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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2013 -00372 T LGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/09/2013 Parcel: 2S102BC00106 Jurisdiction: Tigard Site address: 10290 SW BROOKSIDE CT Project: Dickman Subdivision: WALNUT ACRES Lot: 5 Project Description: Install a /c. Placement of unit must comply with manufacturer's clearance requirements. Contractor: COLUMBIA HEATING & COOLING INC Owner: DICKMAN, ALFRED E & CLAUDIA H PO BOX 230397 10290 SW BROOKSIDE CT TIGARD, OR 97281 TIGARD, OR 97223 PHONE: 503 - 624 -2704 PHONE: 971- 409 -4657 FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Air Conditioning 07/09/2013 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 07/09/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/09/2013 $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. Issued By: �t___m J Permittee Signatu =: , idifr ,�i,� — _ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. 07/05/2013 12:31PM 5035980270 COLUMBIA HEATING PAGE 02/02 • . I Mechanical Rerm Appl a Li. ' IS FOR OI r li I': t yF. ONLY City o alga .d ® p °, Q 3 O. Permit No.: ill; , i f ' — 3 7 - 13125 S Huila] Tig /rd, OR 1�' Date/Rif: Q Plan Rarity/ / It • Phone: 5 3.7182- Fax 503.59 8 2013 tlrr Permit T I , Pi) Inspectior Line: 513.639 -4175 Dare.ReadyjBvt . runt 65 • Pace 2 for Internet tvww.t > d- or.g0v C ITVOFT'A - RD 'Nolified/MaPood: S' •Dal terermonon • V fM�l�7 " �� ' -`Sf t t` '•w t `4+t , 9 Ri 717177-.1 I ti a � i !' t ' T f: :1 i � 1 l Ili �` Mechanical permit fees' ate based on , e • v of the work ❑ New • construction [ Addition /alteration/repiaternent performed, indicate. the value (round . to the nearest dollar) of all in Demolition D other: mechanical materials, equipmctl la.. overhead. and profit. • . +t\:d .,� •• Vahte: $ , 'Y:..' . 1' : `' 'w fa1r,OfiT et+ c! _ttt:' n �'-qa i, rir� , '" � ` _nod. • ""`{I•�,v'� -may �11,°7j��„�{ �.�+'> »' ';;''" -4 I- and 2- family direlling ❑ Commercial/industrial Cl Acros-eory building For specialinfbrnwf/on se checklist D Multi- titmily ❑ Master builder ❑ Other. 1 Description 1 Qty. J Fa. Total :..,r:�.*.(;.,'C{'u , ��'_� _• ,' :0 � +�•'' l �� y -" .R i#eadnPJcogag. Job ', .. i ce' �`� - r r w � Air•comiitia f Sob site address: 1 • ' , �eC1 M AIM I i AhA i nM.rtIA•Mo n a 46.75 r!. b1Z671 T nlde�� �i Furnace 100,000 fiTt acuiveoto j 46.75 • /[-!r.r rMr _ Furnace 100,000+ BTU(duets/yenn), 54.91 Suite/bldgdapt. no.: Project name: , i♦ lcoat pump �' `�• • (i'cquiica sea pla she:Ping pldee we 61.06 Cross atrcctldirecdons to job si Duct worts; 23.32 _ • A _ F1�dr_uaie fto t.wates , em i 23.32 Resideatia of er ra 'ator or I hydronic) i 23.Jj Unit heaters (fuel -type, not eleclt it), in -well, in- ducksuaeeaded Subdivision: I_ Lot no,: ; Flue/vent for any of above 23.32 Tax ma Other Z33Z p/ � i no � � Other 11rd appliances: r„v r '. ` r" v" "' aJ : I 'I Vi to \ - 7 . 7. 1. 4 • It, Water beater � . � '�atr�:;� \I '�...nk..::�:a.:3r_�.'_ , R _r •. a , 'ace �, -, 2332 I thin o ft r• � IIiTT m t waIIIGY heater or gas' (P,as) t stove p� `. a lace/iniert ' 2332 t l rj,,; ' `a1f�> �^; : " ' h imiley /flue/yent 23.32 � �� ©LL 23.32 � arit r i �" . __ o II Environmental exhaust and veatilati m: Address: • -': . 4� .. • �y r7 /I�� ✓�1/' I7r i� garage rw 'o itc hen ! � � eglnpmen 33.39 City /State/ZIP: ii l` /r lti ` • _Clothes dryer.exhaust _ 33.39 7/1 1 � Fax Single -duct exha lbmhrnotnt. Phone s► � Fax: ( ) ■ toilet compartoients, utility rooms) 2332. 1 •d ' < 40.'',. f -e1v „ I',r . tf A f 'b ; I. c iS' irF rJ ✓, L .�S' i m _ " i Ati acrmvlSpaGe farts • , ._ 23 -32 -- other: 23.32 Rucine.4a name: Colndbia Ha flag and Cooling; inn, • - —� Fool piping: Contact name: Mgtle, a Meed I m . • Sld.ts Ali' first 3 first roue; for each additional Address: PO Box _ 30397 Furnace, etc. L Cps heat pump City /State /Z11 57281 Wall/suspended/unit heater Phone: (503) 624 -27* 1111111111. Fax: : (503) 598 -0270 Water heater fi -malt: cotomblic ' Range an R e 1, 'r .:Ik o a ' i' • qtr' '- T I, , -e, l.i '., J4 sr ,;:, �x �; e. o. o r1St C' Barbecue Business name: C olu ! bla rte dog and (soling, Inc. - Clashes dryer (ens) _ I f • Address: PI) 8nx 8 97 Oihei v -- �_,. .... -- '.•'.;''C:r,„'cr't,:s" )'3 tr.,'+s''1!Y;i s"Its. ,.• ., City/State/ZIP: Tlgur. OR Owl ; Subtotal I Minimum permit fee (590,00) 9 .vim Phone: (503) 62 Fax. (503) 598 -0270 Plan review (1ia of et�mit 4eo) r— CCBtic.: i � State surcharge (12%ofi rmitfse) 10.5'O TOTAL PELT FEE /Q() Authorized sig11attlie: 41 I ,' Tab pet met aplilftentlon aspires If o pe t is not obtained what• Ion J l .. r .. + L ` 0 days atter it has. been ACM u eomplrte. IPrint. name: Marietta 4 Meed J mote: •7 -J I $ Per inG oi.totog y yet by Tii -Cow ly Duet 'ng Industry Seraice Boan1 ! , e..!Mwnit r. m.1!�nw Mt ell 4411-46 711'11 t /mmn(v1/Wa'R1 r