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Permit 1111 w .t CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2012 -00076 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/09/2012 Parcel: 1 S 133DA09300 Jurisdiction: Tigard Site address: 11156 SW 130TH AVE Project: Smith Subdivision: CASTLES AT BRITTANY Lot: 23 Project Description: Replace duct system in crawl space. Contractor: COLUMBIA HEATING & COOLING INC Owner: SMITH, KATIE PO BOX 230397 11156 SW 130TH AVE TIGARD, OR 97281 TIGARD, OR 97223 PHONE: 503 - 624 -2704 PHONE: 503 - 317 -0292 FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Duct Work 02/09/2012 $23.32 Type of Use: SF 12% State Surcharge - Mechanical 02/09/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/09/2012 $66.68 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 N. • -: •: • 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 di - t questions to ► NC • ..If.• 503.232.1987 or 1.800.332.2344. Is ed By: I / . d Permittee Signatu j`r ardlir 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. Feb 08 12 01:16p Columbia Heating /Cooling 503 -598 -0270 p.2 Mechanical Permit Application FOR OFFICE USE ONLY Rcei ed / ye. erj " City of Tigard r d 3 Re e ,er QL /A / pc sir Nn.: / OI a ° (/t/ / II le 13125 SW Hall Blvd. Ttgl , li d'7 Han Resew I Phone: 503.718.2439 Fax: 03 981960 O�� �ate.;By Outer Permit: RI 503.63 4 Q ion Line: 503 `� Date ReadyiB' : Judy See Page/ for Internet: tvww.tigard -or. 2 Vo `� ■ 17 ® may NotifiecliMethod: Supplemental Information c v •4���9 c ` b�!'� • TYPE:•OF• � ," COMMERCIAL FEE" SC3I.EULLE — IJSECHBCKLIST_ r. ,� , M echanical permit fees* are based on the value of the work ❑ New construction Z Additiontteih f treplacement perforated. Indicate the value (rounded to the nearest dollar) of all © Demolition 0 Other: ';?)`-v - mechanical materials, equipment, labor, overhead, and profit. 4A. ' xpu'Y dF' „Ct"QrikItIIC? . :, ...._ ; ... RES value:S . IDElNTIAL tQt.JYPMENT lSYS7'E1M3 FEES' . Xi I- and 2- family dwelling ❑ Can ercialliridustrial 0 Accessory building Fe pedal infa,rnatJon rue checklist 0 Multi - farnily ❑ Master builder © Other: Description Qty. I Ea. [ Total Lleatinglcoolint;: - . - 'SITE- L .. A7A`1' .. t I fiCATIOPI i Air conditioning Job site address: // r 5 l , /- Bey/ h trc:pine site plan showrnk placement) 4E - 75 V � y -S'/ i ()I max q 7 ,3 Furnace 100,000 BTU tdocts'venls1 46.75 City/Stale/ZIP: �, � furnace 100,6004- BTU (dnct,wents) 54.91 Suiteibldg /apt. no.: I Project name: ./rn 1 +/I Heat pump (re ehen site plan shcwiny placement) 61.06 Cross street/directions to job site: Duct work L i 23.32 • A jydronic hot water system 23.32 Residential boiler (radiator or hydror.ic) ' 23.32 - chit heaters (fuel -type. not electric). in -wall, in -duct, suspended, etc. 46.75 . Subdivision: I Lot no.: I FI:cn for any of above 23.32 Other: 23.32 , • Tax map /parcel no.: ' Other fuel appliances: ' D,SG!ITJP7I(}h1 OF XYURk :..: ; Water healer s 23.32 ^ ,�� Zy 4 �, f�+ y aria)? Gras fireplace , 3_.34 1:?A i.1.� C -ems I 1 ( Flue vent for eater heater or gan fireplace 1 23.32 I., cg lighter (gas) I 23.32 Wnod /pellet stove , 33.39 Wood fireplace insert 23.32 PROPERTY - ., •_ . Chimney/liner/flue/vent 23.32 Other: 23.32 Name: ) �.3i � at '+� /// Environmental exhaust and ventilation: Address: ( � J ^� �� L / 1 l cj A / .,J ),,,.)t) J m Range hood/other kitchen e t ��� quipment 33.39 City /State /2.1P: 77 , (77:1:13 Clothes dryer exhaust 33.39 Phone: G Fax: ( ) Single -duct exhaust (bithmoms, 3 - l toile[ compartments, utility rooms) 23 32 E APPLICANT-`- ' :'' - ': - .0. : COI+ITACT.PLRSON•• Atticicrawispace tans _ 23.32 —. _ 23,32 ss Busine name: Columbia Heating and Cooling. Inc. _ - Other: __.. — _ — Fuel piping: Contact name: Martens Meedom S14.1S for first four; 54.03 for each additional Address: PO Box 230397 — Furnace, etc. Gas heat puma Cicy /Statrl7..TP: 97291 Walltsuspendcd'unit ht:atx Phone; (503) 624.2704 Fax: : (503) 598-0270 Water heater Fireplace E -mail: eelumbhc telepori.com Ran • C(3N CRAG COR Barbs : cue ttusinei name: Columbia treating and Cooling, Inc. ` Clothes dryer (ens) Other • • Addre es: PC) Box 230397 bf,ECltANICALPERAIITFEES* City /State/21P: Tigard, OR 97281 Subtotal • Minimum permit fee ($90.00) 41 /0 , it Phone: (503) 624 -2704 Fax: (503)598-0270 Plant review (25aat+ permit fee) — • CCB tic.: 76359 State surcharge ( 12% of permit fee) 0 , a -. _ TOTAL PERMIT FEE ` "/ 210 ._] Authorized signature: Artilitilik. This permit application expires ifn permit is not *btained within , QP!�Q y days after it hers been accepted as complete. r13�C/�l k I Print name: Martens it Meedom Bate: c. _ r / a ` Fee ioeIbodclap5 set by IA Building Industry Service Boan_ ....... w..,,a n..... ». „ c..•.n.....t..,,.,, w,. r+>m.v•n aarh.e.srn ii nh» +rMfM"Fa: