Permit CITY OF TIGARD MECHANICAL PERMIT
.. .1
l: COMMUNITY DEVELOPMENT Permit #: MEC2012 -00639
Tic AR 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/06/2012
Parcel: 1 S 133DB05200
Jurisdiction: Tigard
Site address: 11245 SW WINTER LAKE DR
Project: Warner Subdivision: BRITTANY SQUARE NO.4 Lot: 80
Project Description: Replace gas furnace
Contractor: COLUMBIA HEATING & COOLING INC Owner: WARNER, NICK
PO BOX 230397 11245 SW WINTER LAKE DR
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE: 971- 400 -4824
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/06/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/06/2012 $10.80 ..
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/06/2012 $43.25
Occupancy Grp:
Stories:
•
Fuel
Fuel Types: Natural Gas
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 Notifr:atin 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 dire questions to € NC by - 'ng 503.232.1987 or 1.800.332.2344.
Issue By: / • i/ t Permittee Sig
• id s.
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.
,.
12/05/2012 03: 09PM 5035980270 COLUMBIA HEATING PAGE 02/02
CI
Mechani I Permit ApplieaBE E
1 iED •
FOR 01 3 II L t.si (),,
;,
CO of Tigard DE 0 5 0 12. omenEt Y: bt ilAtral P-it No.:
II 131 r. 5 SW Hall Blvd.. Tigard, OR 97223 Plan Review
' ' • Ph 503.7182439 Fax: 503.598,1966 oF T NID t' 00.0 Parini°
n t ; .,,. it , .) Inimical Line: 503.639.4175 D !t
ata ingly/By: Mir. 21 See Page 2 for
Int - www.tigard-orgov Bail G ISV3" Notified/Method: Supplemental Informution
... .,..- .., _ .
- '
77.7;1;;74:K.4-Mif;:t:•-;t:%3_35Wiffiki,gr; T'sh 2 '. .14:tile.4.1=- •
Mechanical prank lees* are based cm the value ate work
0 New consul ction e it&idition/alterationk •lacemen performed. Indicste the value (rounded to the most dollar) Of all
'
0 Demolition 0 Other: mechanical menials e ' ent, labor overhe end milt
Value: $
wilantc;.,r4-.• T-:-,w.facirmwmiaM2P....41411 : .,!.../..7_ , z., 4 ,-1 4 H.,,.'11-TI.':4 , 'fdiiizi5";:'
'f - and 2-far4ily dwelling El Commercial/hid 11 0 A • ssory building For spedalinfonnoliaa ase Manta.
El Multi-family 3 0 Master builder 0 0 , era Description Qty. Ea. Total
1,:ri-Nt r.., Heatirtr/eootix
•‘a:','•W, : Air k f-5- . .....:4.17Vr Ai con
113:=UFC,,- cillirijilTgairiirgraliii= (murines sile Won showing encamp El
=I 7 IIIIIMMII Furnace 100.000 EMJ ducts/mu - ' • 46.75
1 11111I Furnace 100,000+ BTU duets/vent% 54.91
Suite/bldg./apt. ito.: d Project name: TT t , Heal PUMP
Cr aim site tan ahowin taminencl 61.06
Cross street/di4tions to job site: Duct wOrk 2332 • A .1..
1-1 dronic hot water 9 Gil 23.32
Residential boiler (radiator or
trydronie) 2332
Unit healers (fuel-type. not electric).
in-wall in-du- sus . - ded Mc. 46.75
Subdivision; Flue/vent lb; an of above • 23.32
men 23.32
Tax map/parcel Ino.: Other fuel a . dianeest
:!iiif.grz.V.V.,EMM-32=r-t417M';77...F.411-, Water heataer water heater or gas 2332 111
-4 ,,,,I. --,, - , ks.-.3 , :- , .....- , -- - ..' ...., , • ,-
Oos fire lce 33.39
.11M, riMareiL I k Flue vent Ibr
.1.111111111111.1111=1.111 I il dace 23.12
1 I Log lighter COW
23.32
Wood/pellet stove
33.39
I Wood fireplace/insert 23.32
"•"' ". - •r ' . - • - ‘ --. t. tr.,„:"-:W.4li _ .1 '7.13..
. -,.- .:.: ,... a . 11 WW,L74 1 .• -.4 g Clain diner/fluthent 23.32
, s c i o h IL „ _, -,,,E1 ,,,, • ,,,,..n., _ ,-....,-,, ;AC.7,1 other 23.32
1:211■11WIff1ili1iflijM1 Environmental exhaust and ventilation:
Address: j • '' s ' .1 0.1 111 017;11.Var i 3 M MEM Range hood/other kitchen
eitiMment 33.39
City/State/21p: tit le 71 111111111.11111 - °thcs ` t
a 1.3 33.39
Single-duct oaten!. (bathroomS,
Phone: iffeli ' 11 toilet en - • ents utili rOC•MS . . 2
r332
'' InMETTIMMIMINI 2332
Business name Columbia Heating and Cooling, Inc. le .
Fuel 4 , t
Contact name: 1 &Herta Meedom $1.4.15 for lirst fear; St1.03 for each additional
Address: PO x 2.30397
131
Furnace
Gas heat um
City/State/ZIP912111 Walllsu ■ rided/unitbeater
Phone: (503) 44-2704 I Fmc : 503) 598-0270 Water heater
Fireplace
E-mail: columiThegteleport.com I
Ranite
.....1.4: Ega3N04...3.1.42.-1-ii-c.FOgriaailailia Barbet=
tsusineSS name Columbia Heating and Cooling, Inc. 1 Clothes dryer (evs)
Other:
Address: PO Box 230397
City/StateJZ1Pi Tigard, OR 97281 I Subtotal
Minimum permit fee ($90.00) 4 '4 . 00
Phone: (503) T4-2704 I Fax: ( . 13) 598 Plan review (25%0 permit fee)
CCB lir-4 76349 1 State surcharge (12% of permit Re) 0. .
I TOTAL PERMIT FEE a i 6.
Authorized Minim: ,Akul k_ , 0 • The derma application expires if a permit ie sat ataninad wi
daya after it has been accepted es complete.
Print name: Mirtena R Meedom Date: i 2 1 .7" " Fee nunaudoitiva set by Tri-Counly Building mammy Service
11.1q...1.1,••■• %IF r.P0 6Mo Ale nqineli fl attnatAvrr n I antrnww7.11)
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