Permit X CITY OF T GAR® MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT
Permit*: MEC2010 -00277
Date Issued: 06/18/2010
,TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111AD18700
Jurisdiction: Tigard
Site address: 14925 SW JONAGOLD TER
Subdivision: LADY APPLE Lot: 11
Project: Vonletkemann
Project Description: Heat pump installation.
Owner: FEES
VONLETKEMANN, KENT Description Date Amount
14925 SW JONAGOLD TER Heat Pump 06/18/2010 $61.06
TIGARD, OR 97224 12% State Surcharge - Mechanical 06/18/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 06/18/2010 $28.94
Contractor:
COLUMBIA NW HEATING
PO BOX 622
SCAPPOOSE, OR 97056
PHONE: 503 - 543 -3624
FAX: (503) 543 -6285
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. _ /)
Issued By: t r _ Permittee Signature: QN ,9 / . e<9./ /Ow
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
06/17/2010 07:43 5035436285 PAGE 02
Mechanical Permit ADD1i �� 2_') a [`.�° it p ,+ trx°x ,° " .. tl (11t4UL, I I( I +t,51 Div ; 1 ��'r' E yj
17 4 . d „m:„w,...„i,r,.. „; ,.- n,. roi�.,,,, 4� ' ,,„.,,.
`' City of Tigard i' h �” ` Datara° .� r t
4 113125 SW Hall Blvd.. Tigard, OR 972* nnII 1 Pi 2010
y
0 4 Phone: 503,639.4171 Fax: 503.598.4980V 1
-
47' F. 1 In action Line: 503.639.4175 llUMIIMIMIZ
T r c ,1 bate l ed]? lc o El See Page The
1�_fsS IInternet www_ti� OF CITY IGARD NotiGedlMctRod: � Supplemental lnfirmaUon
Ruii DEW; rii\IIcIr)N
. TYPE 'OF • ` TYPE o oRIC. :, ' . c i1V1 RCIA.1 IMF* J1..�7 mirtA tJ J �. a c.io -Tv5
❑ New constriction El Addition/alteration/replacement Mechanical permit fees* are based on the value of the work -
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Dcmolitiotl ❑ Other: mechanical materiatz , equipment. labor, overhead, and profit.
OF CATEGORY O [ti)1kl$TRUJCTION Value, $
(0 1- and 2- family dwelling 0 Cotmnercial /industrial ❑ Accessory building thsllDrY 1[X4 ]L EQUIPMENT ! SY5TE11ts FiES*
For special information use checklist.
El multi-rattily 0 Master builder 0 Other: Description 1 Qty. i 1 n. Total
JOE SITE. rialtRMATIO$ AND :LOCATION Heattng/cogling _
Job site addict!: 14925 SVP.lnnagnld Terrace . Air conditioning
(requires site plan showing placement) 46.75 _
City/Stute/T_iP: Tigard, OR 97224 Furnace 100,000 BTU(deco :/gent,) 46.75
Furnace 100.0001 BT U (demi/vents) 54.91
Suite/bldg. /apt. no.: Prnjcctnamc: i/c,Llt° Bent pump 1 61.06 61.06
Cmos street/directions in lob Site; Duct work 23.32
Ilydrottic hot water system -
Residential boiler (radiator or
hydtottic) 23.32
IJnit heaters (lire! -type. not electric).
in- veatll, in -duct re pcndcd. etc. 46.75
Subdivision: Lot no.:
Fluc/venl. for any of above 23.32
Other 23.32
Tax map /panel no.: Other Mel appliances
DESCRIPTION OF WORK . Water hewer 23.32
install Hcnt Pump W -' d Gas fireplace 33.39
Flue veal for water heater or as
•
fireplace 23.32
Log lighter (gas) 1 23.32
Wood/pellet stove 3339
Wood fireplace /insert 23.32
Chimney /liner /flue /vent: 23.32
. Egi .. PROPERTY OWNER I 0 TENANT („her: 23.32
Name: Kent Vont.,atkcmann Enviromoental exbnnot and ventilation
Address: 1.4925 SW Jonagokl Terrace Range hood /other kitchen
ecEipmcnt 33,39
City/State /L[P: Tigard, OR 97224 Clothes dryer exhaust. 33.39
_ ' ' Single - duct exhaust (bathrooms.
Phone: (503)750 -5885 Pax: ( ) toilet compartments, utility rooms) 23.32
fa APPLICANT ❑ .CONTACT PERSON Atticfcrawlspacc fans _ 23.32
Business name Same as Contractor the' 2332
Pact piping
Contact name: 514.15 for first four, 54.03 for each additlnnnl
Address:
Furnace. etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit hearer
Phone: ( ) Fax:: ( ) Water heater
' Fireplace
E-mail; Range
CONTRAG ° fC7lZ Barbecue
Business name: Columbia NW Heating Clothes dryer (gas)
Other.
Address: P(.) Box 622 MECHANICAL PERMIT FEES*
City /State /'LIP: Scappoose. OR 97056 n __
Subtotal 61.06
Minimum permit fcc (590.00) 90.00
Phone; (503) 543 -3624 Fax: (503) 543 -6285
/ Plan review (25% of permit fee) 0 1
• CCl3 lie.: 61947 State surcharge (12(14, of permit fee) 1
TOTAL PERMIT FEE 100.80
Authorized signature: !� ► 4 t C / /' t i • T t sp ci 10 h r+ ai'R'g F eep rtt Ia no obta iced within 1110
. L\. � w. r� then after It ms been geeepted as mmplrfe_
P nL name: (:erri.larnl ► son I Dale: _ /7 f � • Per methodology set by Tsi -County Building Industry service gaud rAtuldina∎PeTmiistnarc -Prams Aparloc 10/01/09 440 -4co T (1
r7 /
06/17/2010 07:43 5035436285 PAGE 03
JOB# 10V334H
VONLETKEMANN, KENT
14925 SW JONAGOLD TER
TIGARD, OR 97224
503- 997 -5885
Installation Property Information
DIRgCTION;
Property Line
! � � 3 FT.
1)
ri
FT: FT:
f 7 v
?7 FT:
Property Line
(F= FURNACE)
............_..__.
(X= OUTSIDE UNIT) STREET
Columbia NW Heating, Inc.