Permit -/1 •
CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/7/2008
PARCEL: 2 S 102 C C - 02 000
SITE ADDRESS: 10195 SW HILLVIEW ST ZONING: R - 3.5
SUBDIVISION: FRELEON HEIGHTS NO.2 LOT: 023 JURISDICTION: TIG
PROJECT: CABE
Project Description: Replace gas furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
CABE, CLIFFORD C + SHARON M Description Date Amount
10195 SW HILLVIEW ST
TIGARD, OR 97223 [MECN] Permit Fee 1/7/2008 $72.50
[TAX] 12% State Surch 1/7/2008 $8.70
Total $81.20
Phone: 503- 624 -2704
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. 230397
TIGARDRD, , OR 8 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: AZ,t,,c A, Permittee Signature: _ • ' C�2�i
Call 503.639.4175 by 7:00 a.m. for inspections 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 App! , - -PI.
Et
City of Tigard Received
13225 S W Hall Blvd., Ti N DdteBY: / �/ p '16 Pemut No
Bard, OR 97? 0 d 200" r — ! - D ' DO
.1114 : Plan Review
Phone: 503.639.4171 Fax: 503.5 8 Otter R.,uot
l' I c: AT U Inspection Line: 503.639.4175 1 OF TIGARD Date Date/By:
Ready
/By: ReBy: lutes. S See Page 2 for
Internet: www•tigard- or.gov ®e DIVISION Notified/method: Supplemental Information
..i . TYPE OF J WORK IV .
f.... :COMMERCIAL FEE*- SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of wurk
❑ New construction ❑ Addition/alteration /replacement
❑ Demolition ❑Other. performed. Indicate the value (rounded to the neares duller) of all
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION .- Value, $
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ... . . N I 7AL EQUIPMENT SYSTEMS FEES
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling •
•
/� Air conditioning or heat um
Job site address: /! /l � � j �� f g pump
1 (requires site plan showing placement) _ 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) / 14.00
Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (duels/vents) 17.90
Gas hem pump 14.00
Cross street/directions to job site: Duct work 14,00
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, 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no,: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
f Gas fireplace 10.00
-e ! r G i �. (e4 0 7J Flue vent for water hearer or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
. . .. . P OWNER ❑TENANT ChitnneyflinerlQue/vent 10.00
Name: /c, ( .GG ; Other: IO.OU
Environmental exhaust and ventilation
Address: Range hood/other kitchen I
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Phone: (503 <e y /.5 /V Fax: ( ) t duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
• ❑ APPLICANT . . . . - ❑ CONTACT PERSON Auic/crawlspaoe fans 10.00
Business name: Other: 10.00
/�_��� Fuel piping
Contact name: ! !7 h"'I tt� $5.40 for first four; $1.00 for eacb additional
Address: v I 4�j l Furnace. etc.
Gas heat pump
City, State /ZIP: d2,7 Wall/suspended/unitheater
Phone: (5 � Q — ..,--.2 I f (� Fax: : S Fireplace
eater
Firepl a C acse
E -mail: .
Range
CONTRACTOR Barbecue
Business name:
�GC }} )) Clothes dryer (gas)
117�1f I 1 epC�l n cif e.,{1--0 /l Other:
Address: !/ x - i O : i1•IECHiANICAL PERMIT FEES'' -
City/State/ZIP: T ,1 O2 9 7?I - J subtotal t
Phone: pY ...,-,7)._-20 u r Minimum permit fee ($72.50) /OS •
(Sj} 3) 6, - l Fax. eJ C �-7� Plan review (25% o it fee)
CCB lie.: C 9 � {/ ! 9 / .� /
7�' 3 J State surcharge /o of permit fee) 2r, 70
/ � TOTAL PERMIT FEE �� - AO
Authorized signature: 'Phis perm application expires if a permit is tint obtained within ISO
i � � � days after it has been accepted as complete.
Print name: 4,1/4y Da te: l * Fee methodolo'set by Tri- County Building Industry Servi e 3oard
1: -Per nitApp.dac 00O6'06 440.4517T f t I,n7JrOLA(WPM •
'd 0LZ0 DNLLV3H viewniOO e8C 1, l• 80 LO ref
CITY OF ��m m m n=«u� u u�ew~u�m�� -
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BUILDING DIVISION PERMIT #: k8EC2008-00008
\ 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/712008
Phone: (503) 639-4171 ee
Inspection Requests (24 Hrs.): (503) 639'4175 AA e �J..
INSPECTION WORKSHEET FOR DATE: 1110/2008 TIME: 7:O2Ak4 PAGE: 76
SITE ADDRESS: 10195 SW HILLVIEW ST . CLASS OF WORK:
. SUBDIVISION: FRELEDN HEIGHTS WO_2 LOT #: 023 TYPE OF USE:
PROJECT NAME: CABE
' DESCRIPTION: Replace gas furnace.
OWNER: CAGE, CL C + SHARON K6. PHONE #: 803
CONTRACTOR: COLUMIA HEATING & COOLING INC PHONE #: 503-624-2784
Inspection Request Scheduled For: Date: 1/1(/]008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 063364-01 603'624'2704 Y
Corrections/Comments/Instructions:
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~ -- G n PARTIAL APPROVAL ri CANCEL ri NO ACCESS
n FAIL n CALL FOR INSPECTION I | ADDITIONAL FEES ASSESSED
ji LL____ ,,,
Inspector: P141 Date: Phone #: (503) 718' \ ^~~^
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