Permit •
i CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit# MEC2009 -00462
Date Issued 09/02/2009
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171 Parcel 2S103DD00407
Jurisdiction Tigard
Site address 10865 SW FAIRHAVEN ST
Subdivision Lot' 0
Project. Crump
Project Description Install gas lines for range and dryer
Owner: FEES
MARK CRUMP Description Date Amount
10865 SW FAIRHAVEN ST
TIGARD, OR 97223 Fuel Piping 09/02/2009 $5 40
12% State Surcharge - Mechanical 09/02/2009 $8 70
PHONE 503 - 267 -3968 Minimum Fee Adjustment - Mechanical 09/02/2009 $67 10
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: 4 .%%a, ji Permittee Signature t,_. /L• (46970.01
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
Mechanical Permit Application E r COROI I SP•-' ONI:v' "
City of Tigard ln _ C
irr
• }3t2S SW Yell 4171 gard,OR 97223 Plan °lies +err"rtiS vO'fc
Phone 503 Fax 503 AU� 3 1209 DacJB
Date R eadYB , .. ee ry , 0 See Page 2 for
TtGAit- Inspection Line 503 639 4175 oaFedluedmd 77 2 S Suppler,' enlel lnfunnamn
Internet www ngard -or gov
CITY OF TIGARD N
TYPE OF WORJC JI ivt_I UI VIJ0irltl COMMERCIAL FEE SCHEDULE - USE CHEC}a.1SI ,
Mechanical perrmt fees' are based on the value. of the ward I
❑ New construction ❑ Additiout performed Indicate the value (rounded to the nearest dollar) ut .ill I
1 0 Demolition ❑ Otne: mechanical materials, campmate labor ode and ?do 0t
Value S r --
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES`
❑ :- 41.0 .o 2 - family dwelling ❑ CommeretaVindustnal ❑ Accessory building I For Taco! information uoe checklist
❑ Multi-Family
❑ Master oullder ❑ Other Desenpnon 1 Qty ha l oral
I JOB SITE INFORMATION AND LOCATION Ilea hag/cooling 1 —
Atr conditioning o he.: pump I : _U
!(4 � [[ e- (reywres site plan showing placement)
Job sue midi t., - Ci,-l/ Ul U 1/Jq .�+> — ite 14 00
Furnace 100,000 BTU Iductsl�enlst I
CI MS gldg / F urnace 100 BTU(d :tsvrrus l I1 v6
Suite /b ldg /opt no I Project name Gas heat pump _ — 1 CO
I-1 o0
Cross slrecldnzctions t Sob sil Duct wort I-1
Hydrant° hot water system 14 00
I Restoe:Thal boiler (radiator or
- - I hvdron'c) I41.1-= -
Unit hearers (fuel - type, not electric), ll
Subdivision I Lot no
m - wall, m - duct, suspended etc f I IC 00 -
Flue /vent for any of above _ I to oo
Other _ C Cu I -
I ax map /parcel "0 I Other fuel appliances —
Wafer heater I I O O t
DESCRIPTION OF A'OI2K Gm fireplace r,3 0'I
/f,�„ - A a , 1 202 clue vent for w Met heater o - vas
.GL/(�4 fi rep l ace It' n0
9/ drut.vr Log lighter (gas)
W J 1090 _
ood/.diet stove 10 00
Brood fire.lac insert � I0 00
Chlmnevfhnerfflce/veat i 10 00 --,
TENANT I J 0J
Range PROPERTY OWNER Other
Environmental exhaust and ventilation
Name (a/l K LAM, o nge hooa'other kitchen
Alf e ul•mert I0 tin Std
Clothes dryer edmus[ 100u
ity /State'ZIP I Single - duct exhaust (bathrooms, 6 0 --
�-, / 4.i ,..33 /e Fax ( ) to corn paryrcnis uuhty rooms)
Phone ( ) U7 Attic/crewlsnace fans I I 10'00 i - -
❑ APPLICANT ❑CONTACT' PERSON Other _ I 10 03
Business name piping
�/ 55 for first four. SLOO 00 for each add«;onal
Cunac'rmne� � R / Furnace e I _____
,c ddress. __ Gas hear Oran
W alVsus•endcdrunit heater — 4-- ---
Cuy; Stzte(L!P _ .- Waterheater
Phone 5---;7-3 ) (9i q �;17D+J Fan) ( 9�`- 0 / O ; ire.lace — I �
Ran.e
t -marl —
_ ID coo ' -
! CONTRACTOR B Cloth drver (ass) _ —I
Al L s7 b �! (o��l r Other. I
Business :tame • —
MECHANICAL PERMIT FFI S•
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Plan rot row (25 of permit fee; _ -
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