Permit CITY OF TIGARD MECHANICAL PERMIT
• = COMMUNITY DEVELOPMENT Permit #: MEC2009 -00407
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/07/2009
TIGARD 9 Parcel: 2S111 DB03100
Jurisdiction: Tigard
Site address: 15335 SW ALDERBROOK CIR
Subdivision: SUMMERFIELD NO.8 Lot: 490
Project: Poorman
Project Description: Replacing existing gas furnace and air conditioner Must maintain 3' rear and side yard setback
Owner: FEES
POORMAN, DIANA D Description Date Amount
15335 SW ALDERBROOK CIR Air Conditioning or Heat Pump 08/07/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 08/07/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 08/07/2009 $8.70
Minimum Fee Adjustment - Mechanical 08/07/2009 $44.50
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97223
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:
Gas Pressue:
Total $81.20
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: t .J Permittee Signature: ( � " �" tt�1� �%(�'t /'v
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.
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.. . .• .. . . . . .
. , Electrical Permit Application RECEIVED. . ' ' • ' . .
FOROFFICF. 1.1SE ONL
I • - ' ' ' ' .
1. . • • - tity of Tigard •ReCeived 4 _ , -.5 #
• .• , • .....- . • .13125 SW Hall Blvd,, Ti gard OR 9722 3 A
I iii Datc/By: l'cimit N it.. - 1_,
C. ---- i --
• . - . .
. 7 ' ' '. Phone: 503.639.417 I Fax: 503.59.1960 LIG 0 5 2009 '9. Revi- odic, pe,mi,,
Date/By: ..
.......
. . :
. TIGARD , Inspecti L
on i It
me: 503.639A175 pate eady/Byi 1 Ed See P.see 2 for
Ilitertlet Www.ti gard-ongov CITY OF TIGARD • :Notified/Method; Supplemental tofermation
, ... ..
. - , .. ... ..
1721,14igni''Il".L...‘,::;:,:::. i.*.k.k..0t.ii.Mtk..,MItAftl,144.0.g0?"1.11 ,■'' ' 'N:! 1 /1 11 ' ''' ..'r• ,' - legailliI034 .. '
' . 0 New construction A Addition/alteration/replacement Please check all that apply(.Qati it 2 sets of plans othtems checked below):
to Service or feeder 4(X) :linos 0: inucc 0 Building over three stores.
'.. . .; 0 DerriOlition CI Other:
where the available fault current rl Mathias and bOatyaLds. .
'. : Xtlen.i0q■tet::'':' 4W1r6Attikitfpliii-771140'. exceeds 10,000 amps at 150 t olts or 0 l'IvatitiF buildings.,
=•• ,-...: ..,... ,. .. •-•-‘ .‘,.;',.,,,L.,i,, i-i,i',., ()A.- . .i , /■ri' ,. i , d• less to wound, co exceeds 14.000 1: COMincr I i;t1-to$C agricultural
Zi 1- and 2-family dwelling 111 Commercial/industrial El Accessory building amps for all other installations. bitildititts.
: 0 Multi-family 11 Master builder El Other:. . . ID Fire pump. 0 installation of 75 KVA or
.
Q ,....., ,:.::..,..,,,,,,„4,,;.„,---mr;;;.-z•,,n).7,,,t,i.saji;74;•„:„In,,A,v.".,12:.,, in hinargeney systc m. tat eCt ht.Tatately derived system,
1Wif „....,..,4qq.?^!. zfI:......v..rip#.i,I,tttA,rt4,„R,tlgq,k;,.,;y$,M,5r,'.N.p4,4Vtig In Addition of new motor 10sd oi 0 "A",
Job site address: & j, ke3 b .....,. ' et 100HP or more oncoormnoty
.J01? no.: • • . .
I (1.1 El Six oi more residential univ, Rocret;Itiomll vehicle parks.
--,
... .
City/State/ZIP: ' o' In &cc, 4. . Health-core facilities. 0 Supply voltatte for more than
.
1=1 Hazardous locations. 600 volt; »ominal.
'Suite/bldg./apt. no,: Project name; ,e,d . 0 Service or feeila 600 amps or mom .. .
. . '
Cross 01.4;ttG.n 0,
' ';:"'H ' ' X
EMatif,g
streeddirections to job site: . Description T -. ......•.•
......._
,. New residential single- or niulti-family dwelling unit. ••
. . ,
• • .
Includes attached garage.
. . ... ..._
,-. . .
Subdivision: 1..ot no:: 1,000 sq. ft. or less 145 15
- - Ea. add'l 500 sq, ft. or portion 33.40
Tax map/parcel no.: ,
, . Limited enefgy, residential
0p
Yiligatife.'N,'' •11'..';:'.. .',7i, ,::::.:•;•• ..„;.,t■#I iii6O VO;', 00iiki7.;!..MqVg11.44.,iiti.k;; 75.00 . . 2
(with above sq. it)
, . ,. ....- FAIaltliII.I.,14.1I1ltitliuttltilIst..i;l:1;3; ,
. 75.00
AceCe-. __C,LCCA C... . Limited energy, multi-family
residential (with above sq. it.)
