Permit CITY OF TIGARD MECHANICAL PERMIT
_ COMMUNITY DEVELOPMENT Permit #: MEC2012 -00311
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/12/2012
Parcel: 25111 CD04200
Jurisdiction: Tigard
Site address: 9510 SW BRENTWOOD PL
Project: Sanford Subdivision: SUMMERFIELD NO.9 Lot: 501
Project Description: Furnace and NC replacement Must meet 5' minimum side yard requirement and approved rear yard setback.
Piping for BBQ
Contractor: COLUMBIA HEATING & COOLING INC Owner: SANFORD, ROSE N
PO BOX 230397 9510 SW BRENTWOOD PL
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE: 503 - 372 -9135
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 06/12/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 06/12/2012 $46.75
Class of Work: ALT Type of Const: Fuel Piping 06/12/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 06/12/2012 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
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: D A I APPLIMV [
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. r ° - v
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.
Jun 08 12 04:01 p Columbia Heating /Cooling 503- 598 -0270 p.2
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RECEIVED
Mechanical Permit Application FOR OFFICE USE ONLY
J I N i i 2012 1+ � sr Pe� -oo311
111 • City of Tigard (p 1� a-�
13125 51h {tall Blvd., 'Tigard, OR 97� ( �E� Plan Review
Phone: 503.711.2439 Fax: 503.591. F IGA�3D ilBr: OrherPtxrtrir. ,
T I G.n l D Inspection Line 503.639.4175 BUJ!! DiNG MINN Daze RembiBy: Aril: lilf See Pape I. for
Internet: www.tigard- or.got Notified/Method: 11 4 I Supplemental information
- -; - - ig.t. -
- .,h �' .WORK; ;::'': ° `:;'� ::�: �`` : :.; - :::: .
CQ'+dl►'iERCfAT,; 1r1?G[:E., i; SS CFiXsC4iL1ST:.
Mechanical permit fees' =based on the value of the work
D New construction Er<iditionlalterationireplacement performed. Indicate the value (rounded to the nearest dollar) of all i
❑ Demolition 0 Other: mechanical materials, equipment. labor, overhead. and orotit, i
Value:
' ....'% _ :':.. +: i;: £P1 .R�' OF eO (V8`€R CANON...1 -3 . " r ;`_:..
` F 1 7.; s ,• N' • RESIDE' 7yAL CT� pm — ENf:7 ..
Er1-and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special informallonaserlter:Mist .
D Multi- family t " 0 Master builder D Other. Description I Qty. I Ea. I To:al
iOB SiC E'INORIY)fAT10DF:ARIL?QC'Ilf1N?
IlgtiuPJcoolirtg:
Au cond
Job Site address: 1570 ,i-w if 6 1 9 A. , (regimes site plan showing pincemen') 46.15
City /StatG2IP: rr 1`i) o q ? i t-/ Furnace 100.000 I3T l (matt /am 54.
•, 0� I Furnace IG0.004� BTU {ductsh:�rwl 54..1
Suitetbldg..'apt. no.: Project name: l Heat pump
i (requires site plan snowing placation') 61.06
Cross street'directions to job site: Duct work 23.32 • A-
Hyttronic hot water system 23.32
Residential boiler (radiator or
: hydronic) 23.32
Unit heaters (fuel -type, not electric),
in-wall. in -duct suspended, etc. 46.75
Subdivisicm: Lot no.: Fludvent for any of above 23.32
Other. 23.32
Tax map /parcel no.: I
Other fuel appliances:
DF$CIR1F!f[ON ?OF; 1O10C ,_, :';:..:.::., Water heater 2332
Gas fireplace i 33.39
'i2M4-CE 0 A/C , 14cte -ot J Flue vent for water heater or gas
fireplace . 2332
• Log lighter (gm) 2332
Wood /pellet stove 33.39
Wood 6roplacc!insert ; 2332
- ... ..._.. iner /tlue'vent
ChimnoyA' i 23.32
�ROPBItTY O�Vi�IEl2? ' %; : .: �; : •_.: - .:::. :.;;.� .�f T>�VAr1T .; ...::.: " `:. ::' .......• � � '
.... Other. 2332
Name: Rase S- FO t Environmental exhaust and ventilation: _ __
Addre : 57 �� Artedrwwa9 i9G i Range hood/other kiichen
• equipment 3339
City /StatclZIP: riG D 0/2- I .2 Clothes dryer exhaust ! 33.39
» Single -duct exhaust ihathmoms.
Phone: (50;1 J17 ) 07/ Fax:( ) toilet compartments, utility rooms) ! 2332
— 123 - :: : Q .Ct3fVTAICT P)CR$QK Amdcrawlspaa fans 23.32
_ Other. ( 23.32 _
ltucinets rutme: C.:olumhia Heating and Cooling. Inc.
_...
Contact name: Mariena Meetlnm 514.15 for first faun $4.03 for each additional_
Address: PQ Riot 2311397 Furnace, etc.
Gas heat pump
City /State :ZiP:97281 walVsuspended/unitheater
-
Phone: (503) 624-2704 I Fax: : (503) 598-0270 Water heater
Fireplace
E -mail: colttinbhrdtelcport.eom Range
4
TRACTOR.
COIv:. �: -_ .. •".;' `;- - Barbecue
business name: Coltttnbia 'leafing and Cooling, Inc. Clothes dryer (nos)
Other:
Address: PO tiny 230397 _ - -i . . .
_ _ __ _
City /Statcl21P: Tigard, OR 97281 l<YECf fti91CAL _PSR�IR:I EES `,..
' ! Subtotal .
