Permit 71
. CITY OF TIGARD MECHANICAL PERMIT
.,..... q
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00048
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/29/2008
PARCEL: 25111 CC -22500
SITE ADDRESS: 10370 SW GREENLEAF TERR ZONING: R -12
SUBDIVISION: SUMMERFIELD NO.5 LOT: 283 JURISDICTION: TIG
PROJECT: LOOMIS
Project Description: installing 15 ft. gas line to barbeque
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:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
LOUISE LOOMIS Description Date Amount
10370 SW GREENLEAF TERRACE
TIGARD, OR 97224 [MECH] Permit Fee 1/29/200E $72.50
[TAX] 12% State Surch 1/29/200E $8.70
Total $81.20
Phone: 503 - 524 -9188
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
� Permittee Signature: 5jQ-2 � �,��
Call 5 ar_D-
by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
sf I
i
J -
, ~ Mechanical Permit Application FoR outer ri 1sT_ ONLY
City of Tigard Received i Perm"- n Q LlQ
13125 SW Hall Blvd., Tigaz O � Da yt a 0 / / eCSDO5 -- d� 7 O
ri. Phone: 503.639.4/71 Fax: 503.59$;1646022, (1� '(11!., � Y Other Pcrn�it:
•.'i Dat e V`
Td G A R D Inspection Line. 503.639.4175 J NH �V
�
Date Ready/By: Jun El See gage 1 for
Internet: www.tigard or.gov Ct� [1131. Notified/Method: / �
l � r S upplemental Information
ORK. . .COMA RCIAL k LE' SCHEDULE - USE CHECKLIST
0 New construction Addition/alterationfreplacemenf Mechanical permit foes' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition C1 Other
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF _ CONSTRUCTION . Value: S
d 2-family dwelling - ? ESR1EN TIAL EQUIPMENT / SYSTEMS FEES*
y g 0 Commercial/industrial ❑ Accessory building
❑ Multi- family Master builder For special information use checklist.
Oth er' Description
Qty. Ea. Total
. • • , • . JOB SITE INFORMATION AND LOCATION . . . . Heating/cooling
Job site address: C,2_0,_ Air conditioning or heat pump
0 7 6 J u, , t' Y ^tom, / az r' r t A. . (requires site plan showing placement) 14.00
City /StateiZIP: -11 ni -) 22- I Furnace 100,000 BTU (duets/vents) 14.00
Suite/bldgiapt. no.: Project name: 1,.,..00 M j I-- Furnace 100,000+ BTU (duets/vents) - 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
I Hydronic hot water system 14.00 ; I
Residential boiler (radiator or
I hydronic) 14.00 .
Unit heaters (fuel -type, not electric),
in -wall, in- duct, suspended, etc. 10.00
Subdivision: 1 Fiue /vent for any of above 10.00
lot no.:
' Other: 10.00 .
Tax map /parcel no.: Other fuel appliances
. DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00 1
I 1 o-z , ( . 0 1 9 1 1
— r".) S.. e S F r Flue vent for water heater or gas
- _ fireplace 10.00
_ _. Log lighter (gas) 10.00
/to boric) u \ Wood/pellet stove 10.00
Lp -c.,f (_a,� is 1 0 Wood fireplace /insert 10.00
PROPERTY OWNER I \ 0 TENANT . I Chimney/linerltlue/vent 10.00
f 1 .-0 G
Other r nm r!� 10.00
V
Name: 0 v r" 3 '' � ' C.L 5 � " C� `--_ Environmental exhaust and ventilation
Address: j U j - c 6 v - e � Range hood/other kitchen
C S �� ? r' ct C 'z- equipment 10.00
City /State/ZIP: -- 7 - 1.. r , 7 Z7_-/ Clothes dryer exhaust 10.00
5 ` Single -duct exhaust (bathrooms,
Phone:
(5 L1 ' ci 1 S c; F a x : ( ) toilet compartments, utility rooms) 6.80
0 APPLICANT • 9 CONTACT PERSON .. Atticicrawlspace fans 10.00
Business name: Ether. 10.00
7� R. l Fuel pi
Contact name. ,0 r) 1 a y 35.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: ] I j Wa]Ustlspendedlimith0ater t
Phone: {
�b 3 )6 r � 2. 7 0 11 Fax: 9CJ c 6D -2 Water heater
E -mail: F Pf•AC Une._ 1
Range
CONTRACTOR Barbecue
Business name: l , 11 c.. / n �, f � Clothes dryer (gas)
l�tf V Other:
Address: (FO %D o X _2-3 et 3 g -7 . : . MECHANICAL PERMrr'FEES' . •
City /State/ZIP: / I s 4 . 2,4) d , 9- P Subtotal
Phone: (57 3) b ?- `? - ]-'70 Fax ( ) s-Ve? — 0 y-70 Minimum permit fee ($72.50) '7a; SD
CCB lie.: 3 S� ! ' Plan review (25% of permit fee)
- State surcharge (12% of permit fee) IC, '
TOTAL PERMIT FEE 1 j e )
Authorized signature: ®`�� � This permit application expires if a permit is not obtained within 180
�' y days after it has been accepted as complete.
Print name: "47 Z //h ! Date: ///j? / c/ • Fee methodology set by Tn-County Building Industry Service Board
t ^Builaingl'eanntsI EC- Pcrmi :App.doc 64/06!06 440 - 4617x( 1112.e.AM.WEAI
Z OLZO DNLLV3H VI8Wl100 0 l,C :60 90 6Z ref
C flYOF TIGARD
BUILDING DIVISION PERMIT #: MEC2000.00348 -
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/3000
Phone: (503) 639 -4171 / i 4Pl l
Inspection Requests (24 Hrs.): (503) 639 -4175 W "If
IL.
INSPECTION WORKSHEET FOR DATE: 2/7/2000 TIME: 7 :03AM PAGE: 37
SITE ADDRESS: 10370 SW GREENLEAF TERR CLASS OF WORK:
SUBDIVISION: SUMMERFELD NtO LOT #: A33 TYPE OF USE:
PROJECT NAME: LOOM'S
DESCRIPTION: installing 15 ft. gas line to barbecue
OWNER: LOOMIS, LOUD E PHONE #: 503- 524 -91M
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-6242704
Inspection Request Scheduled For: Date: 217/2008
Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 GEas line 064659-01 503.624-2704 N
Corrections/Comments/Instructions:
°PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4.0b Dat e: Q ` 0% Phone #: (503) 718-07-20S