PO BOX 230397 10900 SW 76TH PL #47
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/10/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/10/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/10/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.82.2344.
Issued By: Permittee Signature:
CaII 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 09 10 05:48p Columbia Heating/Cooling 503-598-0270 p.2
WO ••
Mechanical Permit Application 061-• you oFFR t ()NIA
City of Tigard n c\\4 Received
% Lu ' Date!By: II , WIZ . ---
Oil Acza„ 40 _O . - 7
l . 131 SN Hall Blvd., Tigard, "JR 97223
0 0., i .qlfMIIIIIIII Pennit No 1--
holic: 51)3 63 Fax: 503.598. !460 Other PertnI1
I ispeet li3n inc . 503 639.4175 ,,..,,r(‘‘, /IV.' e.■:.
TIC, A1(1) . or . - : v• . eady!By: kris la Set Page 2 fur
I v. ww.ligard-ror.gov c‘t s• NI OVI• Notified/Method: . 7 - & SupplemetttA Infurniattua
k kS)
1
1 • TYPE OF WORK COMMERCIAL :FEE*. SCHEDULE - USE CHECKLIST
Mechanical pennit fees• arc based on the value uf the ...irk
E Nov car s:ruclicn b IKAdditidnialteralidnIreplaceMent
perfonned. indicate the value (rounded to the nearest Julia: I ..; ,..
E t),01:t:on 0 Other: mechanical maicrials, equ.pment, labor, overhea :Inc !iron. _
$
CATEGORY OF CONSTRUCTION.' ''' .....:'... ' ...• • i 1 • - .••• Value:
• • RESIDENTIAL EQUIPMENT / SYSTEMS FEES
V i - and 2-farnily dwelling 0 Commercial/industrial 0 Accessory building
For special .‘iiibrinarior use checkg a.: ,
E mufti-fatuit 0 Master builder C3 Other: Dcription 1 Qiy
JOB SITE INFORMATION AND LOCATION - ' • • • •••••.• • II eati ngkooli ng
Job site itress
1-0.9 I 71414A p, jdtcn Air conditioning
',rt.:quires site plan showing placement, ..:(..; 7::
'77 ;(4 • , e ,, Furnace 100.000 BTU (dLeisiventst / - 75 .
0 - . Furnace 100,000+ B•IU riluets 54..I I •
L ' t' • 1.u. it- Pro,ect name: aj
Heat pump 61 06 ;
_ ... ---
' 0c:is sIjct..] r....ctions .:. jti) SJI...:I Duct work -:- - -•
- - 1-:. y d 1. on ic hot water system
Residential boiler (raciator or
hydrun tit) t- • --
Unit neaters (fuel-type, 111)1 electric),
in-wall, in-duct, suspended. etz 4c 7 :i '
-
,,_
Flue/vent for any of above 23.32 ...
Subdivision: Lot no.:
• Other 23 '
i 1 av 1:•ap,T7trce. no: Otber fuel appliances
DESCRIPTION OF W I ' . .. • . • • • .; • . . Water heater -
Gas fireplace [ --- i 33 39
• b:L___ - A if S...__! Flue vent for water heater or gas I •
fireplatx 23 32 .
...,....
Log lighter (gas) 2 3:
Wood/pellet stove
.
Wood fireplaceiinsert
Chimney/liner/flue/vent -J ..,- ..
S PROPERTY OWNER • • 0 TENANT • . 1. - 1
Other: 1 _3 3_
..: .--:-_-_..__.
t CaMlirr:L--- Environmental exhaust and ventilation
Addresi: 10C/eX 7141 pi *1.177
C9891
Rang:: hooculother kitchen
equipment 33.3Y .
' V
C it 4to7
1.:1' T
. .._. . i __ Dik- p- ._ Clotnes dry•er exhaust _33.3.-1
Single-duct exhaust (bathrc-orns,
'-' i_
_ _ ... .
A - ; Fa.x: 03 j 611, D. 70 , toilet compartments, utility rooms) 1 23.32
40 wAN !
APPLICANT 0 CONTACT PERSON , Amelcrawlspace fans 1 3.3 3...
• ,
Other:
I kii.sitiess narne• Fuel pipi
. ng
' - . i
(.'i..titaci name: / 9.1 0 pc n
i Si 4.15 for first four; $4.0.3 for each additional
__________ . l 1 Z.....1: / I (.4._._ ..r •• , k i
: Furnace, etc.
i Address. r •
Gas heat pump
• (..3)1.itatit. Wall!suspende&un it healer ,
• ,
Ithone• . 4 .._ 3_-1 ._ta i L, 7,0L/.. Fax: : GO 5 8 _n70 Water neater i
1 --- 1 ----.... ..•
Fireplace . --------. .. -
. II-mail: Range - •
•
CONTRACTOR • . Barbecue • ---._.. . ..
, • C:othes dryer (gas)
Business mune: 0 4" .IM i;d/9" CnOk _i_k )6 . Other: 1 ,. .. . • -- _ .
Address:•,•
• ob. '- 41 • • • . MECHANICAL PERMIT FEES*
Cl.tyP.Staiel/..IP: 7Q,/) 0 i.: Subtotal 1 .. _
ee
Phone: .-; .6 : 7 f 7 ( r) 1 Fax: cf \_5( Minimum permit t($90.0(0
/fa _ oa_70
i Plan review (25% 431 fzei I
1— `-' ..k....L..... .
Cf....il lic 'T, -; 9 State surcharge (12% QC permit Ice t _
...i.e....,,-...._
- roTAL PERMIT FEE 1 kos
Authori:ua signi.ourrL),,t 1 ,71 .
i niunelirai- Mee 677-..)
ii,-10 Tbis permit applicat:un expires if a ilernni is nut obtaimd , iii
Prnt Date: n .,,..
days after il has been accepial us complete.
I * Fee methodology set by '1 :load iii,:aJostr■ Se, c.: IS.,
:. t.L.ic.r.e...c:rottu,SIE(S-P.golit A D :1 C QC I 0; Q ) IV9 440-161 rr i 1 oevcoisvw 3131