Permit .•1
CITY OF TIG ARD MECHANICAL PERMIT
I �^' COMMUNITY DE V ELOPMENT Permit# MEC2011 -00470
Date Issued 10/26/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 2S102DB05500
Jurisdiction Tigard
Site address 13244 SW CHELSEA LP
Project Keys Subdivision CHELSEA HILL Lot 32
Project Description Replace gas furnace
Contractor COLUMBIA HEATING & COOLING INC Owner KEYS, TED
PO BOX 230397 13244 SW CHELSEA LOOP
TIGARD, OR 97281 TIGARD, OR 97223
PHONE 503- 624 -2704 PHONE 503 - 620 -9308
FAX 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/26/2011 $46 75
Type of Use SF 12% State Surcharge - Mechanical 10/26/2011 $10 80
Class of Work ALT Type of Const Minimum Fee Adjustment - Mechanical 10/26/2011 $43 25
Occupancy Grp
Stories
Fuel
Fuel Types Natural Gas
Gas Pressure
Total $10080
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Slate of OR Specialty Codes and all other
applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344 �I `
Issued By . _ ! g/ i.� Perm dtee Signature a.•
Call 503 639 4175 by 7 00 a m for the next available inspection date
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection
Oct 21 11 12 03p Columbia Heating /Cooling 503 - 598 -0270 p.2
Mechanical Permit Applit FOR OFFICE USE ONLY
('ity of Tigard u 1 �� n Revved /o 1 ii Pun tN„ 17/16.2011 eb
aloby 1312$ SW h911 Pawl Tigard, OR 9742cr 2 1 2011 011 P lan evixw �-
Phnv SC) 639 7171 Fix• 50.3 598.19 0 1)Mcftly Odra Petit
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TIGARD InrtLine hnn Lc 503 639 4175 CITY OF TIGARD
Date evie 7HY Jun '' � Sun Pagel for
Internet www heard-or gov CITY f r r raAI�D HatdrNMnond i S,mpienrntai loco. muen.
BUILDING DIVISION _ _
l - --
TYPE OF WORK 1 COMMERCIAL FEE' SCHEDULE - USE CHECKLIST II
Mechanical perrin feat' arc based on the value of the work
;.u cllll'ODKA1011 KAddniona\tcrauonireplaccmcnt performed Indicate die value (rounded to the near -t 1lnllml, of all
J lhrn'l :inn ❑ Other mechanical macenals, equipment. labor, overhead and prow _J
Value S - - - --
- CATEGORY OF CONSTRUCTION , • __--1 RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
I0 1 - and 2 -family d•r.ellmg ❑ Commerctalhndustnal ❑ Accessory budding h -ors pe--:
al mfora;a• o., use ehecl bcr l
lulu - fart J) ❑ Master budder El Oyler. Descnpaon I Qiti la I I:i'_
JOB SITE INFORMATION AND LOCATION ticahn -_ I 32 tf� - i Air cora3iU VUrg j
I :lob -de ard;es l ( "e9mres v plea slmwmg Ph sercnP I on 73
t ih "tate' /IP Tr g- - � = ✓y I Furnace 100.000 BTU Iduci, tens) _ 1 i 4e 73
r- -, __ __ 1 7 J 1 _— Furnace 10(1,000- BTU (ducIS ones) 5491
I S ,u am
:cride •apt no. Project name �1i
11 �ts, I Heat pump _
n c _ 61 06
G _ Duct work ' l 23 32 1
UCe : %L' RCCLtOms to JOD site' T
-- -_. ���- FI dream hot water system 2332 1
Residential boiler fradietor or
-- hydromc) f 23 32_
- _, - - -. Unit heaters (fuel -type not electric),
in-wall. m -duct, suspended, etc 4fi 7s I
-- ---- - - - -- Fluebent for any of above 2312 I
r r
volsr. Ill Lot no 21.12 I
Other �_ -
I 3 map'parecl no O1 her fuel appliances _ __
DESCRIPTION OF WORK Water heater l 2332_
• _�.,a _ , � li-J. . Flue Gas f ve n i for water heater ce g as 1 _ 1 33 39
C� � vet f v I
_ . _— i fireplace _ 2 32
- - — -- I I Loa lighter (gas) '3 71 I
Wood /pellet stove _ _�, 133 J6
Wood fireplacdmser, L_23 32 �_
r-- I Ch :mneyilmerttluuvenl 2332 :
L i
—_ _ PRO PERTY OWNER ' ❑ TENANT I Otter 1 233
\riac Ted Environmental exhaust and ventilation _-
. -_ ___ ` Range hood /other kuohrn 1
\d.3res 13 , ) if l . equlpmeet 33 39
! Ut) Atat:,/(iP 1 it 4 Agri £ L /
` 7 7y / 44 , - -_ Clothes dryer exhaust _ - -_ 3719 1
Smgic -duct exhaust (bathrooms,
!'hone /(/l 7 i Fax ( 1 ` toilet compartments, utility rooms)_ 2332
—�:1- `ate - � �• - 4 :hUCrawlspacc fans 2332 t
t APPLICANT D CONTACT PERSON -
-- I Other _____ -___- l 23 I
It is,'C - s ramr Fuel i in• _-
• z on rc ,nine' /
(1r f- , �;?(.1 /21 PP!/(;7"Y] $17.IS for first four; S4.03 for each additional
- --
Furnace, e-c j
C3as Peal um ,_
( ,..',Li e.ZIP - -- Waltrsus ended/umt healer __--__ I -- I _
� I / C G - ��37�7 Water healer __ _ _ _ , .-- _
_nhnnc (S3) r� 7'70 `/— H Tnx_ 1q CJ _--1 Fncplacc _ ___` l ,
-
I CONTRACTOR Barbecue I _,
Clothes dryer (gust _ j
Buw,css name' Ai r • . a.xaQrM • e. �_^' Other I i
_
\ncroc. ..e & . R 7 — - -- MECHANICAL PERMFFFEES'
tr ip
�t Subtotal 9 mot
, C•t State/ZIP 71 • ! o.. (7 -�1 !
_ ! ' / 3 Mtntmum pem fee(S90001 i
!'hone 633 ) 6 , 1t g -,p� "1, Fax: ( 59B - Cj7_ Ilan rc„ew(24% of pennn fee) I �— 1
r State surcharge (12% of permd fee) t .to
LC CB Ix' _ 7f0 .J��• 1 1OTA I, PERMIT FEI no .9d
This pent appiica con expires if a perm,ns not alit. ed mutate lea
4athnrixec signatur •1 // � / /A MA _ _ days after d has been accepted as complete.
Tt) - I' • [cc methodology sea bb Tr-counts Tr-counts ry , 9mtdtne indust So
I er,,i name , /y�,, / j. .. 41/ /S Date ( j