Minimum permit fee (590.00)
Phone: (503) 624.2704 I Fax: (503) 598 -0270 Plan review (259 of permit fee)
/ CCB tic.: 76359 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1 Sr
Authorized ai lature: This p ermit application expire] ira permit is not obtained within ISO
days after It has been accepted as complete.
Print name: Marlene R Meedtme Date: • Fro.nahutlotopy sei by Tri- Coanry Building IndustrySurrice Board
.. u... a :..wi.w.r...•L'1•A.r..:•s.....l„. 114.9c .1411.4 1111111T014/Wr111
Jun 08 12 02:17p Columbia Heating/Cooling 503-598-0270 p.2 r ,,
, I
Mechanical Permit ApplicatiBE„- (11 , ipp ":" I.: FOR OFFICE USE ONLY
City of Tigard JUN 0 8 2012 Received
Date/By: Permit t:
si a.
13125 SW Hall Blvd., Tigard, OR 91223
1/ Mtn Review Mee Permit:
- ' Phone: 503-7182439 Fax 5°339839( OF TIGARD n ' D c y.
riGARr inspection Lille: 503.639.4175 .1"ir. 65 seepage 1 tor
Internet: www.tigard-or.gov BUP DING DIVISION Nca'.6611carm.dals°' supple...I Information
, .
• - : • : . ,, fyiii..,Ot, WORK . :: ..- .th: :::: .......7. •_ --..:,'"" • : : :: .
Mechanical penult fees* based on the value of the work
0 New construction EtIrcldition.'alterationircplacentent I performed. Indicate th value (rounded Lathe nearest dollar) of all I
0 Demolition 0 Other: mechanical materia , equipment, labor, overhead, mid profit.
Value' S
i ..•:.1 01200**,t..:..t:t*:',:' :11...1= f'i ::. :: :-. ,..1: i. , NitiAtitOirsitigx .:..:..
■ 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedal information ase checklist. ;
0 Multi-family 0 !vlaster builder 0 Other: Deseti. on I Qty. I Ea. I TOtal
JOB. grrE t ti).61 - '' ' g .. Y 11
n ' in ; •
Job site address: q to , 8 lifklre,„,cho 0 i4V- , .1 Utre% 511C titan shokvine comment) ! 46.75 .
Furnace i 00.000 BTU Naas/vents) 46.75
CitylStalc/ZIP: 77 6/till) OA 6 7 1 707 ? Furnace 100.00D+ tifli (doete/vents) 54.91
Suite/bldg./apt, no.: I Project name: A H . iiiit ,
tic . i ate plan shoving. placement) 61.06
Cross street/directions to job site: r /t work 23.32 • A :
. i 1 • runic hot water systein 23.32
IP. esidential boiler (radiator or
\ hydronic) 23
1 Unit heaters (fuel-type, net electric).
iu-wall. in-duct, sus. ended. etc. 46.75
Subdivision: 1 ,t no.: Flue/vent for any of above 23.32
Other: 23.32
Tax inap/parcel no.: Other fuel appliances:
• .. . '..... . • titsclurtioN of aivtaik.:.: •: . ,, - .i ,,, --, ,.. ,—. .,..,... Water heater 23.32
Gas tire . lace 33.39
i I N •i 6 1 . C / ' I ., FAJr A ' lue vent for water heater or gas
allrifiriPME ' fir .lace 23.32
ii ww, A mino Lop lighter Inas) 23.32
A11111111116,,M. PMMX Woodipellet stove 33.39
\\ Wood fireplace/insert 2332
23.32
' • . '1 Other: 23.32 .
Name: Rare S /vFoltel ,i, Environmental exhaust and ventilation:
Address: n0 5 at f, Ai trwag4 pc • ile teriugpcmheonotcvothc, kitchen ,
33.39
City1StaterZIP: 77 44. oz. cir7,2 ( Clothes dryer exhaust 33 39
Single-duct exhaust thermos.
Phone: (5D J) , 3'Y7 of ijc Fax: ( ) toilet compartments, utility rooms) 23.32
krite*Nx .; .::: -:':" :::.- --:- , : .,:)=1::0:(4:;13,0t,59N:_::::-:.:: = _ . Anic/crawlspace fans 2132
' Other 23.32
Busine:s name: CnIninhis Hearin: and Cooling. Inc.
_. _._...____ .—....._ Fuel piping:
Contact name: Marlene Meedro 514.15 for first four; $1.03 for cads additional
Address: PO Box 230397 Furnace, etc. .
Gua heat pump
Cit)/StategIP: 97281 Wall/suspended/unit heater
Phone: (503) 624-2704 I Fax: : (503) 598-0270 Water heater
Fireplace
E-mail: columbhe@teleporLcont Range ,
CONTRACTOR B4rbecUe
nosiness name: Columbia [tenting and Cooling, Inc. Clothes drier (gas)
„
..„,
Addis..: PO Boa: 230397 . - .•. . _ , _ , , • ... ..,.. .
City/Stole/ZIP: Tigard, OR 97281 Subtotal
Items permit fee 1890.00)
?imu
Phone: (503) 624-2704 I Fax: (503) 898-02 Plan review (25% of permit fee) .
CCB lic.: 76359 State surcharge (12% of pentad fee)
TOTAL PERMIT FEE .
This permit application expires if a permit is not obtained within 150
Authoriaed signature: days after it has been accepted as complete.
i Print name: hiarlena R Nteedom Dale: .. - • Fel: methodology sel by Tri•County Building lodustry Service awe,
4:114A•71111MTWOWAVFIll
Jun 0812 02:17p Columbia Heating /Cooling 503 - 598 -0270 p.3
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
SITE PLAN I 5h
/I 2
ADDRESS: 6J Sw OC Ci Cad �� _