Permit CITY OF TIGARD MECHANICAL PERMIT
, .' • • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00302
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/29/2011
Parcel: 1 S134CA03000
Jurisdiction: Tigard
Site address: 11980 SW NORTH DAKOTA ST
Project: McConnell Subdivision: BURLWOOD NO.2 Lot: 3
Project Description: Replace furnace and a /c. A/C unit must meet 3' side and rear yard setbacks.
Contractor: COLUMBIA HEATING & COOLING INC Owner: MCCONNELL, BRET T & EMESE
PO BOX 230397 11980 SW NORTH DAKOTA ST
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE: 503 - 524 -6414
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 06/29/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 06/29/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/29/2011 $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 . ification -. er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or dirct questions to OU b • i . 13.232.1987 or 1.800.332.2344.
•
Issu =d By: s j Permittee Signat e:
L / L . � ./� /. /.'1
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.
Jun 27 11 04:16p Columbia Heating /Cooling 503- 598 -0270 p.2
Mechanical Permit ApplicaBECBIED • FOR OFFICE USE ONLY
2
City of Tigard 2011 Received Date /13y: fl if I I rem" edolOI�'DOc,10,21
N - .. 13125 SW Ilan Blvd., T JuN "Tigard. Olt 97223 Plan Rev':ew 1
Phone_ 503.718.2439 Fax: 503.598.19W Oilier Permit:
DarelBy.
T Inspection Line: 503.639.4175 ate Ready/3y:
funs: to See Page 2 for
In ternet: ww�s.iigard or.�ov C D � ` SI (Z � V� NonfLetl /Method: Supplemental information
' ' 7' i OI' N7V0)1K , ., I. COMMERClAL FL nV
Bilk ONG E' SCHTLE.- USSECHTC LIST • I
Mechanical permit fees* are based on the value of the work I
E New construction IZIAdclitiOnialterationireplacernent performed. Indicate the value (rounded to the nearest dollar) of all
D Demolition [] Other: mechanical materials, equipment, labor, overhead, and profit.
Value: S
•
CATEGORY OF CONS•'RI. - • J TENT[At.EQUIPMENT /SYSI`EMS FEES'
I2NS
Id 1- and 2- Family dwelling, Q Commurciallind uatrial D Accessory building For specialleJo- random use cheefdist,
Q Multi -fami ly 0 Master builder ❑ Other: Description I Qty. Ea. I Total
JOB SITE I`FOR IATION _4h1D. LOCAT • . ... t•leatinuJeooling:
) Air conditioning 1
Job site address: / 1 y,yr3 u ' ;rec. site plan show np placement) f 1 4 6.7 •
Furnace I00,060BTIJ ldncts , cenrsl 1 46 -75 1 4 ,/5
City/State/ZIP: (em
�d effi, 9 Furnace 100,0(104• BTU U (dectsivelitin 54.91
Suite/bldg. /apt. no.: 1 Project name: Heat pump 1
C i G a✓� Y1 J :r euires site plan shoit•nng placenmu) 6 (.06
i Cross street'dircctions to job site: Duct work : , : _
I Hydronie hot water system 23.3 I
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct_ suspended, etc. 46.75
Subdivision: Lot no.: Fluefvent for any of above 23.32
—•— l Other: ; 23.32 I •
Tax map /parcel no,: , Other fad appliances:
ITESCR1PTION OF V OR1 `" : Water heater 23.32
Gas fireplace 33.39
<J / Flue vent for water healer or gas — - I
/ /
fireplace 23.32
Leg lighter (gas) I 23.32
Wood/pellet stove 1 33.39
V /cod fireplace/insert 1 23.72 :
Chimney /liner/ flue /vent I 23.32
PROPER'T'Y •OEWNE.R . ' . , I' Q .TENANT 1
- Other: 23 32
Name: itil 4 01 2 �,fUj_ # I Environmental exhaust and ventilation:
�� I
Address: ' ! / ` atrr lWAR7 /3.12+x% - Range h0adiother kitchen,
cr uipmeet 33 39
•
S j t7i „,(4-- q"--far . Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone S13) - y a Fax: ( I toilet compartments, utility rooms) 23.32
.. • 1 fans 23 32
attic'crwis ace
0 A PP.LICA*P!F• ... :. _. [1 7PERSCIM .. P'
Other: 23.32
Business name:
_ Fuet piping:
Contact name: S k_ & kan.......) 514.15 for first four: S4.03 for each additional
Address: Furnace, etc.
Gay heat pump ,
City /StateiZIP: Wait/suspended/unit heater i
Phone: ( I F•ax:: ( l Water heater
p Fireplace _.
F.. -moil: 0 •Si.s 'Ut. -Si C'fa twiv , -b, O..L_ -b f. Range
Barbecue
col+T�xac"rbit , ,
Business name 1 (t,`� a ` s s • '41"... �.00i„ Clothes clr�crf'a
Other: i ,
Address:
_____Ci/ ._._6-6 y � t l ' `:ikiCOIANICAI, 'gR*T LES ' • -
City/State/ZIP: T� / � ! SutrEtltal • _
Minimum permit fi re (590.001
Phone: (J7? ) 4 r7.. -70 t Fat: 1 ,V .5 -FY _ 0,z-z0 Plan reviciv (25'o u(perntit fee)
CCB lie.: 7l0i . State surcharge (12% of permit Ice) ft- . '
TOTAL PERMIT FEE /0q• %.
This petite applieatinn expires if • permH is not obtained within isa
Authorized signature: � r•, �, �. — � ys t _ / JJJ I la after it has been accepted as complete.
Print name: Jac J •" 1 ,, I A„ I Date: j'� p..�^ / 1 ' Tcc nick o lolog set by Tri-Chi int.• Building Industry Scr•:lee Board
I l asld ;neipesmio\ara :- t'tnnirA:xl.doe bAUV!IC. 44O.4(.17T( 1 /COt' OV
Jun 27 11 04:17p Columbia Heating /Cooling 503 -598 -0270 p.3
it I i
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
SITE PLAN
1. 3(7
7 7
,g9ifi 61,0 Al .bal<thi-)&f. .
ADDRESS: //9//1