Permit �. CITY OF TIGARD
. . ;;
74 MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00024
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/14/2009
PARCEL: 2 S 114 B B - 04100
SITE ADDRESS: 16535 SW GREENLAND DR ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.1 LOT: 055 JURISDICTION: TIG
PROJECT: KELLEHER
Project Description: Install (4) gas lines for tankless water heater, barbeque, range and clothes dryer.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS: 0
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:
CLO DRYERS: 1
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 4
> 10000 cfm:
Owner: FEES
KIM KELLEHER Description Date Amount
16535 SW GREENLAND DR
TIGARD, OR 97224 [MECH] Permit Fee 1/14/2000 $72.50
[TAX] 12% State Surch 1/14/200C $8.70
Phone:
Total $81.20
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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: R <1 " 1 1 111 Permittee Signature: ( � ` Q 1, 0 ,, q cy ,e 1
Call 503.639.4175 by 7:00 a.m. for inspections 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.
W _ 13 09 02:08p COLUMBIA HEATING 503 - 598 -0270 p.1
.' ii.
k___,..
Permit Application f� \ , j OFFICE VS'E ONLY •
� � ° Y r /1� fir. 1
T e r Y a4 0 - i • l3 • as m tx ecz • 000zq
Da rece Permit #
�- • ^. JAN a ; 2009
• . • .• Date Issued: By: Receipt:
TYPE OF WORK CrrY0F1 •, I
BUILDING DIVISII COMMERCIAL FEE SCHEDULE - USE CHECKLIST
❑ New construction Calydditiodalteration/rep acement r Mechanical permit fees are based on the value of the work performed. Indicate.
❑ Demolition ❑ Other: the value (rounded to the nearest dollar) of all mechanical materials,
equipment, labor, overhead, and profit
CATEGORY OFI CONSTRUCTION
®'i- and 2- family dwelling ❑ Comrircrcia /industrial Value: S
❑A tybutldmg RESIDENTIAL EQUIPMENT / SYSTEMS FEES
❑ Multi - family ❑ Master builder ❑ Other.
For Special information use checklist
JOB SITE INFORMATION AND LOCATION Description I Qty. 1 Ea. Taal
Job site address: / /) Heating/cooling
Furnace, inel ductwork, vent, and liner 15.00
City /State /ZIP: ' 7:54,_,,,,,r" 0 /, 7 Z- Zt_. ,
T / Air conditioner (site plan required) 15.00
Suite/bIdg. /apt. no.: Project name: A /de Heat .um. (site plan required) 15.00
Cross street/directions to job site: Duct work. alterations and additions 1 15.00
H dronic i.in• stem 1 15.00
•
Residential boiler (radiator / hydronic) 15.00
Unit heaters (fuel -type, nut electric),
in-wall, in -duct, suspended, etc. 15.00 _
Flue/Vent for an of the above 15.00
Subdivision: Lot no.: Other:
Tax map /parcel no.: Other fuel appliances /0'00
Water heater
DESCRIPTION OF WORK Gas fireplace/insert'stove I 15.00
�� ` j Gas log/log tighter _ 15.00
A J�t,, j� 'r i � ,�, llet - Pool or spa heater, kiln'
^' 15 -00
15. jL r3 4 2.y 1 r "-" "n' i# Wood/ stove /insert
Wood/pellet 00
1 Wood fireplace 15.00
Chimney /liner /fue/ventw /o appliance 15.00 _
I
- -- Oil tanks/gas/diesel generators 15.00
PROPERTY OWNER ❑ TENANT Other:
Name: ki fit i 1 ' J I e, 4.-e Environmental exhaust and ventilation
Address: 535 5 / te � / Range hood/other kitchen equipment 15.00
r t �`*�zP/I /j, d
th
Cloes dryer exhaust
� / J&�i0 Od
•
City/State/ZIP: J J 4 t5 A__ 97 2. 7 f Single -duct exhaust (bathrooms, toilet
[-
J r compartments, utility room_ s) 15.00
Phone: 57 3 72,7 /U /4 i Fax: Atticicrawispace fans _ 15.00
APPLICANT 1 Whole house ventilation or Radon — 1 —
mitigation _ 1 15.00
Business name: Other:
__ t
Contactname: j,r a Fuei .i in• • HO or �; • ' .Ua . -
Address: 1
$�S9C1 for first four; 0 for each additional
I Furnace
City/Sutte /Z P: 1 Wall/suspended/unit heater
Water heater .
