Permit u� CITY F TIGAR
� � MECHANICAL PERMIT
' ° COMMUNITY DEVELOPMENT PERMIT #: MEC2006 - 00579
. 4 11 DATE ISSUED: 11/17/2006
Ev RD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
`} °"" PARCEL: 2S104DB - 04400
SITE ADDRESS: 13130 SW ROCKINGHAM DR ZONING: R - 4.5
SUBDIVISION: AMESBURY HEIGHTS LOT: 044 JURISDICTION: TIG
Project Description: Install venting and gas line for new gas water heater.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
ERIC DUFORT Description Date Amount
13130 SW ROCKINGHAM DR
PORTLAND, OR 97223 [MECH] Permit Fee 11/17/20C $72.50
[TAX] 8% State Surchar€ 11/17/20C $5.80
Total $78.30
Phone: 503 - 524 -2443
Contractor:
COLUMBIA CONTRACTING SERVICES INC
38197 SE HUDSON
SANDY, OR 97055 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 225 -0774
FAX 503- 668 -3701
Reg #: LIC 103764
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
G
Issued B ti ji / lf t Permittee Signature: J %L=l�" wZ '�._.
Y G -
Call 503.6394175 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.
p. 2
MechaktitaiTermitApplication in II i I •.t. uN1 1 .
City of Tigard limited
DoO6y: i mArami Pcntlii Wc. MO, 4_ )(0 - oo‘7 ?
N ......, 13125 s$0/ Halt Blvd, Tigard, Oft 97223 Pan Review :
• L. Phone: 503.639.4171 Fax 503398.1960 thserlhe Other P
Inspection Line: 503.639.4175 Dec Rady/fry: FIJI El See rage 2 for
Internet www.tigud-ougov tortiOantaket Sepplenestal Infonimmen
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Mechanical permit km° are based on the value of the work
0 New consauction erisddition/alterationheplacement
performed_ Indicate the value (rounded to thc nearest dollar) of all
0 Demolition 0 Other - mechanical rnattsials, equiptnait labor. overhead. and Profit-
-
' l .-.::':1..tiljy,, :...- : ':r::::.!::;:i57::7:: Value: $ •
AErind 2-family dwelling 0 Commemiaindosnial 0 Accessory building 7 .440
For special befonnalion use checklist
0 Multi-family 0 Master builder 0 Other: Description r Qty. I Ea. J Total .
7 '" :
Job site address: /i/SD sec Ze ,. z..., Air conditioning or heat pump
(requires itnitine thawing placement) , 14.00
City/StatrJZ1P
7. 34 V e.e..._ Furnace 100.000 BTU (doetsiveas) 14.00 _
Furnace 100.00W- STU (doesivents) 17.90
Suite/bldg./apt no.; V Project name: Das heat pump , 14.00
- ,
Cross street/directions 10 jOb site: Duct work , 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Gait heaters (fuel-type, not electric),
in in-duct. suspended, Me. 10.00
.Subdivion:
1
Tax map/parcel ao.: LOt no.: Flue/Vest for any of above 10.00 10.00
Otha7
Other feel appliances
5 .'-...- r e:::.. Willer hear: j _ / 10.00
Gas fireplace 10.00
- -Z2i0 / 41017- ' Flue Vali for water beater or gas
///y &glace
"- & lenil_____) ' ---,
I-001101er
.. /7 (nas) _ 10.00
WoodAtollet stove 10.00
Wood fireplacefinsat 10.00
• • - ..- ., ........ .... ... . Chiznaest/liner/fineivad 10.00
...* *. *,,::`'.. * *0 ' -..*: n . .-.14.,. t....:;ff ,......... . . ... , 1..11';;. 4:. .....-: ; .
Name: yee.c 1 Eavironmental exhaust stud treateatioa
4 1
Range hood/other kitchen
Address: S .14 . .----
0101i17711011 10.00
City/Statc/Z1P: ' Clothes dryer exhaust , 10.00
Sine-duct exhaust (badossoms,
Phone: ( gie-,,zy.4. Fax: ( ) toile compartments, utility rooms) 6.00.
: ."?.;;;,:. .,- -'!..;:.: _. :••,1 ,... p:prsoiAizioce•-4:. r. AtlicklimisPnon Rog 10.00
Other. 10.00 _
Business name:
, Fuel pion
Contact name: S5.40 for find four; 81.00 for each additional
Addoxts ; Furnace. ete.
Gashed tramp_
City/State/MR Wall/suspended/unit heata
Phone: ( ) j Fan: : ( ) Water better (
• Fireplace
E-mail: Range -
;:; ...:..::: -- •-;,.'..41:0* - Stikric3*: :; : :.: ..;.... ...:::;-.. e.... , t.::-." . ::L.-:.....;:i.. Barbecue
Besieeis name: Zoi.isli.,644 .. .12,4 ,- 71.5':e V. -.274-c Clothes d9etr (as) ...
Other
Addreri: , F5/77 -re
City/Slate/ZIP: .4,f/a e, -.- Sibtottal
Phone: ( 1 2A . 6* -e7 777 Fax: ( Loy .0%, 374/ Minimum permit fee ($72-50) /9 , 5U
Nan rrview (25% of penult One)
CCB kn.: Z 7' Sudo surcharge (0% ofperunit fee) 6 W
TOTAL PERMIT FEE 7 RI 3?
Authorized signature: c2Ve-e.e_--P Tlas waft avocation meows W • permit In set otealeml within tie
sues stark Ma been mampted 115 amotose.
P rint name ...72 '---„LF..e."2.4)e-ie...„ I Date: 4 ' Fel mcalodolki7 set tor Td•Calla algal% Winn Serdm Rood
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