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Permit CITY OF TIGARD MECHANICAL PERMIT ' ii Permit #: MEC2011 00532 COMMUNITY DEVELOPMENT Date Issued: 11/23/2011 R TIGAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S134BD02700 Jurisdiction: Tigard Site address: 11965 SW SPRINGWOOD DR Project: Lawler Subdivision: ENGLEWOOD NO.2 Lot: 115 Project Description: Replace gas furnace. Contractor: COLUMBIA HEATING & COOLING INC Owner: LAWLER, WAYNE J PO BOX 230397 11965 SW SPRINGWOOD DR TIGARD, OR 97281 TIGARD, OR 97223 PHONE: PHONE: 503 - 624 -2704 FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Furnaces < 100K BTU 11/23/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 11/23/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/23/2011 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas 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: , /- /c 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. I Nov 22 11 04:47p Columbia Heating /Cooling 503 - 598 -0270 p.2 Mechanical Permit Applie 'r► Hall Blvd., Tigard, OR 0 FOP, OI'FICE USE ON] . City of Tigard R e c e ived e ! `', uatdt3y: f vt 3 I� Penni: No.: / $ 3125 SW' ;224-�� v � (/ - �© ° Phone: 503.639.4171 lax: 503.598.19 v 2 2011 Plan Review. C irn Permit: Datrllly • TIGARD Inspection Linc: 503.639.4175 D Ready/ By: Ants: Rl See Paecl lb. Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: i7 'Snonlemental I nfermatier BUILDING DIVISION ' • TYPE OF WORK - 1 COMMERCIAL, FEE" SCHEDTII..F, - USE, CHECKLIST I Mechanical permit fees' are based or the value of the work :: c + :t €:.,1n1::1 urt :�dciitionialteration, t replacement performed. Indicate the value (rounded to the nearest dollar, of nil i (_' 1)cmcilirlon 0 Other: mechanical materials. equipment, labor, overhead. and profit .. I CATEGORY •OF -- -- -• '- ,CONSTRUCITON.- . Value: 1,.__, - ` - RESIbENTJAL EQUIPMENT / SYSTEMS FEES' I • 1- and 2- farnily dwelling El Commercial /industrial ❑ Accessory building I For special rnformanor: use chechhsr _ `tuhi- farnil, ❑ Master builder ❑Other: — ! )ascription - i tjtr I -.a _ Thin: ' JOB SITE INFORMATION AND LOCATION lieating'cooting !; h <'e. address. A. Ar Air conditioning / _ '., 4 , t„ , (requires site plan shcw1t _pi:,celnen'.l 16.75 i 1 C II \i 1.lare,7l ° '' • G , Ftn , rrace 100.000 BTTJ (duc Vents) µ F 46.75 i-- - -_ _l- i ..� - • , - -- '�� ��" -_-- Furnace 100.000 F3TII (cm 54.91 i S :ritr9 no 1 Project n ame: i l'V A o �� -- _ . i ` 1 Heat pump 61.06 i Toss stree_'uirectiors to job site: I Duct work 23.32 Hvdronic hot water system - 23.32 • I Residential boiler (radiator or i h 'dronic 23.32 t t -.._ ...._.- -._._ unit heaters (fuel - type, not electric), in -wall, in -duct sus ended, etc. 46 75 . c- rant vision: Flue/vent for any of above 23.32 Lot no.: Other. IT 23.32 , i a>. map - parcel n■ • Other rod an fiances I DESCRIPTION OF WORK Water heater 23 32 Gas fire dace 33.39 1 1 ¢ { / L I� 1 ] / • t 1ti: ......- Flue vent for water heater organ 0 fireplace -- - 23.32 - _— _._ - -- - Lo lighter (5as' - 23. - W stove T 2 1.39 _ I Wood fireplacelinser'. 23.32 Chimney /linerHlue.'vent I i 23.32 PROPERTY OWNER • • 'I - - 'E . TENANT - 1 __.. Other 2.232 1 1 , -nr 7 r.c. I Environmental exhaust and ventilation — — � � Range hoocl!othcr kitchr:n - . ,V1dress: .tui meat 33.39 . Cit'1 %�iP: `II g � (! 1 - Clothes dryer exhaust --- 33 39 1 d �-�0 Single -duct exhaust (bathrooms. "tone: ( ) Fax: ( ) toilet eom r artmcnts. utility rooms) 23.32 _ 1 l 0 APPLICANT .0 CONTACT PERSON Attic/crawls race fans 23.32 r Other 2 ; 32 , ` httsin:ss name Fuel ilia -...._ . ,n;rc ,tame iiIt`d �� /I' /2 a J"J� ep/ /61 519.15 for first `our; $4.03 for each ad dition Furnace, etc Gas heat sums 1 t'i(c•,,tate%7?P: Wall/sus .endcd/un it heater Goa) r Y-. 7 a -r 57 o , t 7 ti'atet heater --• - _.__ -- Pltrns o Fax:: C -.. - — I 1- , •mar' Range . CONTRACTOR. . • . . • Barbecue I .__ .. -r t f l9_" � _ Clothes dryer (gas) = Business name - ��' Other. I ',ddre s: ` ' DI)�CHAIvI PERMIT FEES . ,ink c 9. '7 _ • r - ii, : Slate?.,1? I SE brotal i � Minimum permit fee ($90.00) j , o b P'.t re. 3) � ' 9 i Fax: -1,4,.. _ Plan review (25 %of pcnnit fee) I (7C? lit.: '7 Q , _ State surcharge(,2 %ofpermit fee) / , r O ( ! TO'fAL PERMIT FEE 1 / , re I '',tl: i'nr17.Cl1 .il?TtattirC This permit application expires it a permit is not obtained withir. ISO r � days after it has been accepted as complete. Pr1 ^I carne' ((r /CL /nee I1. Dille: / 2 /J� 1 1-1, " Fee rneihodolc set byT County flail liar In dust Service Bear.; -