Permit CITY OF TIGARD MECHANICAL PERMIT
° °1 g COMMUNITY DEVELOPMENT Permit #: MEC2011 00054
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/04/2011
Parcel: 2S 111 AB04600
Jurisdiction: Tigard
Site address: 14435 SW 92ND AVE
Project: LIEUALLEN Subdivision: PENMAR TERRACE Lot: 13
Project Description: Furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: LIEUALLEN, NANCY S
PO BOX 230397 14435 SW 92ND AVE
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/04/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/04/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/04/2011 $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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.33
Issued By: �- , - fermittee Signature:
Call 503.6 •. by 7:00 a.m. for the next available inspection 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.
Feb 03 11 0442p Columbia Heating/Cooling 503-598-0270 p.2
Mechanical Permit Applicatio:c(., \ _ --',', - 1:(>14 OFFICE I SE ONIA
(Ir of Tigard
'3'W Hai/ 13/rd.. Tigard, OR 919a. ));:, '
111 BY
Date/By; , Alk7 . ,4rjv
Perini t N o
, r . ,x ?Inn Revic
• Phone. 503.63'; A : 71 Fax: 503.598U Other Penni).
0 ...r",,Ap.
TIC Nil il Iristti.teti on 1..ne' 502.639.4 t 75 << \ .‘. \\ ID tpe R.ently/Dy hail ti3 See Piste 2 fur
intermit: www.t;g3rd gov ,k 0 c:ps Not if.ediMetbod: Supplemenuti Inform Live
,
I TYPE OF WORK e ‘ I ''' '' . . COMMERCIAL SCHEDULE - USE CHECKLIST . -
n'x, Mechanical permit fet..-s* are based on the yak:Li pith,: Boris
,__,, iso.). 'ainstructinr
›rAdditioniulterutiurtirepiacument performed. Indicate the value (rounded to we nearest dui , m .
1 D lkino!ltion _] Other: mechanical materials, equipment, labcr, overheau, lincl :7r...0
-
Value: S
CATEGORY OF CONSTRUCTION ' r. :• -'. ::: '..-•.. • •:.!•••' .
• RESIDENTIAL- EQUIPMENT / SYSTEMS FEES*
<1 illij 2- dwelling - family d0 Commerciallindustrial 0 Accessory 'Pudding
For specia! information use checkl,v!
E Mult.-tainily E Master builder 0 Other: Description 1 Qty.
JOB SITE INFORMATION AND LOCATION • ' • ' ' ,;.:.'. .. . • -..' '.: .• • Heating/cooling
-- T -- 7
Air conditioning
.10:2 SI I ,L aidress
. r _la ... I ;;I, 4. , (requires sue plan shoi.eint placement) I ,
CilyiStaief:/.1P: : 0 4 i 4. Furnace 100,000 BTU isluets:vents; / 46.75 1 1(1 , 1 *- 75
1N.
Furnace 100,000+13'n; ',duos/vents 549!
Sai ielblsiE..iap I. no.: Project name:
,
Mn
,..._____,. _. ......
Cmsi :trt.:L: ir....ctoons to Joh sit......: Duct work j :::: 7.2 ,,_
H dronic hot waxers stem 2J 32
Res:tiential boiler (radiator or
. hydrDn -
ici i s ' 2:- -i -)
- F " ;-
Unit heaters (fuel-type, not electric-1.
i---- in .n suspenden, etc. _ / 46.75 .,...
_ F lueivent for any of above F3.32 • •
I Sinxiivislco: Lot n) .:
Other _ 23.32.
lux intspfpartiel no.: Other fuel appliances
- DESCRIPTION OF WORK . • • ..:. • Water heater
Gas fireplace "-3.3'7
_L. - 2 ".“) i_..__
4.ia F . 4,4 a., A ' AI 0 Flue vent for watet heater or g,as
i-- / i fireplace 2332.
t--------- Log lighter (gas) 23.32 i - -
Woadipeliet st3vc 33 3t; )
Wood fireplacelinsert 23.32 '
Chimneyninertflueivent - 1 - 23
1 32r PROPERTY OWNER • 0 'TENANT • Other -
:
1 .: .• .• _ ..
. l \ aloe . 1142/0"- _ i_k_aLes Environmental exhaust and veorilatiou i•
r Range hoocUother kitchen 1 I .
Aarcs;
L_ .' ' /41L3 0, : • . . equipment : 313 :
...—
1 O' ill Ogg - clothes dryer exhaust • 33.3:) 1 •••' .
4111M ..r.avallorr... Single-duct exhaust (bath rooms. - I —
r ____ _______ __._. __. _ •1 _. .. ,
) j,39 z 0 (6 Fax: ( 7 , ..oi.et compartments. utility rooms)
0 APPLICANT . 0 CONTACT PERSON • Atticierawlspace fans
-r- - --- •
Other: I ..•._.-_-;
i 3t.ISille:IS :lame , Furl piping
; L'or.met n4:rue' ,4 1 ,-, a ___ 77) e:polo —
y) $14.15 for first four; S4.03 for each addi tioila I
Furnace, ac. --k -.-
, A,:dress" . Gas heat 'urn.
I — -- — ...___...____ __.. .. _.
, Ci.y/:.-itaic/7.11': Wall/sus • ndedfunit heater _
Phone: k,..3 0 '', 4. Q 4. I Fax: 56 ,acig _OD:70 Water heater
I F.-rnail: Ranoc I
, 1
• CONTRACTOR . . .. • • Barbecue
- ' .. Clcthes dryer (gas)
•
Business name: . h ..z. ,,... 4 s , ... '. qhd i , .., . - Otha: I
•
1 Aduress., , do ...,...■ di; • • MECHANICAL PERMIT FEES*
E. Subtotal - i q&,-75
• Cit:i1StainiZ1P. r .6 illi C.. 9 1----- .
Minimum permit le
P e ($90.0U) , • 0 0
hooe:5a3 I f Z. _a. 4 i- i - 1 3 - ca70 1
Plan review (25`./00t tee) . —
__. ----,-----
1 C(.13 ii..: . .2 -,.r.5.5j___ State surchiuge 02% of p..2rmit Cec) l A), pz,
TOTAL PI:IINI IT I L L I 1 To
Authorized si•2„,x,IturtiLAILAIiizd Tbis permit application expires if ti permit is notobte i ;led %jinni '. x.
days after it has bcgi opted as causvietc.
Priv:: mune:Hh( Oil'a '' 7"f) , Date: i s5Li, a ..... 1 1 i . Fee methodology set by Tri-O.Yonly lial lig Industry Iier.e.:e ttit..
. . . ....... .. . i . „,,..„. 440 I TI I I 11021COMAVEtt)