Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00388
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2009
Parcel: 2S111DC06200
Jurisdiction: Tigard
Site address: 9495 SW BRENTWOOD PL
Subdivision: SUMMERFIELD NO.9 Lot: 532
Project: Peper
Project Description: Replace existing NC in courtyard. Minimum 3' setback from side /rear yard property lines.
Owner: FEES
PEPER, KATHRYN Description Date Amount
9495 SW BRENTWOOD PL Air Conditioning or Heat Pump 07/29/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 07/29/2009 $8.70
PHONE: 503 - 820 - 8270 Minimum Fee Adjustment - Mechanical 07/29/2009 $58.50
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: OTR 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: i te Permittee Signature: C3N / / 9 - AZ re,9-./ /
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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Mechanical Permit Applica
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- City of Tigard & P e i:cry: -7 49 07 -"'
Il - 4 13125 SW Hall Blvd, Tigard, OR 97223,i1 il
i ' d Phone. 503.639.4171 Fax: 503.59.8.1960' 2 7 2009
ILIY°GF nnIGVIAS Plea Review
Date/By: Other Permit:
TIGARD Inspection Line. 503.639.4175 ivi, , Date Rvady/By: im: Ea See Page 2 tar
Internet: wvAvt BUCDIN R
igard-or,gov Notifiedavtahod:
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! . . ... ... .. .. -
TYPE OF WORK - .. " - - . -, .
-- .. .
-- : - ;.COKMEIICIAL - FEE* .SC4EDEI.E.:-4SE CIIECKI.IST 1
D New construction
A
D Demolition ,„■erc'-'7Icraion/alteratio a/replacement pco
0 Other: Mechanical permit fees' are based on the value of the work
tfrmed. Indicat e the value (rounded to the nearest dollar) uC 41
mechanical materials, equipment, labor, overhead, and profit
Value: S
. ... CATEGORY OF CONSTRUCTIQS.....• '.,, ....- , .--;:.:::..--..-,:-,..',: . ,,,,,, ,....... . ,_ ,,,, .....„. . . ._. . . .
' .i1144*PdPitiENT. I SW1rts.FEEs
[1 1- and 2-family dwelling Ej Commercial/industrial D Accessory building For veciai inforrnalion use eheek!isr.
D Multi-family 0 Master builder 0 Other: Description
Ea. Total
JOB SITE INFORMATION AND LOCATION . - : Heating/cooling l i QtY. I
Job site address: 41 415 .9,0 3 r12, Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/StateiZ1P: j"; G.A..11-9 Furnace 100,000 BTU (duets/vents) 14.00
Furnace 100,000+ BTU (duets/wets) 17.90
Suite/bldg./apt. no.: PrOJ ea name: Gas heat pump 14.00
Cross street/directions to job site: Duet work 14.00
,_
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in.wall, in-duct, suspended, etc. 10.00
Flue/vent for uno of above 10,00
Subdivision: Lot no.: Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK .. .... Water heater 10.00
Gas fireplace 10.00
)2A41.61 1 f--14 A--Ir Flue vent for water heater or gas
161-111?-.94--.4-1L.a' fireplace 10.00
• 4 fa r`A J■_' r ' ral.
Log lighter (gas) 10.00
61 IF . orrt 8-tk71- Wood/pellet stove
1
.
Cko Qt.( prneof--1(tif\I__ Wood fireplace/insert
- - . Chimney/liner/flue/vent
0 PROPERTY OWNER El TENANT ' • - - ".--: Other: 1:00000o
. ' _I 10.00
Name: TrafroGlit...,...,, Envi ronment al exhaust and ventilation
Range hood/other kitchen
Address'.
equipment 10.00
City/State/ZIP: ' Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) VieD - 2 2.- PVC ( ) toilet compartments, utility rooms) 6.80
D APPLICANT 0 CONTACT PERSON . ..' Attic/crawlspuce fans 10.00
Other: 10.00
Business name: Fuel piping
Contact name( 1), ft -
/ b y $5.40 for first four; S1.00 for each ddltiona
Furnace, etc.
Address:
City/State/ZIP: Fhone:5:b3 )6 7 q- 3 .---) 0 4
_._
Gas heat pump
Wall/suspended/unit heater
, Water heater
Firepiace
E-mail: Range
CONTRA I CT F O " R : : 9 ) (r. 6 . . 7 .' 6 . - . :,, Barbecue
. . ... , .
Business name: (2„.0 htfr"? obi C..... Fia-A.M//- 1-' ei:70/41 .9-ric
0 3 (F i i 0,k , 2-3 oi -7
City/StaCity/State/ZIP: - G if fe.„4 t ) "2 ,.... . q .2....s:-/ Clothes dryer (gas)
Address:
Other:
.: • '- • :'-: . - mEdiANicAL PERMIT FEES*
Subtotal
-
Phone: (S 6 ?- Li - - 2 1 0 ‘,I Fax: (55 . . 7
xi MUlimum permit fee (S72_50) ,2 ,5
Plan reviesv (25% of pcmi it fc,c)
State surc peurmTitiFf;) ?/. , \
CCB tic.: / 3 s '' ' 101 to
. This permit application expires if a permit is not obtained within I au
Authorized signature: fe 4-/ days after it has been accepted as complete.
. Print name: --e A, / i I Date: 470/ 2 7 ,i , i • Fee methodology set by Tri-Cotuity Building indpciry Service Band
,n...m.r.n11.AMFr.Perrni■Anc clOc 04,06i06 17T (lift COMPW...13)
z • d OL.Z0 6u!loo0/6uqeeH eqwriloo el L:60 60 LZ Inr
Jul 27 09 09:11a Columbia Heating /Cooling 503 - 598 -0270 1
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