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Permit CITY OF TIGARD MECHANICAL PERMIT 1111 • • COMMUNITY DEVELOPMENT P ermit #: MEC2012 00514 T F G A A D 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 10/09/2012 Parcel: 1 S133DB03400 Jurisdiction: Tigard Site address: 11569 SW SHEFFIELD CIR Project: Erickson Subdivision: BRITTANY SQUARE NO 2 Lot: 58 Project Description: (1) gas furnace replacement Contractor: COLUMBIA HEATING & COOLING INC Owner: ERICKSEN, STEVEN A PO BOX 230397 11569 SW SHEFFIELD CIR TIGARD, OR 97281 TIGARD, OR 97223 PHONE 503 - 624 -2704 PHONE: 503 - 579 -6371 FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Furnaces < 100K BTU 10/09/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 10/09/2012 $10 80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/09/2012 $43.25 Occupancy Grp: Stories: Fuel Fuel Types' Gas Pressure: Total $100 80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / Issued By: Altatilit C ke Permittee Signature: �i j ApnU C�j04 Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 10/08/2012 05:17PM 5035980270 COLUMBIA HEATING PAGE 02/02 RECEIVED OCT 09 2012 ` M Permit A. ►licatiofl_ Y T FOR O Ft. i l : F 1∎ S E t; City of Tigard �7 I� n2e3y (0 9 a — yf Penni: ; NMI, oh t Phone S 1 303318-2434 7 Fa= 503598.1960 S I e ,� oche. Permit o r t : R, J Inspection Line. 503,639.4175 p a g e R e a d y / B y n : 0 • Fstte 2 for Internet www.tigord- or•$ov � Nonfied'Method: 11c Sep , lomenml iof6ruetlon `�.�.-�-i�NF �i � . ^�� v j ,y,�ri 'v + 'e _1' l �.i l�,1 rrra —,v_ 177, � _ mss.•. , �.t .. i *' S: 4.i , I _ non — . 31 .:74 �. Vii. :� .a.� ,i :.� : ., �_.., r.�t!rr.. i ( .- 1 &isnkat permit ' arc based On! - Itigas of the weft ❑ New construction '/}. ddition/alterationfreylacetnent performed. lndicate.the value . .. 1 tithe neatest dollar) of all ❑ Demolition , 0 toter: tncehttntcel materials, equipment. tabu overhead, and profit. 'mss Value: $ '►e."f*4�fc E7^Z Y rg 2 � f °5 � Y • Sv....a �..:ma�._u� i9? dLe�'- i��`•i •:v:4 t f�4MPIV I EWITtL.L.'s WI- and 24thtnily dwelling © dommerclal1Industrial 0 Accessory building For specie Isfirmodon ., tl+et1 L Multi- family ❑ builder E] Other: Rescri1iton I Qty. J En.. L 'focal i -� n-- — _, ^ ^ — Reatin e/coorttg: S 1 4 r4 y l � i -iii 7_ �, I a ti } = I� MIEWItprirpAMP , t�,�sE:�.' 1E:if - 1� . roc { r_ •r. ' ci s ' Air conditional site address: igic ar Je �r05; rms. tL uncs site ,,_ el • ..,, oc .. o , 46,75 City/State/ZIP: l Furnace 100.00013T11 (doe-bistros) III 46.75 /ri i✓�� Furnace 100 000+ BTU dnatt/vesno 54.91 Suite/bldg./apt. no.: r Ptojectrti►me; \ �i. Ocepriock teptoh >,hoxdnpofaoeeheat) '. 61.06 Cross street/directions to job site: i Daet work !! 23.32 - .t};;_ H • ronic Lot water - - .. Ill 2132 Residential boiler (radiator or !mimetic) tic) 2332 III Unit heaters (fief- type. notetettric), in-wall, an -duct, auspende cto. 46.1 Subdivision: Lot n0:: Flaelvcait for an . of above I 23 NMI Other. NM Tax map /parcel no.: Other fuel a • •lances: " :i ,;_i_-..',0. r kJ s `r-7 ' _V -XI' 1 �.� T:1 Water heater NM 23.32 r iCJM . ' ).;y t Z cies fireplace 111111111111121111M �� l I av, 1 W 1 / . _illiMIIIIIIIMI _ Rae vent foe water heater or gas I■ 23.32 f. •a" Log lighter (1 23.32 NM • Wood /pellet stove 1111 33.39 Wood fuepteo 65 23.32 � �� 1 �+T'c `� �L�x+w,s�"�x• ` i `T" [ ':`'��"rP1AYni 23.32 r'? ru.1 J �•^RY 7 fL .,xdr - �+F•:r' r { a ty r ^'. � afLC Ry .�n~-i e: ■�j1��.:1 w'.,t..'._ �..+•.... ,.•. a-. .�.�a QL - »•�:'+. s ��. _ �- MIC Environmental C%buS R1t a collie •:N Address: I ��1�i s ' IP W�� Rise hood/other kitchen, 33.39 III A ■ ■ a !tense (b r R ( J it . Clothes dryer•wthrust 3339 � � `' � Singe -dui women women mluoome. 1 wslV= ( ) totletcotn • • • • -• tS utifft ooms I■ 23.32 "Xr:. , 1;,: - . 40;17,77; r ei , E a e ;p7, v r ".9 1 " ' Attic/crawl ace him '111111 2332 MI= Business name: Colombia !Renting - OW Cooling,1uc. Utbts - . Rid pipfii Contact name: Marlene Meedom 514.18 for first fear, $4.63 fo coca additional Address: PO Bolt i Furnace et. • Otis heat pump �■ City /State./2IP: 97:281 . • . Wall/ •. -. &N eat t heater IIII Phone: (503) 624-2704 1 fax r(503) 598 -11270 FRE=1UIIII F..sool:colnmbbe ltieleporLcom I R„ , N . ,c,.. ` ':su';.. NAfi�.'r`:C! i7x�;. 7,1, P'rJ t```i._.+ n .,...?k `r . .r i Barbetxle Hilliness name'. Columbia Heating and Cooling, inc. Clothes dryer (g22) Other. Addtcas: PO box 230397 t"� y t - � x r , `r a :g am Plit F 3 7S �• . 1.v:'Ott:. ':.�iyrl2 s `, "-•J gfii': g City /Stoic/21P: Tigard, OR 972$1 Sbbt0tnt Phone: (583) 624.2704 Fax: (503) S98 -02'0 Minimum 25 • ii fee 'Pirin lav7tw c25% o : • .: it tee) CCB lie.: 76359 State smchaee (12%ofpcmtir tea) TOTAL 'PERMIT FEE i 120. Authorized signature. � ThG permit d � beta 'emoted sa within t8o I Prim name: Marna R Meedom Date: r r • Fee m6t1.0401otiy net tly Tri- Coeaty Melding xudestry Service Bo,nrl ., a.. u.-.. a.....,, omer.o...,...a....A..- MaJWItIt I55 LP.VP5.