Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00223
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/20/2011
Parcel: 1S134CD09200
Jurisdiction: Tigard
Site address: 11645 SW TIGARD DR
Project: Torres Subdivision: BURLWOOD NO.4 Lot: 26
Project Description: Replace furnace and install NC. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: COLUMBIA HEATING & COOLING INC Owner: TORRES, NANCY
PO BOX 230397 11645 SW TIGARD DR
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 05/20/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 05/20/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/20/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -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: /16(2 jam_ Permittee Signature: ‘,/(/ 770/V
Call 503.639.4175 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 20 11 09:56a Columbia Heating/Cooling 503-598-0270 p.2
. . . .
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echanical Permit ApplicatioRECF Pa -
Er rott'ount t sr.--tEstA
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City orrigard
‘ i: 8Ivt.f.. Tigazti, ()k 97223
Er .iiii;
U 3 639 4.21 l'ar. 503 59S 1960 MAY 2 0 2011 h eceR 1 ved
Date/By:
Pitut Reyfew
DaieRy: 4. Parrai NJ.:
Other Perlutt
Immuu, up ., Line' 5.. BUILDING DIVISION Norif0.4en-ion _I .I.: 039,4 [75
CITY OF TIGARD D keadY
j :41 6 Su It
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'tifernt.• vitt iigird-ur.gut• ic
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....
TYPE OF WORK ' COMMERCIAL j'FE'' SCHEDULE - USE CHECKLIST
Mechanical permit foes' are based on the v ante of tna Nl Or S•
g ,Add i tioniattertionirep I acement
performed. Indicate Lie value ',rounded IC the neard-i. dollar; ,..! .i.
I :3eim3iit:f_•i. 0 0.ner mechanical materials, equipilmnt, 4607, overhead, and f)f...11
S
CATEGORY OF GONSTR3.1.C. ' I : •: l 'i' • ' ,"-• • Value
- - RESID*NTIAI, EQUIPM Erg" SYSTEMS FEES
roil. , ..: . ..,.:'1:11L... 7 Commercitili'industrial 0 Accessory OL:Iding
For special inforrrahon use checklist
YILItt , 0 Master builder n Other:
De5cripticn I i Qty La
JOB SITE LNFORMATIOIN AN]) LOCATION • ' ....: ' ':,!.:: ....::" .. • Ha dug/cooling
i IL: : Air cPriditioning
...., -.,.:L:.,:,- I IL,' iis- 6
(ray Ares site pitus slicwittg placetrent;
T 100,000 BTU ;duels/vents) 1 46_75 1
laL, /11 FU
' 4.--srsk.-',...y,.....,A. C) ')2-2.-3
Furnace , 00,000-r BTU (euta_iyeins)
,
S. 1,c.
_ :: :• : 0 Pro. Heat pump
--------------------------- ic.R1 :lam e •
61 .I.P3
_____
. ----
L'•,,,s ni..el .tractioili :, {L.A) ':11::: Duct wor14
• Hydronic hot water system 23 3.2
Residertial Seller (radiator in
- . .
:
hydronic) . 23
Unit heater (fuel-type, not electric)
ti-wail, in-duct, suspended, etc. 46 75 .
Flue/vent for any of above 23.32 •
'fiuti,:i, is ..! Lct no.:
. Other • 23 32 '
...: ' ,:: I l 0
Other fuel appliances
-
DESCREPTION OF WORK - . . Water heater - 1
33 3
Gas fireplace
2 -6-A44 -1 (Aqt/ Flue vent for water heater or gas
lirepiace 33 32
•
. _ _ _ .... _
Log lignter (gas) • 23 32
Wcod/pellet stove I - in 3v
Wood fireplace/insert 23.32
Chimney/liner/flueivenf 1 23.32
PROPERTY OWNER : 0 TENANT .
Other 23.32 '
Pise..._f
kii.10.e--L,/, „ ___... --- Environmental exhaust and veutilafien
Range hood/other kitchen I I
_
ALircf,-, 1 i tQ 4 6r 5 .• ) equipment I
Clothes dryer exhaust . r., 33 3 y
' . ' - i I ' 72 .4 4- 9 2- 2- i
, 'S ingle-d3ct ex haust ',1:).th10
Pilt,:hl' •• ) toilet compmr.ments, utility rocrns I )1 '?
. --, ..- . _..
-----
Attie/crawispeee fans ; 23 22
APPLICANT 0 CONTACT PERSON ,
Other: I 23 32
Ilusines-, :,ailif:
._
Fuel pipiug
i
f,',i•fi ac: in i• it-. // l'' :_ ,,..- kt / 7-)(3 ,..._ iii e c o Cy n .
urnace 514.15 for first four; S4.03 fo , - CAC h addiNc1141_
_ ......... ___________ _ Gas heat pump
L'ifyr'Suite:LIP
WalUsuspendeciunit heater I
'
70 8 7
Water healer
Ir•folid• '02.3; i ' c: . ;.1 LA, Fax: : 6,6 -(,.) ‘. 5 . ( ---i „o
--.---- , F replace
-
15-mini.
Panic I
.
CONTRACTOR ... .. ...' • • .. • , . . Barbecue
t i '
B Clothes dryer (gas)
u. (l e(hone: .
—
• Other:
A dcratis: , \/ _ ?TN '''' .
• - II'' MECHANICAL PERMIT FEES*
.
ttuts'ZIIP 0)-
Subtotal
Frij !C>4
, ,/,-.--....--
Mirimurn permit fee (S90.UU i 7,
1 licne . 6-6 ) ( (I A
lux L
,_.
(.,L. ,,,,
____________ . i cf-i- 6(3 -c,D70
I Plan review (2'5%4 permit Ida;
Slate surcharge 112% of permit reef //,
, I TOTAL 1.' ERM IT FHE /0 762 (,./...
Mil semis lip plication cipinn if - permit is act ub:ained , ith.n I Si
1
A L:L1101 . 0:: 11..1"-iLit 4{1_,/ ()_"11
days after it tat been accepted as ;Dm plete.
Date. /
' . fee citithocioloo set by Trt-:2co.). kitt.Iding I tdusiry Sen...c t3,...::.
May 20 11 09:56a Columbia Heating /Cooling 503- 598 -0270 p.3
#► / / ` F � A rr
HEATING & COOLING INC. l
P.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
SITE PLAN
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