Permit CITY OF TIGARD MECHANICAL PERMIT
II Permit #: MEC2009 00479
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639.4171 Date Issued: 09/09/2009
Parcel: 2S 114BA 12400
Jurisdiction: Tigard
Site address: 16325 SW COPPER CREEK DR
Subdivision: Lot: 0
Project: O'Donnell
Project Description: Replace gas furnace and add A/C Must maintain 3' rear and side yard setback
Owner: FEES
O'DONNELL, LINDA G TRUST Description Date Amount
16325 SW COPPER CREEK
TIGARD, OR 97223 Air Conditioning or Heat Pump 09/09/2009 $14 00
Furnaces < 100K BTU 09/09/2009 $14 00
PHONE. 12% State Surcharge - Mechanical 09/09/2009 $8 70
Minimum Fee Adjustment - Mechanical 09/09/2009 $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: JA-tali—
A- Permittee Signature: 61k gip d
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.
S 'ep 09 09 11:21a Columbia Heating /Cooling 503 - 598 -0270 p.2
Mechanical Permit Applicati CEIVED �''. '_oitoi4[i rirsi.o .z' •
lii City of'I'igarcl a . RA }a w YermtNs (rr/t.�� t' � p
13125 SW Hall Blvd , "l .garc.OR 44727' SEP 09 2009 I
N Pnone' iO3 -79 4171 Fax 503 598.1460 n tan on`w
Uata4Fly (Ahcr Permit:
Inspection Line: 503.639.x1175 !
'r GARD CITY OFTIGARD Date Rmacl ffly ions bee Page 2 for
Internet: WWWtigard- or-gov ?Cob bod/Method: Snp7lemenral Enrr,rmancn
BUILDING DIVISION -
1 TYPE OF WORK COiNIMERCLtL' FEE` SCHEDULE - USE CHEC1 1S•I
i
❑ New constructiun Adtli ion /alteration /replacement Mechanical permit fces • the based 0, the value of the wnrh
prrfcrned Indicate the value (rounded to the nearest du,lar; of 'ad
❑ Demolition 0 Other: mechanical materials, equipment labor, overhead. and preflt-
CATEGORY OF CONSTRIOCCION ..I VCIUe S
RESIDENTIAL EQUIPMENT / SYST'RMS FEES'
and 2- family dwelling D CommerciaUindustrial ❑ Accessory 'building
For spccia! injormarroi use check!rsr
❑ Multi- fammly ❑ Master builder ❑ Other: Description Qty Ed. Iota:
JOB SITE INFORMATION AND LOCATION 1lcating!cooling
Atr cond.tioni hg or heat pump
Job site. address: ;wires sue slam showinh olacerent) 14 00 '
City;Stale/ZIP: Furnace !00,000 BT,] (deeis■encs) 1 14 00
Furn" 100,000+ ESTLI (Ducts ),ents) 17 90
Suite/bldg./apt. no.: I Project name:
Gas heat pump 14-00
Cross street/directions to job site: DLet work 14 00 _
I i' drenic hot water system 14.00
1 holler (rodiseer or
hy:dronic) 14.00
Urn heaters (fuel -type, not electric),
in -wall, in -duct, sus_ ended, etc 10 00
Subdivision Flue/Nan: for any of above I 10.00
Lot no.:
l Q:hcr. 1 10 00
i ax map /parcel no., Other fuel appliances
DESCRIPTION OF WORK Water heater 10 00
je' /°-'2- , r
c Grs fireplace 1 D p0
fireplace vent far water hooter or g
re '
Q ; :�pl.tcc 10 30
_
c Lcg ligh'er (gas) ; 13 00
`r4'oodipellet stove 10 00 _
Wood fireplacei.nsert : 0 00 _ _ '
I ❑ PROPERTY OWNER ❑ TENANT
Chimney line ,'Ilue, vent 0.00
/� n n Otter 303 i
Name: l� (�Xs�'l�r�..� Environmental exhaust and ventilation
Address' 1 (p 3 Z5 5 Ill- ,L,l_Pt_.2 -¢-_iC R sig hood/other lcitchcn
equipment 0 00
City /State/ZIP' C K2 . Clothes dryer exhaust 0 00 1
1 Slbgle -duct exhaust (bathrooms,
Phone: ( ) 1'2-.. «Q7-- Fax: ( ) toilet compartments, utility rooms) 6 tO
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 0,03 _ _
tius.ncss name Other I 0 Olt ��
I Fact piping
Contact name� ' 2) 1 t(j $5.40 for first four: 51.00 for each additional
Address: .
