Permit r '1
•
r � CITY OF TIGARD MECHANICAL PERMIT
" COMMUNITY DEVELOPMENT Permit #: MEC2009 -00393
T1GAAD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/04/2009
Parcel: 25111 CB01705
Jurisdiction: Tigard
Site address: 10275 SW HOODVIEW DR
Subdivision: Lot: 0
Project: Westby
Project Description: Replace heat pump.
Owner: FEES
WESTBY, RICHARD S & DENISE M Description Date Amount
10275 SW HOODVIEW DR Air Conditioning or Heat Pump 08/04/2009 $14.00
TIGARD, OR R 9722 97224
12% State Surcharge - Mechanical 08/04/2009 $8.70
PHONE. 503-380-1521 „ Minimum Fee Adjustment - Mechanical 08/04/2009 $58.50
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97223
PHONE: 503 - 624 -2704
FAX: 503- 598 -0270
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by -.41 503.246.6699 or 1.800.332.2344.
Issued By: J /� ! � � . i Permittee Signature: G /c e j 1 Q
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.
Jul 3ei l 9 12:41p Columbia Heating /Cooling 503- 598 -0270 p.2
Mechanical Permit Applicati =m . i otz coi ,10E 1'yF: ()'L\
City Tigard p , ' �gi�r Permit tvo c ?O?-
`+ ` JUL 3 0 " 13125 SW W 3 114 Blvd., Tigard, OK 972 -
. Phone: 503.639.4171 Fax: 503.598.1900 Plan RevietiJ
s 2009 17atelBy: Other Permit:
TIGARD
inspection Line: 503.634 .Date R dtuis: ® See Pxge2 for
- Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: 7 Supplemental lafurmatiuu i
TYPE OF
W ""iNG DIVISION _.�
COiCIAL FEE+ _ SCIiEDUI E ..– CHF C KL1S'1'
E] 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.
Value: S I
. CATEGORY OF CONSTRIJ ..- , . ••:, .... ":: a` ,, , . 1 - and 2 - Tamil dwelling • i t >? SWEN : I SYSTEMS, FEES*
[
y g ❑ Commercial/industrial [ Accessory building
For special information use checklist. 1
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea Total
JOB SITE INFORMATION AND LOCATION. • lieatingfcoolinc
,�,, Air conditioning or heat pump
Job site address:
/ r:/z-75:— 7l ' rJ' Ji7'6„/ f),,_ (requires site plan showing placement) ? 14.00
City/Slate/ZIP: –Ce' �' �7 �y FFurnace 100,000 BTU (ducts/vents) 14.00
� 7 ` ` 0 � / Furnace 1.00,000+ BTU (duets/vemts) 17.90
Suite/bldg.iapt. no.: Project name: , Gas heat plump 14.00
Cross stnxt/directions to job site: Duct work 14 00
l4ydrenic het water system 1400
• Residential boiler (radiator or
hydronic) 14.00 1
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 -
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
t Gas fireplace 10.00
0 . # {4 • Cal d . „ f' .Sit.11 44j Flue vent for water heater or gas
fireplace 10.00
_ Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
PROPER OWNER C] TENANT Chimney/liner/flue/vent 10.00
• Other: 1 10.00 ._-
Name: f ,r f t (• ? J C, , /
• Environmental exhaust and ventilation
II ( Range hoodlolher kitchen
Address:
ta ' 75 — .i� /,�17j �� equipment 10.00
City /State/ZIP: — - 7 2 . Clothes dryer exhaust 10.00
S''^r Single -duct exhaust (bathrooms,
Phone: 167,,3) •3 _ 2_ ( Pax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT • 0 CONTACT PERSON Attic/erawlspacefans 10.00
' Other, _ 10.00 I
Business name: Fuel r m
Pp g
Contact narnef "D A i f j ,K $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gras heat pump _
City /State/ZIP: Wall/suspended/unit heater ,
Phone: cb-3 ) 6 ✓ il - 2 . q Fax: : c5b3 ) c, s-- Q J 76l Water heater
Fireplace
E - mail: Range
. • CONTRACTOR - Barbecue
Business name: (� i'0,.../ b / r,,,,.z/ (x / C Clothes dryer (gas) •
• O uter. i
Address: ( / 3 0 X• ) 3 0 3 �1 i . . , • MEC[UANICAL PERMIT FEES* •
City/State/ZIP: ia.,4,.,, (9721/, I Subtotal
Phone: („M) la ; ,.- `/ ) • • 7 {t Fax: ( ) ' )"' Minimum permit fee (572.50) _2 ,56
��� �� Pl review (25% of permit fee) 1
CCB tic.: � 3 j s i 9 i I State surcharge (12% of permit fee) r ,
TOTAL PERMIT FEE ,' , in
Authorized sipature: This permit application expires if a permit is not obtained within 189
days alter it has been accepted as complete.
Print nante:� t/7 (—I /! Date: 7/36/ C j ' Fee methodology set by Tri- County Budding tndwLry Service Board
f: 'Huiidine \PerrnintMEC- PermitAno Sne 04/01906 410- 4617T(I IIn2)CCOM/WEBI
-Jul aQ (59 12:41 p Columbia Heating/Cooling 503-598-0270 p.
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HEATING & COOLING, INC.
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P.O. BOX 230397 , TIGARD, OR 97251
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SITE PLAN
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