Permit CITY OF TIGARD MECHANICAL PERMIT
9 • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00415
T [GA 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/07/2012
Parcel: 2S112CA13000
Jurisdiction: Tigard
Site address: 15566 SW 76TH AVE .
Project: Hutton Subdivision: RENAISSANCE WOODS NO.2 Lot: 54
Project Description: (1) furnace replacement
Contractor: COLUMBIA HEATING & COOLING INC Owner: HUTTON, BRIAN D
PO BOX 230397 15566 SW 76TH AVE
TIGARD, QR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE: 503 - 624 -6761
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 08/07/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/07/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/07/2012 $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 calling 503.232.1987 3 or 1.800.332.2344. /� /� ,
Issued By: 11YU Permittee Signature: /9k1 ,4)'PU c 4 1 , o N
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.
08/06/2012 05:32PM 5035980270 COLUMBIA HEATING PAGE 02/02
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R E c iv E o.
Mechanical Permit AD lieafiail
A UG 0 6 2G
City of Tigard C j am ? ' ' i vr/R g � r v P-at�. c e sod - OD�ftS
I3125SW Heti Blvd., Tigard; OR 97223 BU! 5 tvG h5 1 j ,� y m: o ti+�n�;M
Php5a; 503.748.1439 Fens: 503.598.1960 1 7
r e : \ ;,1) inspection Line: 503.639.4175 mate. Reedsas: 1 l0 Soo . z for
[maw www:ttigord•or.gOv 1Veti<eomeesetd: 'n( SupplementaldnfeFina6tu°
.011.27-17-• , °n `./ - � v - 3^'o_G- - •r.,...y Y C -i1� rv" .,,,, y:
T' dS is J I.Z K C. ' ai & : 7-5, ; �, p•S/� d•1 :77%
�'. U '2.. s+e -,, y. � F , .., .. I'Ll-.:ht l. a r '' �- `r�J:40, -"A'' „S,i. "`"'- iy aa..,n.,.l- �- �f - - "-".- ••a
Metfmni®t porn&fees*atet end on tke Milne Kole wort
❑ New construe tion !A ' ° dtli0n/alterationi eplacement palmed. hulk: to value:(rounded to the nearest dotter) of an
El Demolition . ❑ ether mechanical materials, equipmer •
' :l overhead; andprotie
����� 1 tm �`' 4 .Y_ j..?' bpi' 21 1 .A Value: $
ams' 'C7�sk - �c•�, �• �\''.4'' "r'1 4. ..?::"I " . i u" ,.1. Yt ?c {ra�e- ,� _7 • 42::;t0;.".-
` ^'� �� k-�Ldc _+Oi.'� iii_ =�[ -� a� :aStY • i _ '
Iirl - and 2- family dwelling ❑.commerciat/indusirial a Accessory building For tednllet/benadon Oar die liu
❑ Multirfemily ❑,Masts bonder 0 Other: Dcsaiptioa _ I Qty. I da I Total
r,v6, , ii,-R ,. z7 . g ,. neallen
� '� ' -. -':: Air•contlifioning
j ..e ! r / Y lronuitesaiteo0oneltowmttolacatient) 46.75
City/StaterZIP: , 4-4. I i ffI,J - - Purn 100000 BT ( aseventa) j 46.75
Formate e 100..000+ BTU oketsheab) 54.91
SuiteibidgJapt. II P PioJectname: • Vi HCatpomp
(teyeiieedtepleciiNo preae*aeet) r 61.06
Dordwoat i 23.32 • An
. Hydro'aie hot:watersystem .. 23.32
Residential boiler (radiator or
'l;}droiiic) .. 23.32 •
Unit))etttet;; (fire b)pe. eielteleclfiC),.
• lnt 46,75
•
Subdivision; Flee/wilt tbr.any above • 23.32
I-91 no:';
•
Tax map/pan
t)dlter 2332
&
��.r���� tidtaerfail.apiiprpeet4
r - 7� r r ""' s )W�• ` .. :. t r _.. b Wahxbeaker• 2332.
3 / / �. _ c o tlas Rep 33.39
"` l A � Fine yens for water heater or Res
.fuepiace , . 23.32
Log tight titan) 23.32 .
WOad/Deliet'stova 33.39.
Woad fireplace/ Insert • - 23.32.
t." , ,c e > v ;,, ef '
a ;• . . 3C , Ain'tdfluefvettf . 23.32
� .�. ,,'. __,Y.,. - C N ,�., `. %:�r " } ':r Y . � �_n :3. �a 3i , • �. ° ,f-- 16'266
CZ
� " =g Other 83.32 • ,I I r e1 . `[ ,.a Eaviraimcnt8l.e:dulps t and **Outlet,: .
' Ratrgt hoodhxlttx11tohen '•
equipage* 33.39
City /Stale/ZIP: e , S is • , ' - Clothes dryer exhaust 33.39
,1• a Fax: t ) Sit •toil egledurt®tbaitsl(bodmooms.
�. J+ _ mnapeatmtxits•.110kiII raotn4). 233i!. •
r .: .?,t,i, .�:;tiH. .y e _.•:•:: •,-'4 -:: !n_`. ..•.;w.;:,1j;Y. A . 9LtCarawls
y •2 rctlen5
,.'� ?3:32
Businegs name: Colombia Wonting head Cooling; Inc. 2332
Contact name: Mariana .Meegpm ; $14215 etas first Four; 54.0310 r each addidoafal
• Address: PO.1lox230397 i i
•
City/State/21P! 972!!1 " • Gas. p
YV2iYsusptvtaett/omtticar¢t -
Phone: (503)624 -2704 ran: :15133) 590-0270 water heater
F,- mail:columbhc UeleporLcom Fi =•lace
E , . 7 ....?,.t tir t "` i f •y 2:47 4 d t. narbecue
I3us mess name: Columbia.lteating alad Cooling, too. Clothes darn (g .. IIIIII
Othea
Address: PO Box 230397 ; . c; 7it'. w- ; •:ar
Chy /Sta(e/ZIP; Turd, OR 97281 S
Rome: (503) 624-2704 Fax 003) 598-0210 . Miniitimn Parma to ($90,00)
Thal reylety (25%ofueimit fee)
state'aWdratir. •fi295 >iicre
TOTAL.P1 1#IT FEE /Q
Toys permit a cation r Poem
Authorized signature. PPS expires it a its not awned wltkio.180
Prhitnan;te: Mar:lena,R filmdom Date; ' Fee mo 'a y baa y Egyi dl m complete
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