Permit CITY OF TIGARD MECHANICAL PERMIT
11111 ss COMMUNITY DEVELOPMENT Permit #: MEC2009-00269
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/09/2009
Parcel: 2S110BD02300
Jurisdiction: Tigard
Site address: 11949 SW BULL MOUNTAIN RD
Subdivision: SHADOW HILLS NO. 2 Lot: 55
Project: Hunt •
Project Description: Replace a /c.
Owner: FEES
HUNT, HOLLY Description Date Amount
11949 SW BULL MOUNTAIN RD Air Conditioning or Heat Pump 06/09/2009 $14.00
TIGARD, OR 97224
12% State Surcharge - Mechanical 06/09/2009 $8.70
PHONE. Minimum Fee Adjustment - Mechanical 06/09/2009 $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: 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: f �1YD A i/1 I1 / 1 l Y 0/) ∎ Permittee Signature: \
v l �JL 1 �,e Call 50 by 7:00 a.m. for an inspection that business day. 1C
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.
-Jun 05 09:09a COLUMBIA HEATING 503 -598 -0270 p.2
FOR . ,.
Mechanical Permit Application IC usr (At .1 -
`g ' a City of Tigard RECEIVED rived •
Date/By: ' `
13125 SW' Hall Blvd., Tigard, OR 97223 Permit L t • u .11 .. i
U PI
1 Phone: 503,639.4E 71 Fax; 503.598. 19(9 I M Plan Review
J) �1 O �OQ J DatelBy: Other Permit:
T.TGARD' Inspection Line: 503.639.4175 Date Ready/By: turn: RI See Page 2 for
Internet: www.tigard- or.gov FTIGARD Notified/Method: , 1 Supplemental. Information
CITY
TYPE l‘IG DIVISION .
..
•
v:,COIYINEItC1A1;' „F'EP. SC131D.ULE; =.,USE CHECICLJST
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration/replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit_
Accessory building Value $
i artily dwelling ing ❑ Commercial/industrial aCommercial/industrial s t.x i,
CATEGORY OF CONSTRUCPION .i,` _ , v
❑ Ac ry I ;. ,::. S EN7Itf QOTPN[ENT I SI(STEhiS.:FEIES*
❑ 1- and 2
❑ Multi - family ❑ Master builder For special information use checklist.
❑ Other' Description II Qty. Ea. _ Total
JOli SITE INFORMATION AND LOCATION • . Heating/cooling
Q' / l Air conditioning or heat pump
Job site address:
i r7 9 54. �1 #0 ✓+4 4rh JR, (requires site plan showing placement') I 14.00
I CityiState /ZIP: L Furnace 100,000 BTU (duets:Am ts) 14.00 OA 97Z-2-
4,,,./ Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 14 Gas heat pump 14.00
Cross street/directions to jub site: Ductwork 14,00
Hydronie 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
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances •
DESCRIPTION OF WORK . Water heater 10.00
Gas fireplace 10.00
/Cf ;4 LGlt4 Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fu 10.00
0- PROPERTY a TENANT Chimney/liner/flue/vent 10.00
PROPERTY OWNER
Name: to f 17 f , -1I Other: IO.OU
l Environmental exhaust and ventilation
Address: 5 t f 9 5 "(30 I f )fou.4 4? f Range hood /other kitchen
equipment 10.00
City/State/ZIP: - 4 v, 0'4_ 7 2- L ,-/ Clothes dryer exhaust 10.00
I
Single -duct exhaust (bathrooms,
Phone: ( 31 ) - Fax: ( ) toilet compartments, utility rooms) 6.80 ,
❑ APPLICANT L • ❑ CONTACT' PERSON , • Attie!crawlspace fans 1 10.00
Business name: Other: 10.00
Fuel piping
Contact name � ' . n / b y $5.40 for first four; 51.00 for each additional
r
Andress:
Furnace, etc. I
Gas heat pump
City/State/ZIP: WalVsuspended/unitheater
Phone: yj3 )6 ti -3. D,( Fax:: 663 ),S.-.8.-• D D,70 Water heater
E-mail: Fireplace
Range
CONTRACTOR - Barbecue
Business name: (�) �,s,_'y7 b! C`. » J , � &roi/ � I„ +� . Cl dry (gas)
Address: Other. i
Address: o x „2-3 6 3 9 .. : MEGHANicAL PERMIT FEES*
City /State/ZIP: ! U ,f rl 4 /2..... 7 .2.-,c- Subtotal
Phone: (Uj) 6 Li - .- (572,50)
l Minimum fee.
7U Fax:) �� r :-�
� Minim permit Plan review (259% of permit fee)
CCB lie.:
7 4 . 3 5 - '
State surcharge (12% of pennit fee)
TOTAL PERMIT FEE �t . 20
This permit application empires if a rmit is not obtained withi 180
Authorized signature: days after it has been accepted as complete
A
` Print name: =b 5 .i A I Date: ( { / S ' Fee methodology set by Tri- County Building Industry Service Board
I'iauildi n\Pernitilb.ECPerrs tApp. doe WM/06 440-46 ITT (111021COWWEB)
Jun 05 09 09:10a COLUMBIA HEATING
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. . .: 3-598-0270 p.3
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i •• H EATING & COOLING, INC.
P,O. BOX 23C397 • TIGARD, OR 97281
(503)624-2704
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