Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00097
TIGARD 13125 SW Hall Blvd., Tigard OR 97223' 503.639.4171 Date Issued: 03/11/2009
Parcel: 2S110BD02300
Jurisdiction: Tigard
Site address: 11949 SW BULL MOUNTAIN RD
Subdivision: SHADOW HILLS NO. 2 Lot: 55
Project: Hunt
Project Description: Replace electric furnace with gas furnace.
Owner: FEES
HUNT, HOLLY Description Date Amount
11949 SW BULL MOUNTAIN RD Furnaces < 100K BTU 03/10/2009 $14.00
TIGARD, OR 97224
Duct Work 03/10/2009 $10.00
PHONE: 503 - 620 -9768 12% State Surcharge - Mechanical 03/10/2009 $8.70
Minimum Fee Adjustment - Mechanical 03/10/2009 $48.50
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: Natural Gas
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: (1 /I p Q /i) Permittee Signature: S `0
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.
Mar 06 09 09:30a COLUMBIA HEATING 503-598-0270 p.2
,.,..
....:::) . . . .
..3.:.
Mechanical ..
.;•.: Mermit ApplicaparrA\Ell
.,. tirr: FoRo...1.: USE ONLY :
• :
nyr:, 1T,I, ' .. Received .
• •; - • 13125 SW Hall Blvd., Tigard, OR 97223 k A AR 0 6 2009
Phone: 503.639.4171 Fax: 503.598.16
• \ City of Tigard
3N1
It Date/Bv: 5 i (0 - OS. ,Z. Plnit N° ' . 1YN.E.,C200Ct . in cnq 7
Plan ReVieW
Date/By Other Permit:
Ti(imtt) Inspection Line: 503.639.4175 .Da3e Ready/By: Judi: el See Page 2 far
Intemet: veNalv.tigard-or.gov CITY OF TIGARD NotifmcVMethod: I ( Supplemental leforinJtion •
Buil niNG DIVISION _
TYPE OF WORK . :. .-.' , :ti . i'.-•: , ll FEE* SCHEDULE - USE CHECKLIST •
: • --... • -. ..,.......... .. „.... . . ...
Mechanical permit fees* are basecron the value ot the vr'..
D New construction 50 Additionialtcration/replacement
performed. Indicate the value (rounded to the nearest ;:o1:11,. it all
El Demolition CI Other: mechanical materials, equipment, labor, overhead, and pre.fit,
Val:
CATEGORY OF CONSTRUCTION ue S
ILESIDENTIAL EQUIPMENT ./ SYSTF:MS FEES'
4 I- and 2 dwelling 0 Commercial/industrial El Accessory building
For special information use cliecklisi
, 0 Mult1 E] Master builder D Other: Description 1 Q:y. I Ea. 70..al
3013 SITE INFORMATION AND . . Heating/cooling , ____
Air conditioning or heat pump
lcb sire address: / 194/9 5) . - 3 1/ // ,„ra (requires site plan snowing placement) 14 0(.1
C:ryiState/ZEP: -- 7 - 5 AP b A-- C z-z-Y . Furnace 100,000 BTU (ductsivents:■ i 14.00 •
Furnace 100,000+ BTU (duccs.'vents) . 1 I
•,. . Suite/bIdglapt. no.: Project name:
Gas heal pump
I Id du
H. Cross street/directions to job site: Duct work : I 1
Hydronic hot water system 14.0(1
Residential boiler (radiator or
, hydronic) 14.00 _
Unit heaters (fuel-type, not electric;,
. in-wall, in-duct, suspended, etc. 10.00
—
Flue/vent for any of above 10.00
• Subdivision: Lot no.:
Other: j 10.0U
Tax map/parcel no.: . Other fuel appliances
DESCRIPTION OF WORK Water heater I
1 Oas fireplace 10.00
,
.. .,
r 4..iriaa / 2 ,44-4-) Floe vent for water heater or gas
_ , • . -.. - ,-- .
___Glat 4. , fireplace
Log lighter (gas) I 10.0u
10.0'j -------,
. ------.
Wood/pellet stove 10.00
Wood fireplace/insert I 10 00
i Chimncy/1 iner/flue/vent 1 10 00 ' --
0 PROPERTY OWNER 0 TENANT ---
Other: IC 00 I
•
Narne. kDfl j,,_-/_ . Environmental exhaust and ventilation
Range hood/other kitchen
Address: i )6) rrt:) s .---, I t V. /— equipment I 0.1)0 '
- —
City/State/ZIP: - 0 it_ 9 .-? 2_ 2 Li Clothes dryer exhaust i 0.1)u
Single-duct exhaust (bathrooms, - 1
Phone: r, ) 6/2.0_ 9-x f Fax: ( ) toilet compartments, utility rooms)
. ; I
p APPLICANT 1:1 CONTACT PERSON Attic/crawlspace fans , 10.00
• Other: 1 10.00 1
, Business name:
. _ .... Fuel piping
Contact name .titc, .-2) 6 , i b iv - $540 for first four; $1.00 for each additional
r
Furnace, etc.
Address:
Gas heat pump ,
City/State/ZIP: Wall/suspended/unit heater
Phone: 5--b-3 )?, 3 q, -7 Fax: : (93 )s" 6 c-- 0 ), - 26 Water heater
•
Fireplace __
.
Email: Range ,
CONTRACTOR . . -... -. Barbecue ,
, - ---;
• Clothes dryer (gas)
Business name: (1 hi ( ..._, A-1_ no ..,- 1 - . 11 '=' Other: 1 •
' Address: ,(7 13 0 x )3 9 -7
City/State/ZIP: /77 c . ( 7 fa_ Z) ,e2_., , i i f Subtotal
97.2- i--/
Phone: (57.1) 6 .7.- LI - D- 74) it
CCB tic.: 3 s' ''' ' Fax: (5 ) .5" c f) , ,..-- e) ...1.._---20 MECHANICAL PERMIT FEES*
Mnmum perrnit ee (S,72.50)
Plan review (25% of permit fee)
. State surcharge (12% of permit lee) .
.. I
\AL TOTAL PERMIT FEE
This permit application expires if e permit is aot obis:tied wl:nin Si 1
'
Authorized si attire: I. days after it has been accepted as complete.
..' Print name: 641/1 ks:Sk r I Date: , . Fee methodology set by Tri-Coxri Buildiig !ndu_;u, Servii:e bcari.
l:■Buileinat.Penrits\MEC-PermitAPP.d.: 04/06n6 440-4eirr II 1102XCIMAVES)