Permit 1 111- CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00071
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/17/2011
Parcel: 2S112BB01000
Jurisdiction: Tigard
Site address: 8375 SW COLONY CREEK CT
Project: LOFTUS Subdivision: Lot: 0
Project Description: NC, furnace and fuel piping to furnace.
Contractor: HEAT RELIEF CO Owner: LOFTUS, VICKIE L
13122 NE DAVID CIR # 800 8375 SW COLONY CREEK CT
PORTLAND, OR 97230 TIGARD, OR 97224
PHONE: 503 - 261 -9915 PHONE:
FAX: 503 - 261 -9814
FEES
Specifics: Description Date Amount
Air Conditioning 02/17/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 02/17/2011 $46.75
Class of Work: ALT Type of Const: Fuel Piping 02/17/2011 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 02/17/2011 $12.92
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $120.57
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 1.800.332.2344.
Issued By: J Permittee Signature:
I
Call 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.
02/16/2011 WED 13:39 FAX 5032619814 R) 002/002
Mechanical Permit A p p l i c a t i o n „ FOR OFFICE USE ONLY
City of Tigard F EB 2011 Received
1
. ° 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: i . ��� v ` ,
Plan Review
Phone: 503.639.4171 Fax: 503.598.19b0 �(�n �n y Other Permit:
TIGARD Inspection Line: 503.639.4175 CI 1 ► ®� 1 14 P tf1LJ Date Ready /By: 0 See Page 2 for
Internet: www.tigard- or.gov BUILDING iILDING DIVISION Notified/Method: Supplemental Information
> a: -nom I 4 i t,r• N-.... x MA
❑ New construction ® Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
it4 .2..tM: _ �eC ?`! '4 v'r.�?.. �� zc °+qa_ ... *AtFili :Q ..•, . ,. �a +'c��.. . :... 5:37 $ 1 , i,;s`a- �7•."&r5F ..... 'a;sx t3:
.. - "4' .5tt x :JI Io 1 R E <S3egi l;8{ _TAl;
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building TM °~
El Multi- family ❑Master builder ❑Other: w m For special information use checklist. .
�^ Description Qty . I Ea. Total
l -i � 9:. . L1,Al D ITO. 'A• < i . 1), - ';` : „ Heating/cooling
Job site address: 8375 SW COLONY CREEK CT Air conditioning
(requires site plan showing placement) 1 46.75 46.75
City/State/ZIP: TIGARD OR 97224 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: I Project name: R11029C Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
H dronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32 •
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
r m ;or ,-vin :.,t,'• .x" -�. i. .a iilifi ... � Water heater 23.32
GAS TO GAS FURNACE INSTALL, ADD ON AIR CONDITIONER AND WATER Gas fireplace 33.39
HEATER Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chime
„ �, _ H ti
ey /I iner /flue/vent 23.32
_t r - s - ... >t - ct, 6 . `.': I� , t •: g`0'. 6 611 I t 1 . ' 'u. C p Other: 23.32
Name: VICKIE LOFTUS Environmental exhaust and ventilation
Range hood/other kitchen
Address: 8375 SW COLONY CREEK CT equipment 33.39
City/State/ZIP: TIGARD OR., 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms, .
Phone: (503)639 -9830 Fax: ( ) toilet compartments, utility moms) 23.32
*- • �+ t t s • � k Tai i . Attic /crawlspace fans 23.32
, ;._ _ ,I a =_to-r.g n q t omad . •' . f .: 6 , a 0 ' Other: 23.32
Business name: HEAT RELIEF HEATING & COOLING Fuel piping
Contact name: KARINA GRANT $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: 13122 NE DAVID CIR # 800 Gas heat pump
City/State/ZIP: PORTLAND, OR., 97230 Wall/suspended/unit heater
Water heater 1 14.15
Phone: (503) 261.9915 I Fax: : (503) 261.9814 Fireplace
E -mail: HROFFICE rr HEATRELIEFTODAY.COM Range
„ ; . 4 7 Q ('1 � * � ;m ,,e*:,:',.
,; ",.' Barbecue 1
am _ - a - .3 -�c ...•. r {�i� � �:tir"�`.'t';;: .. t
Clothes dryer (gas)
Business name: SAME AS ABOVE Other:
Address: i , .,..,,n: G f 'ERira " -
City/State /ZIP: Subtotal 107.65
Minimum permit fee ($90.00) 0.00
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) 0.00
CCB lie.: 122424 State surcharge (12% of permit fee) _12}4 -1) Cj Xs
P" TOTAL PERMIT FEE i 2 e5S /fo,s7
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: KARINA GRAN Date: 02/16/2011 • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits\MEC- PennitApp.doc 10/01/09 440 -4617f (11 /O2/COM/WEB) -
02/16/2011 WED 13:00 FAX 5032619814 002/004
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