Phone:, j - & 2 L' -a?a V 1 . Fax51).3 , (' -6 -)7d Fireplace/log lighter /gas log
I
E -mail
Ranee AO
CONTRACTOR Barbecue
J Clothes dryer
Business name: P,1 hJ C� 41-Z- - - f e / - Other: Total Outlets
Address: ` r )3 O X 3 3 MECHANICAL PERMIT FEES
� ; / 7 G /
Fee Type 72 -pO Amount Date Paid
City/SrateJZfP -
17 it , 0�� t
Phone: ? L Fax Permit F ee (minimum 6410) 72 .5c
•
✓ ��)- q — �7Q 11 3 5-9',P-0-76 Plan review (65 %of
E- mail: /144011 G Q t� G e' Fire, life axfety (45% of permit fee) .
CCB tic,: City or metro lie.: State surcharge (12% of permit fee) ". - 0
/FZ / r� TOTAL PERMIT FEE + , O
Authorized / This permit application expires if a permit is not obtained within 180
ur
signate: / — days after it has been accepted as complete.
Print name: �,1 �C Date: _l' / _71 " Fee methodology set by Tri- County Building industry Service Hoard
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC1009-00024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /14/2009
Phone: (503) 639- 4171 mpTM'lI
Inspection Requests (24 Hrs.): (503) 639 -4175 M ' 'I__..
INSPECTION WORKSHEET FOR DATE: 215/2009 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 16535 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO,1 LOT #: 0355 TYPE OF USE:
PROJECT NAME: KELLEHER
DESCRIPTION: Install (4) gas lines for tanless water heater, barbeque, range and clothes dryer.
OWNER: KELLEHER, KIM PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503624-2704 -
Inspection Request Scheduled For: Date: 215/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 080306.01 197- 372 -7101 N
Corrections/Comments/Instructions:
( rr S 7 9°Z/
•
4i r PAS . V PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I FAIL //CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
IO P hone #: 503 718- z6. Inspector: � � Date: � ( )
v.
1%6
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2t109.00014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1412009
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): ( 503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/3/2009 TIME: 7 :00AM PAGE: 9
SITE ADDRESS: 16535 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO,1 LOT #: 055 TYPE OF USE:
PROJECT NAME: KELLEHER
DESCRIPTION: Install (4) gas lines for tankless water heater, barbeque, range and clothes dryer.
OWNER: KELLEHER, KIM PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624 -2701
Inspection Request Scheduled For: Date: 2/3/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 080220 -01 503 -624- 2704 N
Corrections /Comments /Instructions:
I \lo6 Rv1 -;° t _.
PASS • PARTIAL APPROVAL n CANCEL I I NO ACCESS
i
�, FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date. V 1 Phone #: (503) 718-
CITY OF �*mm m n~�m nn�m��nm��
BUILDING DIVISION PERMIT #: MFC20O9'00024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/14/2009
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2y3/2009 TIME: 7:O0AW1 PAGE: a
Dwttb4 / ^� 6f-a=4 1 )8 "�
SITE ADDRESS: 16535EtAl GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.1 LOT #: 055 TYPE OF USE:
PROJECT NAME: KELLEHER
DESCRIPTION: Install (4) gas lines for tankless water heater, barbeque, range and clothes dyer.
OWNER: KELLEHER.K!K4 PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624-2704
Inspection Request Scheduled For: Date: 213/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 080229-01 973-727-1016 �Y �
Corrections/Comments/Instructions:
•
•
I I �� RART|ALAPPR�\A\L � ��NOAC(�ESG
/ / / / \^ ��
|| FAIL III CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
' - ~��/^
� '7 h ����
Inspector: A � ���m��~� Date: /�-/ �\ / `� / Phone #: (503) 718- c-~~� /
' "� - � ( `'/ / � ` '
• ' /
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ;
IdiF "t Ufisr0'74
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/14/2009
Phone: (503) 639-4171 ma. �p4tlf il
Inspection Requests (24 Hrs.): (503) 639 -4175 :L' 1..!,..,
INSPECTION WORKSHEET FOR DATE: 1/20/2009 TIME: 7:00AM PAGE: 44
SITE ADDRESS: 16535 SW GREENLAND DR CLASS OF WORK:
SUBDIVISION: PICKS LANDING NO.1 LOT #: 066 TYPE OF USE:
PROJECT NAME: KELLEHER
DESCRIPTION: Install (4) gas lines for tanldess water heater, barbeque, range and clothes dryer.
OWNER: KELLEHER, KIM PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 -624 -271
Inspection Request Scheduled For: Date: 1/20/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 079815 -01 973- 727 -1016 N
Corrections /Comments/ Instructions:
Pj VF .or
pu, "o (5HL) 0 1
1.- . , ,..., in, —.7-84 V
PASS ❑ PARTIAL APPROVAL ❑ CANCEL f{ NO ACCESS
n FAIL • CALL FO' INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �� Date: Phone #: (503) 718 - - 1,