Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00403
?1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/09/2011
Parcel: 2S103BB02900
Jurisdiction: Tigard
Site address: 12148 SW 125TH AVE
Project: Hughs Subdivision: BROOKWAY Lot: 29
Project Description: Replace furnace and A /C. Unit must mee 5' minimum rear and side yard setbacks.
Contractor: COLUMBIA HEATING & COOLING INC Owner: HUGHES, GARY A & SANDRA L
PO BOX 230397 12148 SW 125TH AVE
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 09/09/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 09/09/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 09/09/2011 $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: r dij Permittee Signature: ®n/
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.
Sep 09 11 10:39a Columbia Heating/Cooling 503-598-0270 p.2
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Mechanical Permit ApplicatiotRP t [ 101t 01.1:111.: Si
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City of Tigard
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TIGARD 1 mie...11 , Ji 1 .in.: 503 63Y 4175.
CITY OF TIGAiRD Dste Ready/By: .:La'S RI Sev Page 2 !or
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BUII DING DIVISION Ntdi _ ._....
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TYPE OF WORK COMMERCIAL:FEE SCHEDULE - USE CHECKLIST
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Mechanical permit fees' are based on the value of ihe .,i or
i ,--
.rti,:tioi :o‘dili,mialterutio,tireplacemenl
- • --, - '•': ."
performed, indicate the value (rounded ro ne nearest dollar]
Ei LL!!1■.:.1t1l21: 0 Other:
rnecharkulf9Liicrifi'jralir, overlteau, arm
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A 'TEGORY OP CONSTRUCTI ON ' .• '' ..... l.r., • . - --s —
- . RESIDENTIAL EQULPMENTI.SYSTEM.S FEES
:l-titr.1_ dwelling, E Comine7ciallindustrial E Accessory building
For speck)! inform:1:ton ;.s..i
0 Master ouildor c Other;
Description Qty. I La .._...
JOB SITE INFORMATION AND LOCATION' , • .• ''; .' • •-,','-',•.- ''" flea Si ogiconling
At conditioning
i t 4(9 „5"-c,j i/25 /4 (requires site plan showing plazeinent) '• 45.75
---• •
L':!■;:i',Ic./1.' 7-76ApA C 6/17c2.2S Furnace 100,000 BTU ((Lie's/vents)
11-4
Furnace 100,000+ BTU (oueurvenia) 54.9i _____
Stot3.•.: .tri II_ 1 iirojcc. isme• birc 0 ___
Heat p.imp b I lio
( :,,,.., :r...-._t Jitt. sr...!
DLCt work 212? .. _ .
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Hydronic hot water system -) - --,
Residential boiler t radiator or
•
hydronie) I 23 32
Unit heelers (fuel-type, no electric). I
in-wall, in-duct, suscended, etc. I ab 75 •
Flueiyent for any of above . 23 32 •
1 Lot no,;
-1---
Other: 23 3? '
II la
Other fuel appliances
__
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DESCRIPTION OF WORK- . - . • Water heater 2232
Gas A
e replace 33 3';
rcizAidq-c Z; A gc/1.04-ce"&v7--, Flue vent for water heater or has
tireplace 23.32
_ _ .. ..... . _ -
Log lighter (gas) 23.3?
, Wcodipellet stove 3,3.3,)
1 Wood fireplace(insen 23.32
I-
ri OWNER I . 0 TENANT 1 O Chimneyiler/flueiverit
ther. 23 3? .
23 ?
1. ' 1.-.. Gkfl-r.Y /4 CI Gittsi
-- Environmental exhaust and ventila lull __, .., ..
Range hood/other kitcher
A.:ores:. a I C l& -.. Cr , :i _D , 5 7-1. A-fre ' e Li.meni 35 3' ,.
-..i./ W 7-7411,40 04 99a.,2,_3 Clothes d er exhaust
Single-duct exhausi (bathrooms,
: you :e . , Fax ., ) toilet corn .artments, unlit rioirs 23.32 _.
n APPLICANT I 0 CONTACT PERSON Attic/crawls•ace Fans 23 32
Other: 23 32 -1)Jsice :m: e
Fttel 'silo:
.,,,,_,
/"
.: r` /.. (70_1/2 e. ..; t, i/ / 1 . 514,15 For first four; 54.03 for each. •adtliiit,itai
, Furnace, etc.
A.:ores,
Gas heal pump •
! !
(.• i,i I l'
Wall/sLspended/unit heater
i
P „.,„,
Water heater
,,,,s 4.. , 7 ,-,,, Fax :563 '- s .0„):70 i
---- -,' . Fireplace
'-
E-mail:
Range ' — —
. CONTRACTOR , , ' . .. .
Barbecue ,
-.- - -
Clothes dryer (gasi i•
Bosincss nar:e: in 4 , i c.' ,---. ' `,,- • c- , , , •
Other: 1 '
-
i7eSS: . V c .. f l ,:i C2±.7 I '' PERMIT FEES*
________. • ,.. J., ,
_, ...
c.t - 1 -- ;y:4 1 .2p, 0 ' -- '" - 7,-..;F) I sub..1 •
_ ...
.___.
_ Minimum pcm fee (P;0 UU) ,
hone -15'23, ,i)j.4....G.:17L 1 Lax: '5 5 ( (D _
Plan .. ___ ..
1
an review 1,25% of permi me) !
1 L'Ll li,
_ .
___ t ') t st....-,...D- State surcharge (12% of permit fee)
.
TOTAL PERMIT FEE I /0 1. 6_ , 7.2_,
,
A q:hcrl ziLiLtu.1,/ r" lif Thi ytrroitapplicatior tapires i r A permii is nul obtained ■tithir i .
<,,.. ,,,, - , j L. ,
.
Gays after it has heea a ck:epted as complete
Print niuneln ') Pli-, . Cate: C f , !- . q- J/ I ' Fee methodology se( by TA.Couti iy Hui cli:ig InJ■ztry Ser,,
Sep 09 11 10:39a Columbia Heating /Cooling 503 -598 -0270 p.3
IECEPIED
SEP 9 2011 -`
OF TIGARD
HEATING & COOLING, INC. CITY
P.O. BOX 230397 • TIGARD, OR 97281 BUILDING DI ISiO N
(503)624 -2704
SITE PLAN
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ADDRESS: / 0 f (- i8
7-16