Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00631
TIGARD: 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Date Issued: 12/07/2010
Parcel: 2S112BB12600
Jurisdiction: Tigard
Site address: 14134 SW FANNO CREEK PL
Project: Ireland Subdivision: Lot: 0
Project Description: Furnace change -out
Contractor: COLUMBIA HEATING & COOLING INC Owner: IRELAND, DAVID P
PO BOX 230397 14134 SW FANNO CREEK PL
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704
PHONE: 503 - 998 -9103
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/07/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/07/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/07/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
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 No -: •• - • -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -0 1 -0090. You may obtain a copy of the rules
or dir. questions to OUN • allin. 232.1987 or 1.800.332.2344.
I -sued By: //„ f� Perm ittee s rz
Call 503.639.4175 by 7:00 a.m. for the next available insp•ction date.
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.
Dec 03 10 06:23p Columbia Heating/Cooling 503-598-0270 p.2
.. . ... . , . . . . ..
. .
.
Mechanical Permit Applicaticri . ' . ',kilt (ii t:r_
co Cit of Tigard # 1
1 Reccived
.. VE ,,, DuLerny: I — " ,... p., Permit N0.1 0 - 6, 3/
, . 1
I
Plan Review
Otbox Perttur
13125 y SW .-Iall 31vd., Tigiu OR 97223 7 I pr
l -.•., ,! 2 :'.. !Tho[lc: 51)3 171 Fax. 503.598.19611C 7 2010 Dye/By:
ioectiOr. Line: l'303.F39.4 .
T1GARb nsF394 17) Date Ready/By: Juri. Pi So: Page 2 fur
" . .1. :oternet: ,....N.o.v.tigaid-or.gov l' 9 F T/GA 0 r., Notified:Menial Suppleateatul tr.fcrinatiL4;
[311/1 nplic nu
1 • TYPE .OF WORICY D IVISION COMMERCIAL 'FEE SCREDULE - USE CHECKLIST ,
Mechanical permit fees* arc based on the value of - the ':so;I;.
N t: w construction lXidon/aIteratiorircplacement
perforned. Indicate the value (rounded to the nearest &II ar)
D D.:11101012n 0 Othe:: mechanical materials, equipment, labor, overheat!, and nr,..t't.
i
CATEGORY OF CONSTRK.TION - ' • : • Value: l ',.•••• ::'.• ' -;.••
•
• • RESIDENTIAL EQUIPMENTI SYSTEMS FEES*
V(and 2 dv;elling El Commercial/industrial. 0 Accessory building
For specia! informarion lee CileCkii-Yi
El MUII Ln k 0 Master buibolr 0 Other Descriplion Qty. Ir.i.
JOB SITE INFORMATION AND LOCATION -.. : '•• . •.'•:•,.. • .• '.;'.'•• .• ' - Heating/cooling
.1..b .,IIU LiilTuss: /lily 5 / C - A A/At2 cir /at, Air conditioning
(tequires site plan showine,placeiren 46.7f:
L'..t■ :'..-itatel 7, I I' : 17 i'0, 0/2 4722 ti Furnace 100,C)00 BTLl (duets/vents) „X,..._ 46.75 ,
Furnace 100,300+ BTU weetx.'vetts) 54.t; I _
ldv../apt. io.: Prcject name: - t eCt A.AJ/2 Heal pump (.) I .....,...) ,
.—.— _--_____---______. -... ..
(fruss :ill','CL C 1:1:C11011.S It: 101'. Sill:: Duc wo:k -,.. ,-
_Flydronic hot Water systern .:32
fesidetitial boiler ,.rtaliator cr -1--
i
! ' by:ire:Mc)
Unit heaters (ruckypc. not electric),
in-waJI, in-duct, suspended, etc. ' 4h 7S
Fluevent for any of above ' 23.32
5., u bd i . s :ow Lot no.:
-32
...._______........... ..........____ ..._ other: 2.
23 ______.....
1 a nutpiparc2; no.: Other fuel appliances
.
1 DESCRIPTION OF WORK . ' • -
: -': .. - ' • ' '':, ...• , Water heater 211 ..1. ,.,•-:. . •
Gas fireplace j_ 33.3 ::-
CH4/•- 4 6 -Q( T Flue vent for v.ater heater or gas
,
• fireplace ' 23 32
__
., Log lighter (gas i 23.32
Wood/pellet stove 33 3Li
_ . .
, Wuxi fireplace/insert oo -1 ,
L _ -- -.'-
, Chimney/linertflue/vent 23 3' '
lig•IrliOPERTY OWNER ' • ' E TENANT 3-
Other: 1 23 32
. i
Environmental exhaust and ventilat ion
j -----___._
Range hoed/other kitchen
ALit.lre:s, / .Y),1 g -54) /- CZE fiL — ,,
l"Ity:SWI...!:"/.11' •. 776A.I) 0,2_. 9 "7020 if Cloates dryer exhaust -- — 1 .: .
_ f Single-duct exhaust (bathrooms,
23, .
,,,,,,
lone: ,E6ig ) yz ell (.. ,„... .. Fax: ( ) toilet uorri partmtt.r,ts, ui 1 1 iy rooms) 3., - • -4 .
• 0 APPLICANT 0 • CONTACT PERSON . ... - • A:ticieranvIspace fain 23..
Other: [ L2 32 7
liusiness lthr.:e:
Fuel piping ___..,.......-..... . .. ..... . .
(ont;:et trartPL': 7" /7--) e.6)(7107) s / 4.15 for first four; Sf.t.13 fur nail addi(ioaal •
{
Furnace. etc.
Address: -- [
,
-- Gas heal pump
City/Stutel'/IP: Walb'sus.ended/unit heater
P Itene: Q . , ---- 3) • r j__ ,z 70 V Fax: : 6?) 57 6 _0(;)70 Water heater
•(.2
Fire.lace ' ,_
Ran:e -
CONTRACTOR. . . . • . . ' Barbeeue
.
,
. Clothes dryer (gas)
Busi:tess gall1c; "
' • -0-0-LIM.gli-IC ' '
A2,1)ress:10 ,60 \ , .Q , -.... ) - 7-.'_3 V 7
. ..: • MECHANICAL PERMIT FEES*
City/State:71P: 71(9.142 0 i 7..)y / subto,:ii .:
,
Minimum permit lee (S90.00:. i
Fax: cf _59 _,0j70 , .
... Plan rev:ew (25% 01 I I
'....(.... liQ 1 7/,i L---9 1 State surcharge (129/6 21 F. tee)
• TOTAL PERMIT FEE i
This [permit application expires if a permit is nal Qbtained ,,..th in l .so
Authorizett Th
sig,:tEturt2/) . , days after it bas been accepted iiS complete.
Print it '.a_rndkLi--- ,5 e /' if A Date, , .. ,,_ Fee methodology set by '1'n-Count Bui(...ine insu,try Scr..1..., :5,
I ".Jk...1cmg-Porum:',M1 Apr duc 10 445-It: I rr 51 !(12/2()M14/WI,111