-
Services or feeders installation, alteration, and/or relocation . • : •
. .
. ,
• ' • , 200 amps or less 80.30 • ' 2
tif(P 04 t
': itilt(4diilAAliliVeRA • :'.1.....A(!..?'* ili„,,`" 4,,....-. 44,t.,,,,Ia.mmoi:: 20 --- „„,., - -
.,4.- . . _ _.. ,..., s, :. • . • ..:....: L. •,,•, .,,,,, ..-., ,; •.,;„.....),..,,,,, ,r.,,,,A., LV1 amps to 4v1/4/ amps 106.85 2
: .. Natrie•: • Sk cf cxx A , 401 amps to 600 amps 160.60 . . 2
, 601 amps to 1.000 amps 2,40.60
" 2
Address: . ' 5 Avvf_ ... . Over 1,000 amps or volts
454.65 ' 2
City/State/ZIP : • Temporary services or feeders installation, alteration, and/or'
relocation
...._. -. • ________ .
. .
Phone:.( . , ) Fax: ( ) 200 amps Or leSS 66.85 . • I
„ -
,..,.-
.:, Owner installation: 'this installation is being made on property that I own which is not 201 amps to 400 amps 100.30 • - 2 . :.
intended for sole, lease, rent. or exchange, according to ORS 447, 449, 670.; and 701. 401 amps to 599 111111/ti 133.75
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Branch circuits - new, alteration. or extension, per pioel:
Owner Signature: Date• .
._ - A. Fee for branch circuits With
' o titt1itk'wo•O .,•• , to -,.. "rr ., ', ',.. .7' ' , ,,,„.4,F .,...1,,,-
:. ..
APPLICANT ... .7 : • • . :; , i . : ;i i •i/iiigi:.b i a bove service or feeder fee. •
6.65 " 2 .
each branch circuit .... .
. .. ..... ..- -
Business name; •
. B. Fee ftw branch circuits
:Is ' fir -
„ „ •
.. . , . withow service or realer fcc. 46.85 IbP 2
:Contact name: -- branch circuit
. ' .
Each addl branch circuit • 1 r ..- 2
6.65 to.tiala
.• Address: ,. , •
. -- ___ - MISCC112111C011b (seryiec or feeder not
• .
• • City/State/Z1P: Each manufactutcd or modular
. 00.90 . . 2
-- - • . clwellisi g. service and/or teeder ._
• .. .....
- Phone: ( ) --- Fax: : ( ) Reconnect only r 66 85 • 2
...
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... E - mail: • Pump or irrigation circle .... 53.40
2
•• , :(Tositiiii6ctifitaV,,i4F:01^*,g0;141;Ripiter4i;g1,2 Signor ouiline lighting 53.10 • 2
----- •
Business name"
Cir-k. ‘'_2 _Le,
' ---- .. energy pa
-4V- C- Signal cireitit(s) ta limited-
pastel. alteration . Of
extension Describe: Page. 2 2
Address: - s 0 c7.2 -
SA••• ' . --- w - -
Cit (2...„.._4 A , C.-.: - C t, .1, 0 ( .--1 Each additional inspectitip ON cr a 110 ably in any of the ab0 'c . _
1 0. SO
Phone; gb , - 21 _ c - 7 i --1 c 5 LL _ investigation per - s
how Li ii, ww 62.50
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k...D....... - .,_..
Industrial plain oc. hour ] ... .
CCU Lic.: - 2_6 0, --‘ 1 Elccusieti_ I ,ie.: -1 .._.k t 7 c Suprv. Lic.: 2._ L .2,,
- " . i:11:77 1;ERftilli• 1
_... -• -- -
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1 - - - '-
Suprv. Eleetrtylan Si atu / .. ruquir (to. Sttbioal '' 5
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,.._............ .•••---.• • --- • """ . - - - Plan ■c vicv I permji
. _ Si 1,)(ile.
Print name: '.•,) ,., L ,_ , ) is.4 t 6 ,._,1 s ,1 i .'.'!;, i,. Nn Ii
une): 674
AuthorizCCI gZi ll tire : i , -_ __i r' ..L ,(7
r4 .,•-•••-•
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.1( 11,\ 1 1 Hi • 5 1 .. 92-,
---- ... - This pulpit ;i...a1;051 iekpil e.:,Ti . tt posenit is 001 ■obtailied Within ISO
.,-,,,-, _.. ........ '''--.,....... ',.- ‘
P rint name ) : , -- C) . ; 1', ..) i„..4 l e-4
-1,71,..-' -Fate: a,i Si I. I ,IS'IVI/it'll an t' 01,114CO.
440 MO: n I 1111s/CONVW1 II
l'111tuldirou \ ruo mitt. 1 I t • l'o .\ pi ■ to, , t.,.
Ed Wd62:20 600E SO ' £1S992OS : 'ON 3NOHd ONI DIdlOD ),E[NHO : woad