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Permit
CITY OF TIGARD MECHANICAL PERMIT 111111 2 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00411 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/14/2011 Parcel: 1S 135CD07500 Jurisdiction: Tigard Site address: 9713 SW LONDON CT Project: DAVIES Subdivision: LONDON SQUARE NO.2 Lot: 27 Project Description: Installing ductless heat pump Contractor: COLUMBIA HEATING & COOLING INC Owner: DAVIES, KATHRYN L PO BOX 230397 9713 SW LONDON CT TIGARD, OR 97281 TIGARD, OR 97223 PHONE: 503 - 624 -2704 PHONE: FAX 503 - 598 -0270 FEES Specifics: Description Date Amount Heat Pump 09/14/2011 $61 06 Type of Use: SF 12% State Surcharge - Mechanical 09/14/2011 $10 80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/14/2011 $28 94 Occupancy Grp: Stories: Fuel Fuel Types: 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 1.800.332.2344. Issued By: < " J► ' Permittee Signature: � � ' ` "r 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. Sep 13 11 03:47p Columbia Heating /Cooling 503 -598 -0270 p 3 Mechanical Permit A A. *hen Lr. . _ . p Roeelted , . City of Tigard oatr,�S, g • l i 12 ` 5b<' I tall Blvd , Tigard. CSR 9 7'2 f lam T a, w s „ AI ' new ©3. 18.2439 Fa;' 51.13.598,1,.P.0-1 1 3 2011 paterAt� Other Fe our T IGARD inspection Line. 3()3 639 413.5 Date Ready, ey Sec Pope 2 for ... _. Internet; www.ttgard- ar.no.• CIT'1' OF TI GARD Motlfed'�teilmd: Supplemental information BUILDING D IVISi r TYPE OF WORK ., C IikCERGIAL.TEE°i .SCHEDULE USE CHZ CKUST Mechanical permit fees" are based on the value of the work ❑ New construction >11 Addition /alteration /replacement performed Indicate the value (mmnded to the nearest dollar) of all n Demolition ❑ Other. mechanical materials, equipment, Iabcr, overhead, and profit. -- .•- ...... Value: S CATEGORY' OF CONSTRUCTION RESIDENTIAL HMI 1PMENT / SYSTEMS FEES" ip and 2- family dwelling ❑ Commercial. industrial 0 Accessory building For special Information use clrerkllsr. U Multi- fam :13• ❑ Master builder ❑ Other. Description Qty. I a• I total JOB Sf-E -INFORMATION AND LOCATION Heating/cooling: Air :onditmaing 701) site address: f 7 i re (uires sac plan sl,o,+rn;; placztr eat i 46.73 7 Furnace 100,000 BR: . iduc:.s .eat%) 46.75 (it}' /tilate'Z]P: � - L 3 Furnace lt)0,000+ E3TU 0,0.;,.2,1t,) 54.91 '1 Suite/bldg./apt, no. Project name: tiles Heat pump p (region's cne plan showing •tiaeeireutl 1 61 06 Cross street/directions to job site: Duct work 23.32 _ _ Hydronic hot water system 23 32 1 Residential boiler u or ' lwdronic) , 2332 i Unit heaters (fuel -type. not electric), • in-wall, in -duet. suspended, etc 46.75 Subdivision: Lot no.: Flue/vent for any of abate 23 32 ---- -- Other 1 23.32 Tax map/parcel no , Other fuel appliances: DESCRIPTION OF WORK. •'' '' - Water heater ? i 23.32 + � K - - 1 , 6LI €5 � P Gas fireplace 33.39 d [� ( ` JJC� AP Flee vent for water heater or ear fireplace -_ 23.32 • Log lighter leas) 23.3 Wend/pel let stove 33.39 Wood firepleceainsen 23.32 I - , PROPERTY OWNER © TENANT Cltintnc3 /liter flue veil 23 32 Other. ) 23.=2 Name: - • 1114 CO 1 P6 Environmental exhaust and ventilatian: _,- Address: j 1 • �, Range hood /other kitchen e3 iupment 33 39 Ctty;/StatciZIP: f I • • (��{aa3 Clothes diver exhaust 33.39 i Single -duct exhaust (ballrooms, Phone: . 3 71 0 ? q 1=a.�: t ) s ; 23.32 E hone: r ! � toilet compartments. utility room, I [} APPLICANT i ❑ CONTACT PERSON Attic'cratvlsace fans 23 32 11ns.ness name, Jther 23.3 2 I ,. � Fuel pipit Contact name: S1 Sl4.IS for first four; 5..7.03 for each additional Address: E Furnace, etc Gat heal puma ('1l} /State!ZlP: Wal /s uspended,'unit heater Phone ( ) Fax: : ( ) Water heater { Fireplace F -mail: 1 C i /'1'1,S- i !ttt,.NYa ) rkIN.r (}.- • i'LC. Rat,gc CONTRACTOR . Barbecue I r C M 1 - Ot her doer (Kos) Business name i t.� ♦.s t_ . r c i U(14 t .Address: � Other: J Pc L_36 30 t MECliANItAL P> RMCI' ticks City /State /ZIP: 74a 0 97 '/ J _ Subtotal — �'�� M inimum permit fee ;390.001 Phone: ( l�) �. �- e 1 E,v ( ?�) - -;® Plait review (23;'o of penult fee) — CCB lie : °� C� Q Slate surcharge (12% of permit fce) ( TOTAL PERMIT FEE �, } This permit application expires if a permit Is het obtained within [NU Authorized signature: f � b' + = _n n --r /^, flays after itlas been accepted ascomplete. I Print name: jar_ JC S 1,�� -- Date: [� -t - i II I ` SSee f elln:+tree55 +er t't' Tri- Cu,ency Bui tdinp l ,dr str; Sr p u ■en Board 1 Fhride ,c,Pw,rlicS:elEr- Permainr+ dnc 99'09i1e 445 -4517'f (II ,n, 5- will, Sep 13 11 03:46p Columbia Heating /Cooling 503 - 598 -0270 p.2 410", „4, x HEATING & COOLING, INC. P.O. BOX 230397 TIGARD, OR 97281 (503)624 -2704 SITE PLAN 01„414-pt- f� I i r � � r 4 � 1 � ADDRESS: q- Iz - .