Furnace, etc.
Gas heat pump
City/State/ZIP 4alVs.ispendcwunttbaater I j
Phone. 'l v 3 )6,- q '' 2.70 4 Pax- ( C C. 3 ) ( C ' ' 70 Voter heater
Fireplace
E -mail: Range
~ -
CONTRACTOR 13arbccuc
Business name: 2_6 /,Lm C,,,,, 1;1 C,,,,, r, .t-iv //1_ / " V
(? - // ,) r 1(
C./ f Clot es dryer (gas)
Other
Address' ( Fe /3 0 3 0 3 a -7 MECHANICAL PERMIT PEES'
City,'Staia ZIP: J � � � Z f/ Subtotal
,�f ) C ?- '1 - !',1 Fax: G _ Ivfinim' m permit fee ($72 50}
Phone: (
() � y76 Plan rev.ew (25% of perrn,t fee)
7 3 s 9 '
(_:CH tic State surcharge (12% of perm ,t fee)
TOTAL PERMIT FEE ,Y S?f'
Authorized signature This permit application expires if a permit is sot obtained within 18G
days after it has been accepted as complete.
Pr tnt name. _ale: I • F e methodology set by Tn- County l3u'Idtng tndustr,, Scnice Board
I '\Au,idtnv \Poem ICLMFC•'Hmit Any dne "wrwrvs nnn 'CI — r r1. rrfl rrn..ntmn,
aep 09 09 11:21a Columbia Heating /Cooling 503 -598 -0270 p.3
•
ee ,
es
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SHE PLAN
\ \ \ Y •
"21
ADDRESS: 3 3 25 C Dr2
CITY OF TIGARD ELECTRICAL PERMIT
,: COMMUNITY DEVELOPMENT Permit #: ELC2009 -00476
GAR.O 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Date Issued: 09/11/2009
T
Parcel: 2S114BAl2400
Jurisdiction: Tigard
Site address: 16325 SW COPPER CREEK DR
Subdivision: Lot: 0
Project: O'Donnell
Project Description: (2) branch circuits for A/C and furnace
Owner: FEES
O'DONNELL, LINDA G TRUST Quantity Description Date Amount
BY TERRENCE & LINDA O'DONNELL TRS,
16325 SW COPPER CREEK 2 crt Branch Circuits 09/11/2009 $53 50
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/11/2009 $6.42
Electrical
Contractor:
BEAR ELECTRIC
PO BOX 389
DONALD, OR 97020
PHONE 503 - 678 -1355
FAX' 503 - 678 -1108
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $59.92
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: 9 MI E9 e �" Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
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.
5'P- 09- 2009(WED) 15:20 Bear Electric (FAX)5036781108 P 001/002
I
Electrical Permit Application j ` .. FOR OFFICE USE ON La'
City of Tigard S E P 0 9 200'I oaidII Permit lvo. G� U S
• 13125 SW !tall Blvd., Piped. OR 97223 Plan Review
Phone 503.639.4171 Fax: 503.598.1960 Crfy OF TIG , . k rx id
-- Other Permit.
Inspection Line: 503.639. Dale Rady(By. Jura la See Page 2 for
Tit. /MD I nttxtta tthFtw•dpand orgov BUILDING DIVISIi FffedtMn suppkmonvrl thformytioa
TYPE OF WORK PLAN PLAN R»W -
❑ New construction ® Addition/alteration/replacement - Plcnccterck all lttatapply ( wbmlejsctsafptarowtncau checked blor):
r^t QServiceor feeder 400am a
ps ormore ❑Buildingwthreestories-
0 Demolition ❑ Other where the available fault Curren ❑ Ma MIS and boatyards.
- - CATEGORY OF CONSTRUCI1ON exceeds 10,000 amps At ISO volts or 10 Floating building
less to ground. or exceeds 14.000 ❑ Comsat-mist-use arricultaral
el 1- and 2- family dwelling 0 Commercial/industrial 0 Accessory building amps for on other installations. buildings.
