Permit CITY OF TIGARD MECHANICAL PERMIT
111 ; - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00271
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/15/2011
Parcel: 1 S134AB00200
Jurisdiction: Tigard
Site address: 11302 SW IRONWOOD LP
Project: BONNER Subdivision: ENGLEWOOD Lot: 1
Project Description: NC installation.
Contractor: COLUMBIA NW HEATING Owner: BONNER, SHERI R
PO BOX 622 11302 SW IRONWOOD LP
SCAPPOOSE, OR 97056 TIGARD, OR 97223
PHONE: 503 - 543 -3624 PHONE:
FAX: (503) 543 -6285
FEES
Specifics: Description Date Amount
Air Conditioning 06/15/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/15/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/15/2011 $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 1.800.332.2344.
Issued By: Permittee Signature: C f
Call 503.65 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.
06/13/2011 15:03 5035436285 PAGE 02
Mechanical Permit Application p r•c' on . l Isla r.) \ 'n
I...
City of'Tigard �� // . # ` Recciwed I
N 7 13125 SW Hall Blvd, Tigard, OR 97223 Detc!Cy E %I V ��
®Rev Othcr Femd1
` Phone: 503.639.a171 FaF: 5o3s98.1960 JUN � 4 2 y en r iew
.r 1 i s A it: I) Inspection. Line: SO3.639.4175 Date Ready/By. MIIMEREM
Interact: www_tigard- or.gQP t o i tif -cu ", nd:
TyrE OF woIZIC . -- - " " 1 01V COMMERCIAL FEE* SCl3E010LE uSE cusc}.IsT
❑ New construction i'Additiml/alteratioteplacernent Mechanical permit Flamm are based on the value of the work
performed. indicate the value (rounded to the nearest dollar) of all
Demolition ❑ ❑ ou=t: mechanical materials, equipment labor, overteead, and .. t
CATEGORY OF CONSTRUCITON Value; S
RI and 2 family dwelling ❑ Ccnm ie t ia1/indnstrial El Accessory bail:ling RESIDENT/AL EQUIPMENT r SYSTEMS > FSa
,For specie / irttormetien use ehecklfA
❑ multi - family ❑ Master builder ❑ Other. • Description r Qty. Ea Total
SOD SITE INFORMATION AND LOCATION
address; �f�/`j r
�, Air conditioning
lob site a
61w_.i.' -�• JW - a �L _ �. ��� y � ; raiieaaite. nnsfiawin: •laeemmt n 46.75
City/State/ZIP: - 66 t- o f 7 gloms/vents 100 000 BTU chs/vents M 46.75
Suiie/bldg. /apt, rte,: Project name: Pounce I00,000 +BTU / ' _ 54.91
N� Heal pump _ 61-06
Cross street/directions to job site: Duct work 23.32
Hydrortic hat warm system 23.32 _..
Residential boiler (radiator or
hydrant) 23 -32
Unit heaters (fuel -type, not electric),
in -wall, itt -Mica. suspended, etc. 46.75
Flmetvennt for any of above 2332
Subdivision: ! Lot no^ pfber er 23.32
Tax map /paarcel no.: • Oth l�od appliances
DESCRIPTION OF WORK ter Water heater 2132
Gas v L / COIV tV_z T.zove Fine vent for water hatter or gas 3339
Ll�-
fireplace _ 23.32
Los 1i. ex _.., 2332
Wood /pellet stoves -�II
Wood fireplacchasert,
i,PROP1;11TY OWNER 0 TENANT
Other 2
Chimney/liner/flue/vent 23.32
/) �+p 7' 3.32
Name: 5T Tfi y ,��� exhaust and vans latlun
Address: �/ / I 1 1.- A .I /� other leacher 33-39
City /State/ZIP: Clothes dryer exbawa
T. G- G - ( Single-duct exhaust (hathirroma.
Phone: (503) 33 _ , % i9 Fax: ( ) toils coin titilit. rooms
® APPLICANT ❑ CONTACT PERSON .
Basilicas name: 591116 as Contractor
Contact name: $14.15 for 111 !bur.; 34.03 for tub add/Cloud
Furnace, etc.
Address:
Cliet heat
City/State/ZIP:
Water heater
Phone: ( ) Itax:: ( )
E -mail: Range
CONTRA
ON'T'RACTOR Barbecue
I3uriness name: Columbia NW Beating Clothes dryer (gas)
- - - - Other
Address: PO 1300 622 , ' MI3'iC ANICAI: PERNIrI FEES"
City/Smte/ZIP: Scappooso, OR 970S6 ��6,
Phone: (503) 543-3624 (503) 543 62R$ Minimum permit fee (590.00) lay. 0
Plan review (259 of permit fsc)
CCB lie,; 61947 State cur bli (i2 %of permit Tee) {U
TOTAL PERMIT FEE t(,) . $U
This p
Authorized signature: ermi {!aa t appltea expires if a permit is not obtained within IRO
gars attar II has been accepted nx complete.
1 Print name: Gerri - Jacobson f Date: 4 6_/,_-.. 1/ 1 • Fee means/stogy net by TO-County Bandies trntavnry Service Roma
L'1TjUitainoremMpamm- perinea pdne mom 4ID- 4atlt /ONCOM/WFB)
•
06/13/2011 15:03 5035436285 PAGE 03
JOB# 1182981-1
BONNER, SHERI
11302 SW IRONWOOD LOOP
TIGARD, OR 97223
503 - 332 -2$19
Installation Property Information
DIRECTION: i u
Properly Line
( b Fr:
Fr: P 2- Fr: )2
22- FT:
Property Une
(F= FURNACE)
(X= OUTSIDE UNIT) STREET
•
Columbia NW Heating. Inc,