Permit M= CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00083
VIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171
Date Issued: 03/02/2009
Parcel: 1 S 134CA07600
Jurisdiction: Tigard
Site address: 11580 SW BURLCREST DR
Subdivision: BURLWOOD NO 2 Lot: 16
• Project: Hower
Project Description: Install tankless water heater
Owner: FEES
HOWER, PHIL W & Description Date Amount
BAY - HOWER, DEBORAH J, 11580 SW Water Heater 03/02/2009 S10 00
BURLCREST DR Fuel Piping 03/02/2009 $5.40
PHONE: 503 - 278 -7030 12% State Surcharge - Mechanical 03/02/2009 $8.70
Minimum Fee Adjustment - Mechanical 03/02/2009 $57.10
Contractor:
COLUMBIA NW HEATING
PO BOX 622
SCAPPOOSE, OR 97056
PHONE 503 - 543 -3624
FAX • (503) 543 -6285
Specifics:
Type of Use:
Class of Work:
Dwelling Units: — - — -- —
Stories: Height: ft
Bedrooms: Bathrooms:
Value: $0
Floor Areas:
Total Area'
Basement
Carport:
Covered Porch:
Deck:
Garage.
Total $81.20
Required: Required Items and Reports (Conditions)
Fire Sprinkler: Parapet
Fire Alarm Protected Corridors'
Smoke Detectors. Manual Pull Stations
Accessible Parking:
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: ` I ` _ , = : ` i , Permittee Signature: w v
• 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.
Mechanical Permit Applicati t tii FOR OFFICE U ONLY
City of Tigard = ��� pa ' Permit Nn.: f
iv
IIII y: a 'c . ° " .00 .
v 13125 SW Hall Blvd., Tigard, OR 97223 AA Plan Review
' Phone: 503.639.4171 Fax: 503.598.19OP' 0 2 2009 Date/By: Other Permit:
T I G n R D Inspection Line: 503.639 CITY OF Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov G�D Notified/Method: INI Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE- - USE CHECKLIST
El New construction 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
.' CATEGORY OF CONSTRUCTION : Value: $
and 2-family dwelling RESIDENTIAL EQUIPMENT'/ SYSTEMS FEES*
1- y g ❑ Commercial/industrial ❑ Accessory b uilding
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. 1 Ea. I Total
•
.. JOB SITE INFORMATION AND LOCATION Heating/cooling
� �580 Q r � p / casT
Job site address: � !,(,(�/� f a Air conditioning or heat pump (requires site plan showing placement) 14.00
City /State /ZIP: 7,2//4') OR 9 77 7 73 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater / 10.00 i1O.Cb
Gas fireplace 10.00
ZJ (+fin L y� �+ �+ �,
' ! H- 7I NK-./ -.SS ��7t, /,1 Q /r - Flue vent for water heater or gas
-
',n SAS f, fireplace 10.00
/� Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue/vent 10.00
X PROPERTY OWNER El TENANT Other: 10.00
Name: t0e'y3.t�' dove' Environmental exhaust and ventilation
Address:
//See) & / € GC/ ES7 a Range hood/other kitchen
equipment 10.00
City/State /ZIP: 7 74) az g z 3 3 Clothes dryer exhaust 10.00
Fax: Single -duct exhaust (bathrooms,
Phone: (
�.3) al$ - 7 ( ) toilet compartments, utility rooms) 6.80
APPLICANT . El ,CONTACT PERSON. . Attic/crawlspace fans 10.00
n ��+ Other: 10.00
Business name: sAmG /' QJ7 / �7J2 Fuel piping
Contact name: �� ��- $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater I 5
Fireplace
E -mail: Range
t - nn'' C / O � NTRACTOR H /' - . Barbecue
Business name:
C-ett/ m l XA NIL) GA7ZN6 Clothes dryer (gas)
Other:
Address: 1 5 0 ( 6Q • 'MECHANICAL PERMIT FEES* .
City/State /ZIP: -' /)�e az x'7:56 Subtotal /S,
Phone: ( ) L T-43- 14 Fax: (S a,) 5q3 � ' Minimum permit fee ($72.50) 7.).5%) Plan review (25% of permit fee)
CCB lie.: 6/471.1 State surcharge(12 %of permit fee) $ ; 70
' ' TOTAL PERMIT FEE S1 ,j
Authorized signature: This permit application expires if a permit is not obtained within 180
�i 1 `, days after it has been accepted as complete.
�
Print name: c:y1 �p 7 , z /'IJRS �t
1t f Date: 3; — C3? * Fee methodology set by Tri -County Building Industry Service Board
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