0 Multi - fancily 0 Master builder 0 Other ❑ Fire pump- 0 installation of75 KVA or
❑ Emergency systetn. larger separately derived system.
JOB S I T E INFORMATION AND LOCATION ❑ Addition of new motor load of D "E - 1.2 - . "1.3 ".
Job no.: Job site oddre s o C-' - e I00 or more. occupancy. r
a_.� - A II '�. • . ; , (Six or more residential units, 0 Recreational vehicle parts.
City /$tateJZl (' T' . t i M. ❑ I kai h.o laeatlors facilities.
❑ hazardous 0 supply vonage for more than
600 volts nominal.
Suite/bldg./apt. no.: Project name C75ervicoorfredcr600ampsormom
FEE SCHEDULE
Cross street/directions to job site p+.artnttoa I Qty. I Yen I Taut . � •
New residential single. or multi - Gamily dwelling unit,
Includes attached garage.
Subdivision Lot no : 1.000 sq. t. or less 145.15 4
Ea. add'1500 sq. IL or portion 33.40 1
Tax map/parcel no.: limited energy, residential
AFSGRH'[lON -OF WORK Swish abovesq. tt.1 75.00 2
13mital energy. multi - family 75.00 2
la t ` r Oil 1 Q .. % 'lull - , ictidential (with above sq. R)
Se�ees or feeders lnslallA tlon, alternlion, and/or relocation
I ' S ' 1 ` ill " li,II . \\. . r 200 amps or less 80.30 2
• '0 PROPERTY O R - • ❑ T'ENANr 201 a mps to 400 a mps 106.85 2
!dames 0 21 I �i trF�oF C 401 amps to 600 amps 160.60 2
�, J ►a �C� C 1 F -Par A Q'
601 amps to 1.000 amps 240.60 2
Address: Over 1.000 amps or volts 454.65 2
City/State/ZIP: /ZIP: relocation
T o sevices or feeders Installation, alteration, n od/ or
Phone ( ) Fax: ( ) lib amps or lets 66.85 1
Owner Installation: This installation is being made on properly that I own which is not 201 amps to 400 amps 10030 2
intended for sale, lease, rent, or occchangc, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alieratlon tension, per panel
Owner signature Date A F ee for branch circuits with
CI APPLICANT I 0 CONTACT PERSON above service or Eviler fox. 6.65 2
fee ��- mob branch circuit
Business nom= B. Foe for branch circuits
Arbour service or feeder Ice,
Contact name • first branch circuit 4fi.85 y� �(
Address: Each add'i branch circuit J 6.65 (p, (-) 2
- Miscellaneous (service or feeder not included)
City /State21P: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phones ( ) J Fax :: ( ) J Reconnect only - 6¢.85 _ 2
E -mail: Pump or itTigation citric 5140 2
_ CONTRACTOR Sign or outline lighting _ 53.40 2
Business name: Bear Electric, Inc. Signal pa or limited-
energy panel, alteration, or
Address: PO BO/ 389 intension_ DmiCrtbe: Page 2 2
City /StateZIP• Donald, OR 97020 Each additional Inspection over allowable In any of the obese
Per inspection 52.50
Phone: (503) 678 -1355 Fax: (503) 67 &1108 investigation per hoer (t hr min) 62 ______ j
CCB Lie.: 20919 / Electrical Lie.: 24 -107C ✓ Suprv. Lie.: % 7 Industrial plant per hour 73.75
- ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: �-- r --..----- Subtotal- ) J,0
Print saint :, �� `. ` _ C� +i y - Plan review (25% of permit fee):
Tyr S Z` ►�' ■ Dater: Slate surcharge (129'4 of p ermit fee): _ !�7
Authorized signature: _ TOTAL PERM FEE 5 G
1 Date: Tlia permit oppiFrstion espim If n permit it not ebwlned within Sao
Print name 111 days aster It has been accepted as complete.
• Number of inspections allowed per permit.
t Mating. 1wmm'Etr•Pmu,aAwdac QS 23 06 440- 1610(111 Or COMWED