Permit MECHANICAL PERMIT
�. „, i -h %' 1 CITY OF TIGARD •
Permit #: MEC2009 -00557
COMMUNITY DEVELOPMENT
„ Date Issued: 10/21/2009
T,lt krit E 13125 SW Hall,Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111 DB10100
. Jurisdiction: Tigard
Site address: 15465 SW OAKTREE LN
Subdivision: Lot: 0
Project: Johnson
Project Description: Replace furnace
Owner: FEES
JOHNSON, ELEANOR GRACE Description Date Amount
15465 SW OAKTREE LN Furnaces < 100K BTU 10/21/2009 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 10/21/2009 $10.80
PHONE: 503 - 684 -1010 Minimum Fee Adjustment - Mechanical 10/21/2009 $43.25
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Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 9,7223
PHONE: 503 - 624 -2704
FAX: 503 - 598 -0270
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503246.6699 or 1.800.332.2344.
Issued By: x di A JA ( Permittee Signature: -
5),Lia b...6 � ��
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
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'AP' i .
IN/rectal rermii Applicati CEIvEI] :, e ,t, , tip ,r„ �
,��,� t �,,t�,l���.}4 /.f�eu�.aa�. rim.zalm ±rr.�5tilt.a1:'; v t,.�lt��.ir�.��'•'s,t ^€t �rrL_ Ar',r
r ' City of Tigard Receive a Permit NO U5 C,e,,pin . /- 77
f , 13125 SW Hall Blvd., Tigard, OR 97223 n r - T p n {` Pl an Review -
i 1. Lj 1 , - Other Fc mit
61 4 1 4; Phone 503.639 4171 Fax 503. 91i.1950 , Datc/Fly:
''t+ +t 1 ' InSpcction Line: 503.639.417> dale Read}'iTly: n ri, SecPag, 2'r1
TIG C OF TIGARD S u i [[mental lnforniatian
. ,.. l nlcrnet �+wvv.ii and pr; Ov 4n ifiedihlcthnil; I t
BUILDING DIVISION
T E OF WORK 1 . COMMERCIAL FEE` SCHEDULE - USE CIIECKLIST l
Mechanical permit fees* are hosed cm the value of tlic work
❑ New construction Addition /alteration /replacetnent performed, Indicate the value (rounded to thc nearest (Intinr) m all '
❑ Jamolition ❑ OIhcr mechanical materials,cquipnenl. labor. uyerlh,cad. attd 2ront
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CATEGORY OF CONSTRUCTION value[ g
RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
1- and 2- Family dwelling ❑ Commercia1/industrial ❑ Accessory building
For special information use checnlvrl
Multi- family ❑ Master builder ❑ Other: Description Qtr 1:a. 1 oral i
JOB SITE INFORMATION AND LOCATION Hesting/cmting
Air conditioning 1
Job site Address: /� y _ ,�tkfi_ ':squires site plan showing placement)
City Staie LIY; ! J �! D 9 7017( Furnace 100,000 BTU (doers /vents) _I ---- =45.75
�el Furnace 100;000+ BTU Nite c 54.91
Suiteibldp. /apt..no.: ✓✓ lzG Project name: 5-4,,,,s_ j , Heat pump 61.06 1
Cross street directions to job site: Duct woik 23.32
�• Hydronic hot .water system i 23.3?
Alr��a� ((- GIG Residential boiler (radiator or
~ hydronic) 23,3 -
Unit heaters (fuel -type, not electric),
in =wall, in -duct, suspended, etc. 46.75
Flue/vendor any of above 23 - 32
Suhdivision'
L -0[ nn.: ottizr: 23 _.
Tax - map /pared no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39 f
1 -Zo. 0 s , / • - 1/, Ht ' Flue vent for water heater or gas
1 fireplace 23,32
/ —_ Log lighter (gas) 23 32
Wood/pellet stove 3339
Wood. fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
PROPERTY OWNER ❑TENANT Other: 23
Name: Environmental exhaust and ventilation
C'� 5 / � Range hood /other kitchen
• Address: 4 . , -0,i/ - bv'3L� equipment 33.39
City/State/Z1 P: 77.54-(77; Clothes dryer exhaust 33 39
�(1/TG ' Sineie -duct exhaust (bathrooms,
Phone:- ( .03 ��
I / /076 I Fax: ( ) toilet compartments, utility rooms) 23.32
AUicicrawlspacc fans 2332
ED* APPLICANT 1 ❑ CONTACT PERSON - Attic/ 23.32 i •
Business name: Fuel piping _
Contact name: , di r r ® 4 , d - Ira • $ 14.[5 for first four; 54.03 for each additional
Furnace. etc.
Accdsess: t Gas heat pump
Cry /SLatcf7l l", Wall/suspended/unit heater •
� 7 , / �t C� ,,tt--�� "� Water heater
Phnnc ,( 3)- (e a'- ' a 7Q L� Fas: �} i � -tJ O
Fireplace
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I:, -mail: Range
- CONTRACTOR - Barbecue
i
Clothes dryer (gas)
fiusiness name: i - . 1a ,I. AI i[ii�Cas 1 a Ws_ & Other:
Address: t0- k ii9 . 7
MECHANICAL PERMIT FEES*
f Su b total
�7 —
CitylStaleiZiP:
1 , Minimum permit fee 090.00)
Plan Phonc: ) ( _ Fax: [ y �q� Cja7� Plan review (25 % of permit fee;
CCIi lie.: " 1� stale surcharge (12%of permit ice) lD . g
7l(J `�� TOTAL PER 91'1' FEE I /O
,A � ����� A Thin permit application cApitrs if n permit k not obtained within 190
Authorized signatur - dkys after it has been accepted ns complete.
P ut1 iiamc .j-r— 0 I Dale: / ' Pct methodala y , ...et by Tri_Caunty ItuildinC. Industry Sc vi c l card
!. \.1m: nctPerrnnsthlF..C- Pcrmit App,dnc.. Iwo) 440 dbt t o n / CQIIN.'E3)
Z OLZ0- 869 6u!loo3I uiie_eH eigtunio0 0 170:60 60 lZ 1 -