Permit 1 n CITY-OF TI GA RD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00632
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/30/2007
PARCEL: 1 S134AC -02645
SITE ADDRESS: 11030 SW COTTONWOOD LN ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.3 LOT: 211 JURISDICTION: TIG
PROJECT: KONSTEN
Project Description: Replace gas water heater venting.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: BOILERS /COMPRESSORS HOODS: •
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
TINA KONSTEN Description Date Amount
11030 SW COTTONWOOD LN
TIGARD, OR 97223 [MECH] Permit Fee 10/30/200 $72.50
[TAX] 8% State Surchar€ 10/30/20C $5.80
Phone: 503 - 590 -3321
Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC by
calling 503. •....'• ■ 1.800.332.2344.
Is ued By: 10/1/ , (��X22 � Permittee Sig
• Call 503.639.4175 by 7:00 a.m. for inspections to •usiness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
"ElECEIVE
Mechanical Permit Appticati FOR OFFICE FSI_ ONLY
Cl of Tigard . Received Puxtnit No.;
City g OC � 2 ,� 2007 Daiei y: /0 04f9 D A Wee,,00 P--0063
13125 SW Hall Blvd, Tigard, OR 97223 Plan Phone: 503.639A171 Fax: 503.598.1961 TY OF 116AR® Date/By: Other Permit:
T 1 t , A It b Inspection Lint: 503.639.4175
BUILDING p� Dt Rate Ready!$y: 21 See Page 2 for
Internet: www.tigard- or.gov �'��� Notified/Method: Sup plemeotNl forgo ytiau
TYPE . OF WORK : COMMERCIAL .FEE* SCHEDULE — USE CHECUIST "
• c] New construction ❑ Addition/alteration/replacement Mecllal pennh fees arc bated on the value of the w '
performed. Indicate the value (rounded to the nearest dollar) of all '
❑ Demolition D Other: mechanical materials, equipment, labor. overhead, and profit.
' CATEGORY OF CONSTRUCTION Value-. $
RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Markel builder
Q 0th Description I Qty. J Ea. I Total
JOB STIE INFORMATION AND LOCATION • •. treatise/cooling
Job site address: /1& c 7 P � ' G t J Ca / I2Dn /v , f Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,0004- BTU (duetelvents) 17 90
Suite/bldg., apt. no.: 1 Project name: Gas heat Qump 14.00
Cross street/directions to job site: Duct 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
i
Subdivision: 1 Lot no.: Flueivent for any of above 10.00
Other: 10.00
Tax map/parcel no.: Other fuel appliances i '
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
•
g_ G y i Gt) .a Flue vent for water heater or gas
fireplace
i 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood frreplace/insen _ 10.00 .
Chimney/liner /flue/vent 10.00
ti 'PROPERTY OWNER ...:‘,...r.:.... Other: • 10.00
❑TENANT ':::-
�lame: -----
/Ai a '(6YJ ' . Environmental exhaust and ventilation
Address: Range hood/other kitchen •
equipment 10.00
City /State/ZIP: Clothes dryer exhaust : 1 0.00
/ Single -duct exhaust (bathrooms, i
Phones"? 3) „.5 ,'J / Fax: ( ) toilet compartments, utility rooms) ' 6.80
❑ APPLICANT . ❑ CONTACT PERSON Attic/crawispace fans 10.00
Other:
Business name: 10.00
Feel piping
Contact name: } / J 55.40 for first four: SLOP for each additional
Address: Furnace, etc
pas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: c 13 /,., - — 3;7 0 1L F ax: :�J�l 5 6 '-7 O Water heater
Fireplace •
E-mail: T
Range
" CONTRACTOR. Barbecue
J� p J Clothes dryer (gas)
Business name: 1 e ur ,l a.. } AVI 7 f ri? /
1 Qfher:
Address: D K c2 D MECHANICAL PERMIT FEES*
City /State/ZIP. f ! )p 9 J 7 LF / Subtotal
� n 2 / G7 Minimum permit fee ($72 "50)
Phone: 3) •�� 7p LL Fax: l t — U (25% P lan review (25 /o of permit fee)
CCD lic.: State surcharge (8% of permit fee)
r TOTAL PERMIT e mt in ot o trtained within ISO
FEE
r
t This permit application expires if a permit is n
Authorized signature: days after it has been accepted as complete,
Print name: /7.p /�� , Date: 7 ' / / / ' Fee methodology set by Tri -County Building Industry Service Board
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CITY OF
BUILDING DIVISION PERMIT #: ht�20t�7 On532
D AT
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/30/2007
Phone: (503) 639 -4171 _ ME
C2007
Inspection Requests (24 Hrs.): (503) 639 -4175 r:_..
INSPECTION WORKSHEET FOR DATE: 11/1512007 TIME: 7:01AM PAGE: 50
SITE ADDRESS: 11030 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO3 LOT #: 211 TYPE OF USE:
PROJECT NAME: KONSTEN
DESCRIPTION: Replace gas water heater venting
OWNER: KONSTEN, TINA PHONE #: 503.590 -3321
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 -624- 2704
Inspection Request Scheduled For: Date: 11/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 059595 -01 503-624-2704 Y
Corrections /Comments/ Instructions:
/A n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Date: // ""75 "" Phone #: (503) 718- 1-4'5----