Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00068
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/16/2011
Parcel: 25111 DC10300
Jurisdiction: Tigard
Site address: 15620 SW ALDERBROOK CIR
Project: YARDLEY Subdivision: SUMMERFIELD NO.11 Lot: 599
Project Description: Gas furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: YARDLEY, EVELYN R
PO BOX 230397 15620 SW ALDERBROOK CIR
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/16/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/16/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/16/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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. 32.2344
Issued By: Permittee Signature: •
•
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.
Feb 15 11 01:47p Columbia Heating/Cooling 503-598-0270 p.1
: •
•
Mechanical Permit Application. F or 11 #Eri rog. OFFICE LSI: ONLY .
City of Tigard \A ,, , r %,,, i 4 tgl Recaived ,
Date,By: / 11,111 Per N'f)t. —
-- -- •
" f '1122 SW I fall Bld
v., 'Tigad OR 92
r, 723
IIIII 1 Plad R
I' eview
' 1 lu 503.639.4171 Fa: 503.598 1960 FEB 1 5 2.01 Daie/Ry: Other Permit
inspection Lint:: 503.639 4175
TIGARD Dolt Read/3y: furls iil See Page 2 fur
11116111C: www.t.Laard , c400 No:ificciiMetho<i: -- 17( .. p pp
Sulemental !nfortoution
CITY OF T1 .... .
nt1lICZIM
7
TYPE OF WORK 1-." .*-- COMMERCIAL -FEE* SCHEDULE - USE CTIECKLIS'f
Mechanical permit fees* are based on me sts.lue of' ill,: w o 4,
• U No.-s ..:omtruction )i( Add i :ion/alter ionireplacement
performed. Indicate the value (rounded to the near ai dol Hi , •,i ...i
0 Dcfr3 Hon E Other: mechanical materials, equipment, labor, overhead, ar,d Tofu
CATEGORY OF CONSTRUCTION .- • . - • ' - - - ' Value: $ :' - . • • -
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
.1)?
I- arid 2-l3rmily dwelling [1 Commerciallindustrial o Accessory building
For spector iptiorrnailon use cheL
D nii,,,J-: III Master builder D Other: Description
JOB SITE INFORMATION AND LOCATION -• ''''. .'... .•'.• ' . Heating/cooling
Air conditioning
. on , ..rte Address' /3 -6 z $ u.,./ Ajciec.1_001e_ 'g'-,
(requires site plans showing. placement) 46 75
Gitty-tStutc,'ZiP- .7 ca.._ 7V-24( . Furnace 100,000 BTU iductsleents) r 46 7 5 I - go , 1 \
Furnace I 00,000 BTU (ducts:vents) '
54.
-r
Suite/1)MR rum. !le. 1 1 name:
. Heat pump 0 i Oe
---
,
..:ri,ss , dreetcireeliC). - ', 'A) Oh ;lie: Duct work
• -1-
Hydronie hot water system
Residential poiler (radiater or
hydronic) ' 13 32
Unit heaters (11r01-type, not elec
in-wall, in-duct, susalIdeci :10 75
Flue/ r vent for any of above 23 32
SAW'. isk Lot no.:
Other: 23.32 .
1 I 6, iiittitr•pus no Other fuel appliances
• DESCRIPTION OF WORK -. • • • Water heater 7 2 2 ..
Gas fireplace . 3335 V
, _ . A IA I I k -..-...___-
Flue vent for water heater or gas
id il
I
Lo: li.hier t•w;
Wood/. ellet stove 23 52 ..',
- _ . .
,---
Wood fire.lacelinser. 23.32
IBIEMENEIMMIE 2232
X PROPERTY OWNER ' 0 TENANT •
Other
; Name: 5 .te j k4 n v' - Environmental exhaust and ventilatiuti
-i---- - ---
1 . R.ange hood/other kituhen
I Address /51 20
- A ? I 0 ita a-A equipment 1 q. lo ,
.. .
_
_ ,
Ciiv:Stiii;.'7.i:' '71 0
,
4,,, Clothes dryer exhaust St.; ..;4
it
h Single-duct exhaust (b(bathrooms. ns,
l'un 5 k •
.....czei 'D Fats: ',. ) to i'ut compartments_ utility rooms) _ 2.3.32
— ..,—.
APPLICANT CONTACT PERSON .•
1 •Atticrerawkpace tans 23 32
0 0
Other: . 2332
I U 11I1le:
Fuel pipiug_
S1415 for fie-st four; 54.03 or cacti addific or !
Culiiict main:. / 99, (2 1 .--- 7.- /
Furnace, dz.
Adu:
Gas heal pump
Cn.v/StaierAP: WalVsusoendediurii. healer
r Water heater
Phone 603) i ( o & - Q i i.. w _ Fax: :&3 ‘ 6 _O ;170
Fireplace _ ,
[-multi Range . _ . . ...
• CONTRACTOR •. -- . . . • • - • Barbecue ,
Op
. Clothes dryer (airs} I
3usiness name:
. 1 a .ff... At ..0.0421111 IL A o A A N Ike ..- ..- - Other: I ,
i -
Addressy=t") j , 1 , ., 9 . 7 .. MECHANICAL PERMIT FEES*
‘.._
:..:ii:14S1...tce.,7:,:.: 776. 0- 77aE1 Subtotal _ _.
Minimum permit Cue ftiii1.00i __' ...410
Pituric: 6, ) i ,„ : 4 ii . FaX ' qi) 5 IS .- 0 0 Plan review (2.5% of perm! fee: 1
U.:12 IR . : ---- 9 — State surcharge i.12% ut perm I ldo: ft S' 6.
'IOTA L PERM IT 1:El 1 I l...
This germ ii application espires if a permit is not obta.ned iiithin :Si •
Audiori2ed sig,nature/J r ));:lit)
days after it Lim been accepti'cl 4s corm:leaf,
J ill: l iiiiniCliThiliVj-Ck like 1727 DEtle..16.• 1 i • Fee methodology set by Tr Da ifthlg, Indust' Jer lc,
ifin_3:3-i-s-ri ii11,/relkell/rp,