Permit CITY OF TIGARD MECHANICAL PERMIT
III Im . COMMUNITY DEVELOPMENT Permit #: MEC2012 -00433
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/20/2012
Parcel: 2S111DB09500
Jurisdiction: Tigard
Site address: 15555 SW OAKTREE LN
Project: Casciato Subdivision: SUMMERFIELD NO.10 Lot: 583
Project Description: (1) A/C installation Must maintain 5 side yard setback and approved rear yard setback
Contractor: COLUMBIA HEATING & COOLING INC Owner: CASCIATO, DARIO J & JOANN
PO BOX 230397 15555 SW OAKTREE LN
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 08/20/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/20/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/20/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
\, .800.332.2344. /� /�,,�
Issued By: 1/4y'L(_6'[ii Permittee Signature: DA I Goo K) 1 Oki_ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. n
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.
COLUMBIA HEATING PAGE 02/03
09/16/2012 12:35PM 5035980270
echanical Permit A lice
.� rcptOII I,l',FO \( .1
• City of Tigard - �'l � R E� Z
13125 SW Hall Blvd., Tigard, OR 97223 ~�� � n D ap � (..- Permit Naga fa .
a Phone: 503.718,2439 Fax: 503.598.1960 p 1 „� : ew
• ction line : 503 .639.4175 D Date/By: Other Renoir
I I (; ;\ is t) Date Ready/By: Tura:
Internet www.tigard-or.gov
el See Page 2 for
blotMed/Method ! Supplements) Information
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7 _f MI I }. • ....[ 'e�L � ^__ , 1. ^_i ..� . ,;..�Y�' ..u....xu� •��1.e1�.au.w 1
Q New construction II Addition/alteratl .N M ,O..1 1r r (� 14 Mechanical permit thee• are based on the value of the wort;
❑ Demolition B 1 I DIVISION performed. Indicate the value (rounded to the nearest dollar) of i
❑Other
: } � i . r I T mechancal materials, equipment. Value: S labor, profit.
yy o ethead, and o
r
j �..,.:__ .�:..� ' .. , •..•a:,. ;2 ii � : is :t<a : c ' l' is 1.,:,'''; • • 1 and 2- family dwelling ❑ Commercial/industrial °��'' .,
❑ Accessory building
For O” �` checklist.
❑ Multi - family 0 Master builder 0 . E
x ,? , K T Other: Description o ral
_ 1 Qty. ea r
L I i; ). i ; f I r Heetin: cools .
y1 1
City/State/21P 1
` 2,1 1 111 BT1J Wilms/vents) 46.75
Furnace 100,000+
Suite/bldg./apt. no.: Project name; Heat pump -
r- . mires site Cross streetfdirections to job site: 1
Duct work 23.32 •
Residential boiler (radiator or
•
Subdivision: �
Lot no Flue/vent for any of above 23.32
Tax map /parcel no.: Other 2332
Other fuel appliances: _
- ? " I l i ` :i , ' i" ,,` L S , _.z Water heater 23.32 _
/ f Cas fi 33.39
r Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
•
_
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
' S t F IY: G). t I I , .ri: I 1 , < ,- '� cy flue/venl 23,32
1 ( / Chtmn /illler/
. �r� OthCr: �
i _ 23.32
—
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
City /State/21P: equipment 33.39
Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single - duct exhaust (bathrooms,
..,,,r. s toilet compartments, utility rooms) 23.32
;„ v r . k 1t 0 ,'; , • A ttic/crawls,ace f ans 23.32
' Business name: Columbia Heating and Cooling, Int. Other - 23.32
Contact name: Marlene Meedom Fuel in::
$14.15 for first four; S4.03 for each additional
Address: PO Box 230397 Furnace, etc.
City /State/ZIP: 97281 Gas heat pump
•
Wall/suspended/unit heater
Phone: (503) 624 -2704 Fax; ; (503) 598-0270 Water heater
E -mail: eolumbbe@telepot•t.com Fireplace
ytyY Ran _ e • --_: Barbecue
Business name: Columbia Heating and Cooling, Inc Clothes dryer (gas)
Address: PO Box 230397 Other
,-
City /State/ZIP:T Tigard, �� = ' , 'i; , iura�; , : .
Subtotal
Phone: (503) 624-2704 Fax: (503) 598 -0270 Minimum permit fee (590.00)
Plan review (25% of permit fee)
State surcharge (12% of permit fee)
TOTAL PERMIT FEE (j -
Authorized si . 1 . 1 _o
• ire• 11 ' / it permit application expires if a permit is not obtained within )80
/ � I1 days atter It has been accepted as complete.
ene 9 Print name: Marl Meedom • L Date: I • Pee methodology set by 7Yi -County Building Industry Str%isc Bead
i
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60/60 30Vd
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9NI1V3H dIHWIl100
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