Permit CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT Permit #: MEC2011 -00408
TIGARD SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 09/13/2011
D.
Parcel: 1S135DB01600
Jurisdiction: Tigard
Site address: 11560 SW 91ST AVE
Project: Ramirez Subdivision: CHARBEN Lot: 4
Project Description: Replace furnace
Contractor: COLUMBIA HEATING & COOLING INC Owner: RAMIREZ, JOSE C /MARIA
PO BOX 230397 11560 SW 91ST
TIGARD, OR 97281 TIGARD, OR 97223
PHONE 503 - 624 -2704 PHONE
FAX 503 - 598 -0270
FEES
•
Specifics: Description Date Amount
Furnaces < 100K BTU 09/13/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 09/13/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/13/2011 $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: a , f - Permittee Signature: t r /( / 117 L–/C4-7 /OA)
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.
'\lechanical Permit Application Rth F�I Nonni ntit ttiL: City' of Ti and R«cr��d
D"S �/. - Permit Nu
IT
I:I I I . !,g,t:d,OI: y7223 SEP 1 2011 y. �® ..,� r�'��zo —ii if
5.:3 6_ '3 i , ' i l I it:, 5)1' SUS 96 P1nrI Rtvtew
DateBy: k Other Fermi
TIGAit) nsrc. -:.:n l.tnc )U3 b3U 4175
I t.rn_1 •.. •.,\, 4,,4rJ -ar guy e y CAR I D ale e adyl5y tar I See ,', fu
��� �r Y i.� ii'ti� N otifi R ed!? [ethoJ �� Supplerr.L I l: u rnrellu t
- - - -_ �Ui� Dii�G Di��ISK
l _ TYPE OF WORK COMMERCIAL, 'L{E' SCHEDULE - USE CH£CKL1S'1
\c:. •is:nl.tlun • kGdr :o�:iull_rutlori/replacemett Mcchanicxl perma fees' arc b tit d on the value of Me ,tier,
performed Indicate the value (rounded to the nearcl doll.u:.,.
1 r: ❑Other mechanical materials. equten•ent, Gabor, :vcntcad, and pv tt
l� CATEGORY OF CONSTRUCTION - - value S
:rl -.• :• • r111, •.,ell ,g ❑ (ommerciafii [2 Accessory building RESIDENTIAL EQUIPMENT i` SYSTEMS FEES'
For special ` rnf•rrnalion use eheckl:sr
.I�olu- lalwl, ❑ Maste: builder ❑ 0 ,e - - - -- - --
-- Description Qty 1 I:a
_ - - JOB SITE INFORMATION AND LOCATION : -' . fieatanGlcoolluo -- -
l..•_ „ ___, �/ /rq -- Avconditiuning
/!J �f ej • I requlras WC plan showing p a.ement) - 16 7:
2 Furnace 100,000 BTU (dtsetslver.ls) 46 7i 1
T
Furnace loo arm t t ;; ,I
\- .tletLi_ ..It:• tl, Project .:ne
- - ----- - - - - -- -- - -- _l n
- - -- neat pump 0 p
C _n> , i_. n
...- ic,t.•.., , _ L Jct
!) ILu wo-k „? i. - ______ - - Fly3rontc hot a t er system 23 ;
---" - - - - - -- - - - - — Residential boiler (radtulor or
hydronic; ?; ;_�
` I Una heaters (fuel -tyre, not clec ut.,J,
_
--- -__ -- -- _..- - - -- - - in -wall, .n -duct, suspended, etc 46 35 _
'�_ .. ,- _. - FlJervent for any of abcve 23 22
Lot no _ - -_
Other. 23:2
l._rrL_I ` LL i Otter fuel appliances —
- _ UFSCREPTION OF WORK Water heater 213 ;?
r
Gas fireplace
-" -- / - - --g" z�+/u .'It.e vent for water heater or gas ' i
Lire)aace - :3
-- - -- - --- - -- --- - mug lighter (gas) :3 3
- -_ -. - Woodrpellet stove J 3 39 _ _
- _ Wood firepl ace/ lnsen 23 32
- OPER'1•Y OWNER CD TENANT Chimney /liner /tluetvent 72 ;
' Tare A/►9/1.6 - Envtrucmeutal exhaust mild ventilation
1Jdre. t 3 s G� equipment hood/other kitchen
- -•
- - - -- - - I /t/ 1 �= - - -. -_ euulpment
I i i
' " It C,othc> dryer exhaust
- j Single - duct exhaust (bathrooms,
i V wr c Fax. ( J toilet compartments, dui:" rooms) 23 ;'
- - 0 APPLICANT 0 CONTACT PERSON Atti: /craw space ails 23 33 r
Other 27 ,?
-
.t.sln:s• as ,_
H_.___ _ --__ -- _ -_ --- Fuel pipiug
_ -- , _ /L.'_ , -,, ,-, , e -dn - 7 514.1 for firyl four: Si.G3 for each epoltiuuet --
Furnace, ate
' --- --- • • - ---- — ---- Gas Grs heal pump i --
; t 1, - :Ie: % /.I f' — Wa! Vsuupended/unu heater - -- - - - - - --
�- �^ Water heater -- -
5'10'1 - J =. . 5 , 6T 4 -. f j i 7r... � FaA l_X 5 b -t�or73 - -- -
i n,� Fireplace
- - - - -- - Range
CONTRACTOR. • Barbecue
--
13ustnc,_ time ( A i) 4. i ! n--? r i--tle 7 r'L ` - )6,— i Clothes dryer (gas I l l -- -
l Other' I
.\.,Bras' 6,' - 'i X �Z' 9 -
7 MECHANICAL PE RMPI' FEES*
I PI ou•_, r'.1.3 I t ' ( nit
/ lc: !, - ! v (� - 0 0 Minimum permrt fee 159U c: ,
Plan review (25% at permit re :,
',Q -� `� _ S surcharge (I?° /,of permit fez:
TOTAL PERMIT FEE je9 r t0 ✓
;uut,;r.teJ „grt:I:rt� 1 X �t ; A / I i (� , J ���/t This perm ::t it application aspires if s permit is not obtained ,.l;h ISL•
dayi al fter it hue been accepted ,i complete
NrIIII nal'Id 1 ! ' I
r 7 it�pri( I Date 9 /-/ - ) j t red methodology set by 'fn•Coui is dmld - -i5 neu,,rr, Se:,,.. ,,,;,:
I y,c
, .g .H . .un, ', IF— PC ,i r.,. x,..61 • e� -/ =- -�-�.�
Z OLZO 869 - £09 N �,•,,,.� 6upoo/6ugee eiqulnioo eZ9 :LO 6l Z• deg