Permit 4 ,
CITY OF TIGARD MECHANICAL PERMIT
11 1 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00391
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/03/2009
Parcel: 1S136AD07100
Jurisdiction: Tigard
Site address: 6976 SW PINE ST
Subdivision: Lot: 0
Project: Schoch
Project Description: Install Air Conditioner Must maintain 3' rear and side yard setback
Owner: FEES
SCHOCH, MICHAEL & Description Date Amount
SCHOCH, PENNY, 462 SW VALERIA VIEW DR Air Conditioning or Heat Pump 08/03/2009 $14.00
#201 12% State Surcharge - Mechanical 08/03/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 08/03/2009 $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 calling 503.246.6699 or 1.800.332.2344. f'
Issued By: ,XLIAL/ c A D4 Permittee Signature: Q�L Q n�.fLYCL((D�C/
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.
. . 1:.300911:20a Columbia Heating /Cooling 503 - 598 -0270 p.2
Mechanical Permit >application R FOR OFI:1(1: l'til. ONLY
City of Tigard Pe�t1lo... LiE�dea9- m 1
1 to
a 13125 S W Hall Slvd., Tigard, OR 9722 Plan Review Other Permit I
I Phone: 503.(,39 -4171 Fax: 503.598.196 DarefB
Inspection Line: 503,639.4175 JUL i 0 2009 .Datc /B T: /Isis: I 0 Scc Pagel for
TIGARD Su pplemeatal Information 1
CITY OF TIGARD
Internet w"�.tteard- �r.E�� ���
TYPE OF 'COM ER " ;sC uu> t . `,- ..31. ola �sr
Mechanical permit fees' me baud on the value of the work
I ❑ Ncw construction ddiii on/altern iOn rep1 I11 1t performed. Indicate the value (rounded to the nearest dollar) of e.1.
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
valtt� $
CATEGORY OF CON.STRVC!<fQPI;:- r . ;} :' . . • -•.. 571 ? `TR NT1- 4 -Nr J SYSTEMS.FEESa
01- and 2-family dwelling ❑ CommerciaVindustriai ❑ Accessory building For special hgformallon use check![st
O ther: Ea. Total
❑ Multi family El Mtlsler builder CI Dc;crlption �'•
JOB SITE INFORMATION AND LOCATION - Heating/tooting
Air conditioning or heat pump 1 x.00
Job site address: 4 976 $4,, /"^rnG (requires site plan showing placement) I.
Furnace 100,000 BTU (duets/vents) 14.00
City /State/ZII': ` fCVr� dot S 7 2_2_3 Furnace 100,000+ BTU (ducts/vents) ._ 17.90
Suite/bldg. /apt. no.: I Project name: Gag heat pump 14.00
Duct work 14.00
Cross strew t/diredions to job site: 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 {
Flue/vent for any of above 10.00 I
Subdivision: I Lot no.: Ocher. 10.00
Tax map /parml no.: Other feel appliances
Water heater 10.00 •
DESCRIPTION OF WORK Gas fireplace 10.00
,f,AlAQ tJ .4 MA (1/teLt.si,-, 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
Co}timney/liner /flue/vent f 0.00
[3'�ROPERTY OWNER ❑ TENANT . ther t0.D0
Name: Environmental exhaust and ventilation
3�( t [r-�t� � :.( - Range hood/other kitchen
Address: 10.00
y �•� �f'`� Z:..12_4.._ equipment Clothes shyer exhaust 1 0.00 .
City /Stetel%
AP: - �- �� f O ft_ '4 7 ?�� Single-duct exhaust (bathrooms,
Phone: (530 50d---rc3-yr,, 11
Fax: ( ) toilet compartments, utility rooms) 6.80 f
❑ APPLICANT ❑ CONTACT PERSON Attidcrawlspttce fans 10.00_ 10.00
Other:
Business name: Fuel piping
ll 55.40 for first four: 51.00 for each addttiomn _
Contact uamc 1 D Furnace, etc.
Addres Gas heat pump - ----1
City/State; /ZIP: p Wal /suspended/unit heater
Water heater {
Phone: W3 ) (� % .- � --)1)1-/
Fax: : 663)s-g-,676 Fireplace
E -mail: Rang • ' CONTRACTOR • : ;: _ Barbecue
n -
Clothes dryer (gas)
Business name: (� l (,t/'': b i r.._, P.z.n / l e , f)(l �` ✓t Moen: •
Address: % X .� 3 4 3 ; . MECHANICAL PERMIT FEES
City /Statel7lP: C, �,� .1_,.. 7 Zit' - Minimum permit foe ($72.50)
Phone: (, ) (7 ::- `� ' - X) ` F ax ( ) J �' �:J-� Plan review (25% of permit fee)
' State surcharge (12% of permit fee)
CCB lie.: . S i ! q TOTAL PERMIT FEE %I . 11
CL • This permit application expires if a permit is not obtainer within ISO
Authorized signature: T hi days after it bas been accepted as complete.
Print name: � AA E rie, I D ate: 7[54/01 1 II • Fee methodology set by 'Fri-County Building Industry Service Board
.. _ . .enrvt rr rt tPo7/COMmWEBI
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;,.• HEATING & COOLING, INC.
7 .0. BOX 230397.. TIGARD, CR 97221
(503)624-2704
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A) SITE PLAN
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