Permit 117 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00253
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2011
TIGARU g Parcel: 2S111CA13900
Jurisdiction: Tigard
Site address: 9765 SW SATTLER ST
Project: Horton Subdivision: DARMEL Lot: 10
Project Description: Replace gas furnace and add A/C. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: COLUMBIA HEATING & COOLING INC Owner: HORTON, ARLEN DWIGHT & VIRGINIA
PO BOX 230397 9765 SW SATTLER ST
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 06/07/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 06/07/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/07/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $104.72
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: /� ii Permittee Signature: a/ / 9--/0 / 04, /
• , / ` i /0A/
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.
Jun 06 11 02:46p Columbia Heating/Cooling 503-598-0270 p.2
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Mechanical Permit Applicatiri El EP
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City of Tigard Ree'''ve'd 6 7 /7 Of 1k..it N/I/Er-2w_ d er,
Date'lly:
I .3125 SW Hall Blvd., Tigard. OR 97223 JUN 6 2011 p,p.„.,iew
Phone 503.718.,2439 Fax: SW.5.98.1960 Oilier Permil:
Datelly:
Inspection Line: 503.639.417f T i i.T.i A R I) Date Rendyildy: Jurh See Page 2 for
Internet: www.tiaard CITY OF TIGARD No:ified(Methee: ft V
Supplemental Information
BUILDING DIVISION , ... .... ... . . . ,
I . :Whig yEE,.. SPIETIBLEI -i- USECRECKLIST
Mechanical permit fees are based on the value of the work
0 New construction Add iti om'a I tcrat i on/rept ace me n t performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor. overhead, and profit.
- • . ----. Value: 3
•
CATEGORY OF.T.I ON.STRU .: - . • -;_. .. :. • , ' .
. ■•■ .., ... . I • " RE§foiwriAr. icQuIPM ENT / SYSTE NIS l+TES*
. . 0 .,Z1<i and 2-family dwelling P Commerciallindustrial E Accessory building I For special information use checklist.
,
0 M ulti- fam ly 0 Master builder 0 Other: Description Qty. j Fa. I Total
• JOTS' SITE INFORMATION AND Le • ATION • ' • '' . Hea4i
- • : • -• mmi -
.,, - --.• Air conditioning
ff
Joh site address: 1745— . - 7.. et .. ( re q uiter site plan showing placement) ' a 46.75 _
Furnace I (.10,0a) BTU (cIecisIver.:s1 i 46_75
City/State/ZIP: 40',0411-r, Furnace 100,000+ I3TU (thieisiveffis) 54.9 I
Suite/bldg./apt. no.: Project name: Heat purnPM c
It -
(requires site plan showing placement) 61.06
toss streetidirections to job site: Duct work 23.32
----- Hydronie hot water system 23.32
Residential boiler (radiator or
livdror ic) 23.32
Unit heaters (l(tel-rype, not electric),
in-Wall, in-duct, suspended, etc. 46.75
Lot no.: ' •
'Thic;venr for any of above 23 32
Other: 23.32
fax map/parcel no.: Other fuel appliances:
i -• - .- - II -I , ..,: .::DESCRTPTIONIIirwoRK.:; 4 ., . '. ,:]. , ,,.;: '. - - :, ,, '" ._, . Water heater
._. . . ,... ,., . . . _ 23.32
Gas fireplace 33.39
r 4 I N.
F lue ue vent fur water heater or gas
23.32
/ rililPMKORIK. ., 111111111111111111111111 fir
e Log lighter fitas) 23.32
Wondfpellet stove : 33.39
Wood tin:place:insert i 23.32
- i . - • - - Chimney/liner/flue/vent I I 23.32
'0 PR/ 'ERTy OWNER : .. : ... • -- ' •.: • .. : LI. TENANT : - - .
r - " ' - : • ' Other: [ I 23.32
Name: am TO
• Environmental exhaust and ventilation:
. Range hendlother kitchen
Addi.essi _S -- /I/ &---- 1
i equipment 33.39 ,
City:Stale/ZIP: Clothes tirv exhaust 33.3g
Single-duet exhaust (bathrooms,
Pifolie: ( ) Fax: ( ) toilet compartments, utility monist 23.32
. .• ' .0 APPLICANT : :- • ..." - , ' :: ' .: “: :0 - CONTACT PERSON - ' ' , : Atticicrawlspace fans 23.3
i
Other: 23.32
Rosiness name: i
Fuel piping:
Contact name: 501-AtteX.31— CIA ki-P.17.-... I $14.15 for first four; S4.03 for each additional
1 FUtilaW, •de. 1 _
Address: ,
Gas heat pump
CityiState/ZIP: wallisuspended/unit heater
Phone: ( I Fax: : ( ) Water heater •
Fireplace I
E-mail: 0 „;.., , , i:A, , i .x. 0 0,..c._ . A. .
Range
. - ... ..
•
■ . {gas) I
Business name: _... IL, 4 ,,7 , - , 4_:uji ' t s 't . CW/11. Other: I
I dr,
Adess
* ' -. .......1 .6z,K(;Z35 .--...:_.. - : „:„.-...SIEGMWAL.PgRittiTrE • - ' ... . . 1
-..
City/State/ZIP: 7.-Ai( t - 7 c: 237 •• • Subtotal •
, I
_.,
Minimum permit fee ($90.00) 93, 56
_pone: (5 ) 4 ex-70 ei F ' : f c7).3 ) SYS' - e),2.
Plan review (25% of permit fee) I
.
COB lie.: 7( State surcharge (12% of permit
TOTAL PERMIT FEE /0 y , ..a
This permit application expires if a permit is not Obtained within ISO
Authorized signature: - ar _
days , after it has been accepted as complete.
I Print name: j _ , ...... x . :.„ ..y.—. ate.
0 ° Fan methodolny ..et hy To i-errooll y building Industry Sit rice Board
1 doc r331:13.3.'10 .145-1(, I 7T i 3:an:COM:WEE)
Jun 06 11 02:47p Columbia Heating /Cooling 503- 598 -0270 p.3
O P/ /
HEATING & COOLING, INC.
P.Q. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
I T0 r
SA1T LET
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ADDRESS: 1 1 S ,