Permit CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT
Pe COMMUNITY MEC2011 -00194
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/04/2011
Parcel: 2S104ACO3900
Jurisdiction: Tigard
Site address: 12647 SW 133RD AVE
Project: STEFFEN Subdivision: MORNING HILL NO. 8 Lot: 183
Project Description: Gas furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: STEFFEN, MICHAEL J
PO BOX 230397 12647 SW 133RD AVE
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/04/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/04/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/04/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 1.800.332.2344.
Issued By: J Permittee Signature: i
Call 51 .•39.4175 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.
May 03 11 01:36p Columbia Heating/Cooling 503-598-0270 p.2
Mechanical Permit Application RECEIVE FOR OFFICE 1•SE ONLY
City of Tigard Received
Permit No.:
Dalettly- Ai ihr-c.._;01, -0:4 fif
13125 SW 1-1a11 Blvd., Tigard OR 972'23 MAY 3 2011 Plan Reviei -
Phnne' 103 1539.4171 Fax: 503.598.1960 Dategly • Other Pertni( ;
T EG,NRD Imsacct inn Line: 51)3.639.4175
Internet: www.ligard CITY OF TIGARD 13341R'4YiBT Juns. 53 Sec Page 2 tor 1
_Notified/Method 77& Stmplemenbl loftirmatium I
BUILDING DIVISION
_
TYFE•OF WORK • " f,-
-. — I -- COMMERCIAL FEE* SCHEDULE - ustaactain j
....._..._. ,
1 !Mechanical per m it fees' are based antbivaiiiivlllie work 1
' El Slew construction )(Livid iti ontaltmtionlreplaccornt :
performed. Indicate the value (rounded to the nearest dollarl of MI
El Demolition Li Other. mechanical materials. equipment. lab or. overhead. anti profit.
Value: S
ATIEGORY .... 4*•,-,' .. - ' ..:..• "
' • • •. RESIDENTIAL EQUIPMENT / SYS1T.MS Ens. I
Kl- and 2-fnMily dwelling 0 COrnmercial/industrial 0 Accessory building . 1
Far special obrmation we chadlisr.
Ti Nlulti-catnil y 0 Master builder 0 Other: ..
r l •
1)escription i Qn. I La. i total i
JOB SITE INFORMATION AND LOCATION _Iteatig/cooltng______
---
Air conditioning .
Jot site addres5: 1W . 4.) 1 d_ /44.1E . (requites site plan showing placement) i 46.75 .
' . . .---
i C it 1.1Stater/IP : I * . --- .74 Furnace 100,000 HT1) (daub/wow 7 ' 46.7:t 0/7.
i- - Furnace 100,000+ BTU (thicisiventsi 54.91 19 !
Spitc,b1dgiapi. nc.: Project name: 51,
ht.06
L i____
Cross street!directions to job site. Duct work 1
23 32 -
i i----
yi dronic hot %ewer ssy_t_e_rn 1 _23 32
I Residential boiler (radiator or .
hydronics) I- 23.32
Unit heaters (fuel-type, not electric),
i i - •
i in-wall„ in-duct, suspended etc. 46.75 '
*-- — _
Flue/vent for any of above --i
1132 I
! St:hcfivk ion: tut :to.:
Other 23.32 .
T:'.N map;parcel no. Other fuel appliances
DESCItrPTION OF WORK •••••. - ' - --• • • Water heater 1 23.32 I
- (las fireplace ! 33.39 i
H - & - fittnn (IL, ' Flue veni for water heater or gas I 1
1 23.32 I ,
. _
i LD l IL ... ittsr3aL___
•
Woodipellet stove 33.39
Wood firer lace/inscrt 23.32
-- Chimney/liner/flue/vent 23.32
1 if PROPERTY OWNER • r. ' • ' '1,:i TENANT
Other . 23 32 I 1
;. .:,m.2LLy\g6,,i S.4Wet,7 Environmental ethaust and veotilation
Range hcoiliothcr kitrlier
1 T-1
4 a t e il & 13 L 3f-2 u
.
O• Iltornent 33 39 j
Cl !Statc/Z1P: --, 7 Oa_ . ce 7a..49 Mathes dryer exhaust
Single-duct exhaust (bathroonis, 33.39
Phone: 67431 1.4 c2 fax: ( ) toilet compartments. utility moms) 23.32 I
p APPLICANT . . Cl CONTACT PERSON Attiderawlspace trans 23.32 I .
Other. 23.32 i -I
! linsinms name.. Fuel piping • • .j
con t3C: :tame: 02,7,- /t. 1i /22 eedrne) 514.15 Ow Oro four: 54.03 for each additional
Furnace. me. I i
Address:
• . . .........__ . ._....._ - --•••••--- heat pump •-.
City:Slate/JP:
I p ax: : 663 s .O.,) 70 Wel Vsuspended/unit hcatta -.4- -
Pnon
_
—... _ _.,
e: a ( 4Q 7 ii Water he.ater
....._..._---- Firep1fICC -1-
-...... . ....- ------..----.
_
Range i ....... ;
_....._....
- CONTRACTOR, • ..: .• ':.• -. r.. . . .. • • Barbecue - .
.. Clothes dryciLtilas)
Rosiness name: di hi 1. , a ir, . gzaf a ., a.aaa, _ _ ,
. Other: .
I f
..10dtC.5S ' 'V ! _ I, ..,,LN 97 . :-. • --- --- RIECRANICALPERMIT FEES* ,
u i ,
ci,istutuizip. Tit , t . 4 ,,„,---„, 0 1 - 7 „ ) g i
Minimum penal: fee S 7
V
PhtInc; 61D,? 't / . - -- Q1 I Fax: LTE L5 - 0, D-70 Plan review (25% &permit i4&'. C
feel
CC lie. ! "7( aaci I '----- State surcharge (12% ofpennit fee) ,j 1
TOTA1. PERM'S' HE
Thb permit appneation expire, Ira permit is not obtained within tee
Autnorized signatureLAaLii) days after it has been accepted as complete.
..
Priii inzIeLn2-- /41,41 , " "if 417 r` Dare: 5 - ,s4A71711 • Fee mato& lov set by T,ti•Courly ELfildin; Inclusty Scwiec Bawd
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