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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00450 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 10/12/2011 Parcel: 2S112CA01000 Jurisdiction: Tigard Site address: 7815 SW GENTLE WOODS DR Project: BIEDSCHEID Subdivision: GENTLE WOODS Lot: 3 Project Description: Gas furnace replacement Contractor: COLUMBIA HEATING & COOLING INC Owner: BIEDSCHEID, RAND! J PO BOX 230397 7815 SW GENTLE WOODS DRIVE TIGARD, OR 97281 TIGARD, OR 97224 PHONE: 503 - 624 -2704 PHONE: FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Furnaces < 100K BTU 10/12/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 10/12/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/12/2011 $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: Call 503.634 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. Oct 11 11 02:17p Columbia Heating /Cooling 503- 598 -0270 p.2 RECEIVED Mechanical Permit Application FOR OFFICE LIST-ONLY . r City of Tigard P T 11 2011 Received h b irate: i .�i • WI i1 • 13125 SW Hall Blvd , I ieard. OR 9 " l Plan Rcwea Phone: 593.7]L2.439 Fax' 503.59 ) I OF TIGARD f7har Perm': D ate By. Inspection Line. 503.6.9.4175 T.IGARD p BUILDING DateR.ead`aiy: I Jurs: : el See Page 2 for Interact: wl>,wtieard- csr.gav Won nevi Met he 1. f Supplementalluformation f)'I'k QI- ivORK - GONIM1! -rce. see L'SE CNfECKLISr 1 ' 1vlechanical permit fees' are based on the value of the work i ❑ New construction 'Additionfalteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other- mechanical materials, equipment, labor, overhead, and profit. — Value 5 CATEGORY' - OF CONSTRUCTION RIB;SIDENTI LF.QU1PiviENT)SYSTEMS FEES" I- and 2-family dwelling ❑Comnercialind- strial ❑ Accessory building !or special injorma1iotrusechecklist. Multi- famill ❑ Master huilde~ 0 Other: Chscripurin (fly I In I Total JOB STTE INFORMATION AND LOCATION Iicarin Air conditioning I ' I lib site address: �]ei 5, t � }� , sr '.requires site plan showng placement) ; 46 ii ' ll ��l Furnace 100,000131'U(duetsevem K si / 1 4675 rp, l5" CityiStatelZ1P: x. e 11 , a i / D- a J, . � Ewttacc1(1t),000{ Rill (Juclv'vcn•s) 54-91 Suitelbids.:aot. no.: ej Project name , 11 Heat pump J � :' _ � ,� in:qutrrs site plan showing placement) 61.06 Cross streetidirections to job site: Duct -work I 23.32 _ Hydronic hot water system I 123 32 Residential boiler (radiator or hvdronic) 23.32 Unit heaters i fuel -type, not electric), in -wall. in -duct, suspended. etc. 4e 75 I • Fluelvestt for any of above 23 32 Subdii,ision• Lot no.: I 1 1 Other , 2132 lax map parcel no.: E Other fuel appliances: l DESCRIPTION OF WORK -: ' Water heater 23.32 ,` Gas fireplace ' 33.39 / r .0 tL.! 7.-_-....r. 11 _ �Laa Flee vent fur water heater or Leas fireplace 23 32 I Log tie.:nei (gas) 23.32 A'ardtpcllet stove 33 39 Wood firepiaceiinse-s 23 32 RC)I!E€iT! OWNER ❑ I T Cl.irtncy /liner. %Floc /vent 23 32 I - Other: 23 32 Maine .�2 + 1 - t • Environmental exhaust and ventilation: 7s _$ Range hood /other kitchen Addles : • " Fr . R . • F' — _equipment , 33 39 (.itv'Sta'e1ZIP: '' 6 A}•trt n 1 Clothes dryer exhaust I 33 39 Singie -due: exhaust (bathrooms, Phone ) • .. - • Fat• ( ) toilet compartments, utility rooms) 23 32 0 APPLICANT . ❑. C ONrTACT PERSON At :lc/crawtspace fans 23 32 I 23 32 Business name: Other: 1 3 Fuel piping: Contact name: SO ,. 0,..A 519.1:5 fi for rst four: 54.03 for each additional Address Fumsex, etc. Gas heat pump City7State /ZIP :4alL'suspendedluntt hea :er Phone: ( ) h'ar :: ( ) Wet r(teeter ^; Fireplace C- alai" 0 cA C 0 t`fA ( - • ° _*` Ranee CO! TRACTOR I Barbecue ILL Clothes hcs dryer (gas) Business name: i! a ' w." 4 +- `�- 4.i I Other: fl., fit_, ) � ChC£: I ] Address: it t 2 v , t� l MECHANICAL PERMIT FEES' City;SUCte /Z1P �. .,, OP_ _ 9'� I _ Suburtal ; MG...ZS f Minimum permit fee (590.00) I q©, c o C Pnonc 15 ) b , ( Fax: ( W,$ ) ? 02'W Plan review (25 %of permit fee) CCB lie.: "'7�,3 ['Q State surcharge i,12% of permit fee) / t) • S_ ( TOTAL PERMIT FEE /tit This pry m41 application ea pls.., if a permit is not obtainrd ,within rat, Authorized signatui e: .Y (� n n 9 � ^� days after it has been accepted as complete. I Print name: j tr_j�.t�, Fo1.� /'e!' Date: /4 J t _ ( . Fee a etho:loln5y set by Ti.- County Buddnte Lndusny Setsrcc Board I ( , I'•B.: Idm.t?ermtI- EC- Perrrar Opp doe 09■91 a 440 411177 t I -'(12:( (tWLWbH)