Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00541
T1GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/29/2011
Parcel: 2S112CC06500
Jurisdiction: Tigard
Site address: 15845 SW 81ST CT
Project: CORONA Subdivision: BOND PARK NO.4 Lot: 93
Project Description: Gas furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: CORONA, KARLY & JOSE P
PO BOX 230397 15845 SW 81ST CT
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/29/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/29/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/29/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ -- P ermittee Signature: p_
Call 50 /` 5 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Nov 28 11 01:52p Columbia Heating /Cooling 503- 598 -0270 p.2
R ECEIVED
Mechanical Permit Application 2011 FOR OFFI(E I :SE ONI.V
City of Tigard N0� 2 8 Reeo(ved f g m r Permit No.: e
WC C/()$ 1 i
13125 $!�' Hall Blvd.. Tigard, OR 973'1._1 F T1 I GpRD Plan Review'
Phone: 50501,539417i Far 503.593.l96fCfTY 0 1VI$1oN,1 oat lily /1 . Damn) abet Pr:mit.
TIGARD Inspection Line 503 t39.4175 B i1LDI I Dak; ?LeadyBy: Juno: R See Page 2for 1
)n tan ci: utvw. tigard- c '.gOV lJ Notifetl/Method. — �7 y Srtpplemeatalcofnrmatioe 1
, h—'
j 'TYPE OF WORK - 1 I COMhtERCLAL FEE" SCI-iEDULF, - US>:,ctitacLlsr !
Ivlechanit tti permit fees' are based nn the value of Litt work
:,,o.cor.sirut:liitrl X Add ition !aitc.ratinnfrepiaccrr,en( (rfr-mc.ci atc u- valuv .unded to the rtearCL dollar of ill
E Dernolit :•rn C„J' Other: r mechanical materials, cqut sLment. Mot, overhead, and profit
I Value:
l
CATEGORY OF ;CONSTRUCTION °, :.. _._. 1
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
g 1. and 2- fami'.v dwelling C Commercialiindustrial ❑ Accessory building hoe special „tformairon use checnlr,u
II
told- ;amt) ;' C Mitstcr builder 0 Other: r
Descripton 1t I i.;t ?nt3'
JOB SITE INFORMATION AND LOCATION /leafing/cooling _.. - ....
„ 1 �
Air conditioning
,int^ +ile add S [_ress: `j�� ^ [ h I � J C _ __ (�r con n i n3hOKV 6 (±Iscc'nea1 1 ' 45.7?
ctt. /State!7, - . "2 q� . -T. Ftnnace 100.000 BTU(due:s'vcm �
ai i I 4 6.75 t5
. v? 1` [ '', .LLL/���- -- �II�Jft -��� Furnace 100,000- STU (dnctsiventsl 54
Suite.1-Idaiap:. na. Project name: Heat •urnp _._ _ I 61.06.__
Criss: ttrce: directions to job site: Duct work __ 1 23.32
Hvdronic hot water stem 2
Residential holler (radiator er ?
- — hydronic) 23.32
- - Unit heaters (fuel -type, not electric). •
to -wall, in -duct, suspended, etc. 46,35
""_ - ._ Flue /vent for any of above u 1 23.32 J
' s.„i+d•,-i5ib n. _ 1 Lot no.. Other: - -- - - t ~ 23 -.32
Other fuel a itanccs
i a >: mapiparzel no.: I P.P . --.
DE CRIPTION OF WORK Water heater I 23 3 ,
(i as fireplace 3.. ?9 !
' I �ft i� _ .` .� T _ F'e vent for water heater or gat
4 —
I fireplace 1 21.32 i
__._ -_ -__ Log lighter (TS) `3'-2 I •
Wood /pet4a stove 3J -3' y .
- --
Wood fire laceJinserl 23 t
_. -_- Chimney /liner /flue/vent I 23.32 :
•
PROPERTY OWNER I TENANT Other, 1 23.32
t] „1L- Address ( j I/I Environmental exhaust and ventilation
' ^J f- J� r �-- f `� r - Range hoAd /alhar kiu to • ui. 31.39
L i(y'tate %7_IP: r l � i ' a Clothes dive; exhaust - -. __ - 1,.__ 3; 39 ,
A` �� • - Single duos exhaust (bsth ;oe�ms. I I .
�
^� t - Fax: toilet com tartm ^nta, utility rcmms) 1.32 l
.� JA .... - i
C APPLICANT � CONTACT PERSON Attic!crawlspacc fans Y __. ;
- , tither: t 2 3.
i name: i Fuel piping -- --- -
onlaCt name ir/ J � i -- / p . ,p - ... -c-ja x 14.15 for first four: 54.03 for each additional
Furnace, etc T__ 1 dd-ess � - i -__. ---
_ i G as heal pump
I C it':-tit ;ate ;7.IP, I Waisisuspended/unithealer - -- _ �____._ - _ __.... -
_ a 5 I I 'Water heat
°None: .D „', T ` 1 in t i Fax: 56 5`7E `� _ _ - _
. ___ —.. -- -- rircpl
i, -mar• Range
- CONTRACTOR:. Bar .
A —
- Clothes dryer (tests) _. _ _
business name:
sir r / w • a.■ SAIL Other ___ i
I Address: / 1 MECHANICAL FEES* - - :
. p :/ .�5 : 1. I Subtotal i ��e7S
y ii ±5tate�7_1P: �` M u �
1 0 4.= Minimum permit fee (S96A0) y d, vo ,
/`1 Fax: tI� 0,;s - 170
o
Phan: `,. j ! i ks ci _ _ _- - __ Plan review (_5 /. of permit fee)
t'Ci1 lie.: '767 Q J State surcharge (12 of permit fee) /0,
I . _., ._. t ' TOTAL PERMIT FEE /06),. +n
f _ ' This permit application expires if permit is not obtained ISO
Authorized sig,nantr days finer it has been accepted as com,'/tete.
l'r lot name:
. /, 47 • 1 . Cale: I 4_25-
_2 I SO rte.hodotogy s:: by Tri -C.o :' Bu:tdiup s�dusir Service Braid