Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2013-00593
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2013
TIGARD Parcel: 2S111 DB08700
Jurisdiction: Tigard
Site address: 15430 SW OAKTREE LN
Project: Bulkley Subdivision: SUMMERFIELD NO.10 Lot: 548
Project Description: Replace A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance requirements.
Contractor: COLUMBIA HEATING&COOLING INC Owner: BULKLEY, RICHARD L
PO BOX 230397 CARRISH-BULKLEY, SHARON A
TIGARD, OR 97281 15430 SW OAKTREE LN
TIGARD, OR 97224
PHONE: 503-624-2704
PHONE: 503-747-0329
FAX: 503-598-0270
FEES
Specifics: Description Date Amount
Air Conditioning 10/09/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 10/09/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 10/09/2013 $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: Permittee Signature: O� t/OL/e��O'V'
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.
10/03/2013 12:25PM 5035980270 COLUMBIA HEATING PAGE 03/03
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Mechanical Permit A li 1 1L'ri V rrl 1pIU f � ���Jl 1,012 OFFICE F; O,Nt.ti
City of Tigard Received .•�. �yEWQ1��OS9-1
nn T Deceive: /0 9 /3 �:'r Pump Nn,:
N.__y 13125 SW Hall Blvd.,Tigard.,OR 972;1,iC 1 3 2013 p( Rdvia�•
Q . Phone: 503.718.2439 Fast; 503.598,1960 Olhe Permit:
r 1 r,,t i t r, inspection Line; 503.639:4175 CO A A Date/Re .
d I Y �tl U�f�Y�� Caro Ready/By: lull.: 0 See Page 2 for
Internee www.tigard-or.gov r 1 t 0 f NodfattMlethod: / _ Supplemental Information
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ht . -7a.,h— . _ -- - - �,a�xwy„��srar,��:n.. _ ,1. • - 5. _
.- . ^•�1�... .[�.:> :..= . ^;dil �vf•�..�` /..u �,.t'/�„ V..•�1� -w�� j"+._1::16.4L1�!,•�,rv5• r
',`;f. - t Mechanical
Q New construction ViAddition/altcration/replacement pt trait the arc (rounded on the then are nearest wed:
pert-united,Indicate die value Uoundcu to the neatest dollar)ai'aii
❑Demolition 0 Other: mechanical materials,equipment,labor,overheadt and profit
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Value:atilu e:S 1pp:N';';-'-'5,-1, ..,_: l l x•n 0 .� �ka f;��l � �f i F t , ,+W ,1 t ` 1 .
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1131-
and 2-family dwelling 0 Commercial/industrial ❑Accessory buildin b Fat special lajorm c8or are cbccklsi p 1 +1
[]Multi-family 0
HF ..:..'_.r•...,•..Master builder ❑Other ., _c Description
C Qty. , Ea Tots
:, :,te� t 1'Ypas 1\ glti r �.5 `,�H'ctrl.r'T Heating/cooling: l�t
Air conditioning
Job site address: M i EMATINg i ` (requires site ptlan.showlrtaolaeentorttl 1 46.73
City/State/ZlP: i ai,i Furnace 100,000 BTU(ducts/vents) 46.75 _
—
—"`_ Purace 100.000s-BTLI(duds/vents) 54.91
Suite/bldg./apt,no.: Project name: _ M Heat pump
^(requires site plan ihoivina pleeanentL 61.06
Cross street/directions to job site: Duct work 23.32
N jydronic hot water system 23.32 t
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
•
in•.Wall,in-duet.suspended,etc. 46.75
Subdivision: Lot no; ^Fllie/wont for any of above 23.32
~ — � - Other: 23.32
Tax map/parcel no.;
•
' Other fuel appliances:
: M ,1 d A. �aV l77, , i)( �:., 1 ,OL,41? Water heater L 23_.32
' ^
/ Gas fireplace 33.39
_I '. a ` _ '� - _ ' Fhre vent for water heater or gas
fireplace 2332
t-9g lialiter(pas) 23.32
— Wood/pellet stove .33,39
Wood fireplace/insert I 2332 -
-.',n i h$;<t.:i w. :I,.2!.:,- -i.1 5'x tr., }7 t r tafl A I , _ b..t,,,., ChimneYAinehq ue/vent 23.32
• ."+,• :r•. Other, 1 23.32
Name: �f S�J. r� �' f;nvlr onmentrtl exhaust anU_Ventifat1.n: _
Address: 5 . Ti1th , Range hood/other kitchen
~"- equipment 33.39
City/State/21P: �''/ 11J1 Clothes dryer exhaust 33-39
( ,-...
Phone: 7 ?Man. Fax! ) Single-duct.exhaust utilirooms.
c „_, � F . x,-0,. toilet compartments,utility rooms) 23.32
r:;'-9 �4,,,,3.j,s , a+', y.;ry (u ,- n ii, ' `;�y c« a .1:',.‘1.,•:r Attic/cm •..roe thns 23.32
Business name:Columbia Heating and Cooling,Inc, Oilier 2332
—___ Fuel piplatm
Contact name;Marlene Meedom 514.15 for first foal($4.03 fo each additional _
Address:PO Box 230397 Furnace etc.
Gas heat pump
chy/$laic/ZlP:97281 Wall/sucpended/unitheater ,
Phone:(503)624.2704 Fax::(503)598-0270 wire Matter
Fi .lame
E-mail:cotumbbe(g1rercport.com
. - .•..; i r, ! s_+
' "?id , d i at-n 3 ,, .e,.a-eI»i fi r r d- a ::.e ',_T-..,; r Barbecue
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business name Columbia Heating and Cooling,inc. Clothes dryer fps) „
Other;
Address:N)Box 230397 2
City■State/ZIP:Tip v-d,OR 972g — Subtotal
Phone;(503)624-2704 Fax:(503)598-0270 -
Minimum to penal+ (mil Ice)
Plan review(15%ofpermit fee)
CCB lie,:76359 state aurehnege(12%of permit fee)
TOTAL PERMIT FEE Lao lir '✓
Authorized signature: This pornnit.ppncaiiae expiraa:Ca permit is eat sheateej within tea
Jaye after It ban been accepted as complete.
Print name:Marlene R.Meedom i _ Date; -3-B___ ' Fee ineurodalogy set by Tri-Cuuuty Building industry 5areta:Bum]
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