Permit CITY OF TIGARD MECHANICAL PERMIT
�'1 a COMMUNITY DEVELOPMENT Permit #: MEC2010 -00520
Date Issued: 10/22/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S133CD04700
Jurisdiction: Tigard
Site address: 13680 SW ASHBURY LN
Subdivision: COTSWALD MEADOWS Lot: 45
Project: Cegla
Project Description: Replace gas furnace and A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
CEGLA, STEVEN E & MICHELLE C Description Date Amount
13680 SW ASHBURY LN Air Conditioning 10/22/2010 $46.75
TIGARD, OR 97223 Fumaces < 100K BTU 10/22/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 10/22/2010 $11.22
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97281
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: Natural Gas
Gas Pressue:
Total $104.72
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.
Issued By: Permlttee Signature: 2Y(/
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.
Oct 21 10 09:16a Columbia Heating /Cooling 503- 598 -0270 p.2
Mechanical Permit App11i 'o J b EIVED rs}I; tll FIC t: l SI: ONLY
City of Tigard Date lly: ( p2� O 44/---- Pam't No /"r ?J,2O /0 -ad .5420
� ii 13125 SW Hall Blvd., Tigard, 0 /
1 Phone: 503.639.4171 Fax: 503.598. Plan Review
Ins Line: 503.639.4175 CT 21 2 0 10 Date/Br. O1 �n"`��� /D --00.5
i • 1(] A 111) Date Ready'/fly: 3 , „." 1,, , l la See Page 2 for
Internet www.tigard- or.gov Notified/Method: � Sapplemcntalinformation
CITY OF TIGARD
• . - TYPE-84)1104G DIVISION COMMERC[Al:{_'•FEE,'.SCHEDULE - USE CHECKLIST
❑ New construction 54 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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION • • , • Heatfng/cooliug
• Job site address: *8(3 ) t ` � n , f - Air ' '" `' . (reqguires plan show ni ylacemeat) 46.75 City/ State/ZIP: ad Plroject 1 1 Furnace 100,000 BTU (ducts/vents) ! 46.75
1 a H puace 100,000+ BTU (duaswenu) 6.01
Suitz/bldgJapt. no.: flame: `(-;7�/'a Heat rnp 61.06 ;
Cross street/directions to job site: Ductwork 23.32 1
- - — - " Hydronic hot water system 23.32 •
_ - -
' Residential boiler (radiator or
a hydronic) 1 23.32
(;nit heaters (firel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other 23.32 1
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK • • • • Water heate 23.32
R .{..SCIL, C9CS -F , „_ _ - Gas firepla 33.39
-��n '}(�_,/ I Flue vent for water heater or gas
fireplace 23.32
. Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
V PROPERTY OWNER • 1 0. TENANT , OOther: 23.32
`
Name: \\ ` Ce a ' , Environmental exhaust and ventilation
"VVV Range hood/other kitchen
Address: 0:1/1 m LA/0 ill equipment 33.39
City /State/ZIP: - 170, i e I qj u Clothes dryer exhaust 33 39
�-"+�J ` 16-75 . =SZt toilet cox
Single-duct compartments, (bath, rooms) s,
Phone: 5 . Fax: ( ) toilet compartments, utility rooms) 23 32
❑ APPLICANT : ❑ ,CONTACT PERSON •• Attic/crawlspace fans 23 32
Other. i 23.32 _
Business name: Fuel piping
Contact name: fir - A... / . 2a..... 7 eery xy ,� 1 514.t5 for first four; 44.03 for each additional ,
•
Address: / ' Furnace, etc. .
Gas heat pump
City / State/LIP: Wallsuspended'unit heater !
Phone: a 3) � 4•a70 L Fax: X7 _cQ7C7 water heater I
(Q Fireplace
E -mail: Range
CONTRACTOR'. • . • Barbecue ,
Business name: I u m (.� I / ` ' -.F fir f C /IL 16_, Other : dryer (gas)
Address:- k 0 2 2. 3_.3 � 9 7 r " '-- ~/ • • . MECHANICAL PERMIT FEES'
CityIStatefZIP: ��7/c ) Q 7
Minimum perme tee a g J Subtot(590.00)
al '9-3 , so
(` /� Q
one:) `Fax: ( r5q - �� (� Plan review (25% of permit fee)
O lh
CB lie.: '7(�q ___. State surcharge (12% of permit fee) /l1 a / J TOTAL PERMIT FEE /0 y, 72,
Authorized Signal
�A iY .l� This p ermit a expires if a permit is cot obtained within 180
days after it has beta accepted as complete.
Print neme "- - Una / j (S- p Date: f pq- 0 ` Fee met b ado logy set by Tri- County Building Industry Service Boarc
IAIJuild: rtg\Permits\MEC• Penn itApp.do.: IC/0149 440-4617r (II tOVCOM WEEK:
Oct 21 10 09:16a Columbia Heating /Cooling 503 - 598 -0270 p.3
6;r 101,4274 &P
HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624-2704
SITE PLAN
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ADDRESS: , •sip - . .. [ , �,