Permit n/.
V
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00213
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/18/2007
PARCEL: 25111 BC -03400
SITE ADDRESS: 10405 SW VIEW TERR ZONING: R -3.5
SUBDIVISION: DOUGLAS HEIGHTS LOT: 007 JURISDICTION: TIG
PROJECT: BETTY GOSSELIN
Project Description: Replace electric furnace and heat pump.
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:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
GOSSELIN, WILLIAM C AND Description Date Amount
BETTY JEAN
10405 SW VIEW TERR. [MECH] Permit Fee 4/18/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 4/18/2007 $5.80
Phone: Total $78.30
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /a /// Permittee Signature: Sa, J -pi/he-GI liori
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
lechanical Permit Appli �y, FOR OFFICE l SE ()NIA
of Tigard � ��® "� f Permit No.:
• 13125 SW Flail Blvd., Tigard, OR 97223 0 7 n ®� Plau Review �� � — 002k3 p Phone: 503.639.4171 Fax: 503.598.1960 Q Date/By: other Permit:
[ [: A It 1) lospectinn Line: 503.639.4175 w lix Dace Ready/ y: >ui m See Page 2 for •
Internet, ww.tigard-or.gov Notified/Method: Supplemental information
lIVIStON
TYPE OF WORK . ''.,14,::: ':.:;.: ' . . . COMMERCIAL F$E• SCHEDULE -- USE CHECKLIST
] New construction 1:1 Additioniatteration/replace rent Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
] Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION • • • • Value. I
. RESIDENTIAL EQUIPMENT/ SYSTEMS FEES*
] 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special infor»rarion use checklist.
] Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea I Total
JOB SITE INFORMATION' AND LOCATION Headnp/coolins
ib site / Air conditioning or heat pump
��� 5-44.1 � � /P AJ1 r,' (requires site plan showing placement) f /
14.00
ity/State/ZIP: Furnace 100,000 BTU (ducts/vents) , / 14.00
uitc/bldg. /apt no.: I Project name: I Furnace 100,000+ BTU (ducts'vents) I 17.90
Gas heat pump ; 14.00
doss street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00 1
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel - type, not electric),
in -wall, in -duct, suspended, etc. 10.00
ubdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
ax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water healer 10.00
'` / /�' ��� ' c Alm f Gas fireplace en 10.00
t ! / F s T .-74 � Flue vent for water heater or gas
fireplace 10.00
j /� Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insect 10.00
[jROPERTY OWNER 1 ❑ TENANT Chimney/liner /flue/vent 10.00
Other: 10.00
lame: off. f O / - 7= / Environmental calmest and ventilation
ddress: , '/j Range hood/other kitchen
equipment 10.00
'ity /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
honr j) C , 0 Si / Fax: ( ) toilet compartments, utility rooms] 6.80
❑ APPLICANT • ❑ CONTACT PERSON Attic/crawtspace fans 10 00
Other: 10.00
.usiness name:
Fuel piping
'ontact name: h'� �' r r'ij $5.40 for first four, S1.00 for each additional
/
,ddress: Furnace, etc.
Gas heat pump
ityrState/ZIP: Wall/suspended/unit heater
hone: is--23 f3 �L/ - y -7 0 Fax: :Sl 6 -- 6 2:7 a Water heater
G Fireplace
-mail: Range
CONTRACTOR . Barbecue
f Clothes dryer (gas)
[usiness name:
I juari,..7bi i r„. i # gin / tt Cll." el. D / / O ther. I
'ddress: f� }( 4 3 3 p MECHANICAL PERMIT FEES'
:ity/StatelZIP: 7 • I 7 �- / Subtotal
d Minimum permit fee ($72.50) 2.. 50
hone: 3) 6, '-,2170 !3 Fax:( 73 5 - 9 O 6 2 7) Plan review (25% of permit fee) Fj, $'[)
'CB li c.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE 11. D
tuthorized signature: �] ') /jie This permit application expires if a permit Is not obtained within 180
� �f re
1 J
days after It has been accepted as complete.
/ 7 / 9 � /bi 1
'rint name: � Dater !a 7 /! i P • Foe methodology set by Trt-County Building Industry Service Bea
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HEATING & COOLING, INC.
P.O. BOX 230397 •TIGARD, OR 97281
(503)624 -2704
S ITE PLAN
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ADDRESS: , 'e6()
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MITC2007 -00213 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 44k2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/7 /2007 TIME: 7:00AM PAGE: 72
SITE ADDRESS: 10405 SW VIEW TERR CLASS OF WORK:
SUBDIVISION: DOUGLAS HEIGHTS LOT #: 007 TYPE OF USE:
PROJECT NAME: BETTY GOSSELIN
DESCRIPTION: Replace electric furnace and heat pump.
OWNER: GOSSELIN, WILLIAM C AND, PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC . PHONE #: 503 - 2704
Inspection Request Scheduled For: Date: 5/7 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 047650 -01 503- 62.4 -204# N
Corrections/Comments/Instructions:
• .do 14A-6,6,- S— l 24 7,5 6
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: - Date: ,5= 7- o ? Phone #: (503) 718 -
. , ,