Permit CITY OF TIGARD MECHANICAL PERMIT
`• tS COMMUNITY DEVELOPMENT Permit #: MEC2011 -00433
Date Issued: 09/30/2011
TIGAR.D 13125 SW Hall Blvd , Tigard OR 97223 503 718.2439 Parcel: 2S102DCO2800
Jurisdiction: Tigard
Site address: 13978 SW BRAYDON CT
Project: MARQUEZ Subdivision: MCDONALD WOODS Lot: 1
Project Description: Gas line to dryer
Contractor: COLUMBIA HEATING & COOLING INC Owner: MARQUEZ, DAVID
PO BOX 230397 13978 SW BRAYDON CT
TIGARD, OR 97281 TIGARD, OR 97223
PHONE 503-624-2704 PHONE* 915 - 471 -9499
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Clothes Dryer Exhaust 09/30/2011 $33 39
Type of Use: MF 12% State Surcharge - Mechanical 09/30/2011 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/30/2011 $56.61
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.
A / 1
Issued By: J L Permittee Signature:
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 29 11 11:47a Columbia Heating /Cooling 503- 598 -0270 p.2
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. Received
City of Tigard DateSy: PeruntNcr 4°7 — -
13125 SW }call Blvd., Tigard, OR . 3 2 J 2Q �� Phu R ,:ne, r L
Phone: >(ti.',1 S.2 &i9 C ax SC3.59R.196(l (� D rte'B5': 0' her Perini' I
TIf,rARD Inspec:wn Line: 503.639 4175 C ITY ( 't TIGAt�D Date Ready'I3y
y,,,„ I a See Page 2 for
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Internal: www h ard- ar.gov FotiOed'O thtd /�7) P t Supplemental €nrnrmatton
BUILDING DIVISION t
TYPE OF-WORK CON MERCIAL :FEE! SCHEDULE -- USEC1IECKLIST
Mechanical permit fees" are based on the value of the work
0 Nco construction iJ Addition /alteration /1 eplacement performed indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, eq'uipmect, labor, overhead, and profit
- -- Value. S
CATEGORY OF ;CONSTRUCTION RESIDE NTtA1.EQUIPMENT / S ysTE MS FEES*
I- and 2- family dwelling ❑ Canlrrtercia:;industl'la! ❑ Accessory building e _ For specalinformation usecr,eek/rs,.
❑ Multi fun:t[ Ell Master builder 1=1 Other: I Desenpunn I Qty I La i Iota]
JOB SITE L\"FOItMATION AND LOCATrON I Heating/cooling:
i Air conditior.mg
Job site address: l3c1-7 S ) at ( �� ;raquiecs sae pla>> shovonse plaeemectl 6 75 77 G� 0,2.... J / Fulr.ac 100,00) BB11. (coot act. st I $4 4-6.75
91 i
C'it };Siate'Zll': � E.arnace 100,000t LITU (du,,t./veo.) 5471
Suite/bldg./apt no.: 1 Project name. r 1 ..e. , Heat pump
:requires sae plan showi placement) 61 06
Cross strectldirections tD )O: Site. Duct wark 23.32
l- tydronic lint water system 1 23.32 J -
Residential buster (radiator or I
Itydronic) I 23 32
Unit heaters i fuel -type, not electric), ,
_ 1 in -wall. in -duct. suspended, etc. 46.75
Subdkision: ! Lot no. • I
Flue/vent ucfvt nt for any of above 23 32
Other I I 23.32
lax map /parcel tto.: , Other fuel appliances: _
DESCRIPTION OF WORK• b1'ater healer € 23.32
(O ��j r �� /� ,. ) Gas fireplace 33 39 •
S d 1 I. iz 0 (/) } Flue. vent fur water healer or
firepla:e _ 23 32
Lou lighter (gas) 23,32
Wood/pellet stove 33 39
- I
Wood fireplace/ insert 23 32
Chimney liner /flue/vent 23 32
PROPERTY OWNER ❑TENANT rJtlrer: 23 32
Name, /� E �1•� ■ ,
` � � '` ( Environmental exhaust and .ventilation:
Address: �' r . — .- 1
♦. • • • i * eq,tipntent i 3? 39
City/State/ZIP: e Clothe, dryer exhaust i 33 39
r � + « � � ing euct tm nts (uathrnutns, I
f hone. f� )'ax: ( ■
toilet compartments, utility rooms) 23 32
❑ APPLICANT . 0. CoNT•ACE PERSON Attiefcrawkpace fans 23 32
Business name, Other: 2 _3.32 •
Fuel piping:
Contact name: 5(3.. tom jt_ CI.1 534.15 for first four; W33 for each additional I
Address: Furnace, eta.
Gas heat pump
City/State /ZIP: W'alVsuspen heater
Phone: ( I I Fax• • ( ) Water ,tester —
r Fireplace
E -mail: G 7 >
t - *� C1a bi ;10 • A.ek" Range
GQI�TRAGTpti - Barbecue - 1
Business name: Cothes dryer (gas) I / t 1571 tt.► • ■►_ ay 1 !- � SJ E >> It
Caner
� (j
Address: _ )( c . ? J ! '� 4iECkIAAiCAL P]sit sit [.7 EF5'
Citx';StatesZlP: J +` ✓ � �� �7 X10 sub...] i -- f min. mum permit fee (SAW) '''10(.0° ,
I Phone- ; .5 ) t �_ 7o et Fax ( .V 5 6a1, Plan review (25% uf gernlit fcc)
Rlie.: 710 ,S State surcharge (12% of permit fee) i()< W1
I TOTAL PERMIT FEE Q3
-°� 1 hiy permit a pplication !expires if u permit to not obtained wi thin I SP
Authorized signaiu re: !� n y _,. ,hI is days after h hat been accepted as coinplete.
Print name: jar .k.ie .. i, i•4,r' vv" �-�� Dale: 9 _ i / - Tcc meth',<iotogy se- by 'i n- C'only Building Intnsas Ser,:ee Board
I Headencd`crniits PermnArj dnc a9/09r10 - 454617r ttl i O.'Ort was: