Permit t� I
C
' Pr ITY OF ‘ TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00509
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/21/2007
PARCEL: 2 S 110 D D - 01100
SITE ADDRESS: 15940 SW GREENS WAY ZONING: R -12
SUBDIVISION: SUMMERFIELD LOT: 089 JURISDICTION: TIG
PROJECT: SMITH
Project Description: Replace gas line to furnace and fireplace.
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:
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: 2
Owner: FEES
BOYCE SMITH Description Date Amount
7400 SW FAIRWAY DR
WILSONVILLE, OR 97070 [MECH] Permit Fee 8/21/20W $72.50
[TAX] 8% State Surcha 8/21/2007 $5.80
Total $78.30
Phone: 503- 880 -5843
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.
1
Issued c / 1 11 / 1)/// Permittee Signature 9 gf
� �
Call 03.639.4175 by 7:00 a.m. for inspections that business d
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 FOR OFFICE USE ON IN
I N • City of Tigard • Pt�ntit xa.:
23 1 25 SW Hall Blvd., Tigard, OR • ' ei ECEIVED
Date/By: _I /t "� /
Plan Review
Phone: 503.639.417] Fax: 503.598.194) G 2 l • r
,, D Other Permit.
Inspection Line; 503.639,4175 /�
Ttt'i.1R1] DateReadytBy RI See Page 2for
. Internet; www ,1igard- or.gov * Of Notified/Method: Supplemental Information
MY t6o��B! iI
TYPE OF.� : ':CONLIKERCIAL FEE* SCHEDULE - USE CIIECIOAST
Mechanical permit fees" are based on the value of the work
❑ New construction ❑ Addition /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
. • • CATEGORY OF CONSTRUCTION ` • .. Value: $
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building EQUIPMENT /SYSTEMS FEES"
For special information use checklist.
❑ Multi -family } ❑ Master builder ❑ Other: Description Qty. I Ea. Total • . . JOB SITE INFORMATION AND LOCATION - - • • • Heating/cooling
/ Air conditioning or heat pump
Job site address: ✓ 5 Jd r S2 -U / � i 2e -e-A !/ / >S d t (requires site plan showing placement) 14.00
City /State/ZIP: // �f Furnace 100,000 BTU (ductsvents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
SuiteJbldgJapt.no.: Project name: Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
Flydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
1
i Unit heaters (fuel -type, not electric),
in - wall, in - duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue/vent for arty of above 10.00
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK , :. Water heater 10.00
�' Gas fireplace 10.00
r=', /..- Cr", Qom! .5 / 4_ a - e Flue vent for water heater or gas
!/ � / fireplace 10.00
2 ! Ar G' Log lighter (gas) 10.00
i Wood/pcllet stove 10.00
Wood fireplace/insert 10.00
• )4 - PROPERTY OWNER ill TENANT
Chimney/liner/flue/vent 10.00
/� . Other: 10.00
Name: `��7C r" . Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
. Single -duct exhaust (bathrooms,
Phon, 5"If7) 5 - 7 ,5 Fax:( ) toilet compartments, utility rooms) 6.80
I ❑ APPLICANT ❑ CONTACT PERSON • Attic/crawlspace fans 10.00
Business name: Other; 10.00
Fuel piping i
Contact name: r ' r rljj Y S5.40 for first four; $1.00 for each additional
Address: Furnace, etc. J f5.4() '
Gas heal pump
'. City /State/ZIP: Wall/suspended/unit heater •
Phone: cS-13 f, )- `Y -2-7 0 14 Fax: :V l -C-It? - 6 .P-7 6 Water heater
E-mail: Fireplace / el
Range • • - ' • - CONTRACTOR . .. • Barbecue
1 l Clothes dryer as)
Business name: Jy tU?2O/ c" e O/ 7 / d - 0 !! I
Y Other:
Address: x D 3 . MECHANICAL PERMIT FEES* I
city /State /Z P: vp G� 7?-' l Subtotal
2 �p i Minimum permit fee ($72.50) 72.60 Phone: J ) 7 /1 Ftlx:�' Q L �D Plan review (25% of permit fee)
CCB lic.: ! !I State surcharge (8% of permit fee) 5. s
// TOTAL PERMIT FEE _ 7S' .30
Authorized signature />�‘/f/ ,. 2% /6 1/ This permit application expires if a permit is not obtained within ISQ
J days after it has been accepted as complete.
Print name; a Date: .. 1 • Fee methodology set by Tri- County Building Industry Service Board
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° CITY OF TIGARD'-
BUILDING DIVISION PERMIT #: MEC2007- 00509
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: W21/2007
Phone: (503) 639 -4171 A it
Inspection Requests (24 Hrs.): (503) 639 -4175 � ' W' ` _..
6 /30/2.007 TIME: 7: 00AM
INSPECTION WORKSHEET FOR DATE: TIME. PAGE: 38
SITE ADDRESS: 15940 SW GREENS WAY CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 089 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIPTION: Replace gas line to furnace and fireplace.
r OWNER: SMITH, BOYCE PHONE #: 503 -880 -5843
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503 - 6242704
r Inspection Request Scheduled For: Date: 813012007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 . Gas line 054865 -01 503- 624 -2704 N
Corrections /Comments /Instructions:
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PA : PARTIAL APPROVAL f l CANCEL ❑ NO ACCESS
='' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,Inspector: _ Date: 9._ 3e --- a7 Phone #: (503) 718- 2-44-4.-