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Permit u CITY OF TIGARD MECHANICAL PERMIT 114 -• COMMUNITY DEVELOPMENT Permit#: MEC2013-00047 Date Issued: 01/23/2013 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503 718 2439 Parcel: 2S103DD01700 Jurisdiction: TIGARD Site address: 10990 SW GARDEN PARK PL B Project: Wrench Subdivision: GAARDE PARK Lot: 1 Project Description: (1)gas furnace installation and(1)gas line Contractor: COLUMBIA NW HEATING Owner: WRENCH, DAVE&BARBARA PO BOX 622 3550 SW BOND AVE.,#1804 SCAPPOOSE,OR 97056 PORTLAND,OR 97239 PHONE" 503-543-3624 PHONE: 503-688-6826 FAX: (503)543-6285 • FEES Specifics: Description Date Amount Furnaces<100K BTU 01/23/2013 $46.75 Type of Use: SF Fuel Piping, 01/23/2013 $14.15 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 01/23/2013 $10.80 Occupancy Grp: Minimum Fee Adjustment-Mechanical 01/23/2013 $29.10 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: AbAkti > Permittee Signature: O A-PPu6q-no,L 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. Mechanical Permit Application FOIL 011:11F ( SE ON 1.1. City of Tigard RECEIVE' / :I 13125 SW Hall Blvd.,Tz rd.OR 97223 liad� l r 3 )3 `J i P�rtNa �L�L -(�D(� "� Phone; 503.639.4171 Pare 503.593.1960 JAN 2 2 20 Other remit: ., h.., ,:., Inspection Line: 503.639A175 Date Ready/By hin WI See Page 2 far Internet: www.tigard-or.gov CITY OF TI(j■ , 1 NotifietIrMethott Supplemental Nation r :I C p11QAI 'I • SCHEDULE USE CHECK IST T ,, 1R• Ij New c i Cacti a 'Add1iodal Mechm;cal permit fees*arc based an the value of the work •performed.Indicate the value(minded to the nearest dollar)of all ©Demolition 0 Other: .mechanical materials,equipment,labor,overhead,and profit. . CATEGORY Or C N S T k U C 1 f•....•. . . •.,, •. ante:S 11E-S/DENTIAL/0911'1t4F IT/SYSTEMS F1 Es*•:• `•. pi-and 2_fautily dwelling Q CotrmrerciaI/erbotrial ❑Accessorybadisvg ❑Multi-family © btu7dv D Other For special Information asa checklist:• Description J Qty- I Ea I Total ail 11E<IN 6111WION ANII:I OC.ATION gealfue �p �d SW P1 L. /4.B Air site adder .y (reghdhes site plan jtowiea piseereent_ 46.75 City/State/ZIP: .i.I d 027 Furnace 100,000BTU(da es) ( - 46.75 Yi, ' . Furnace 100,000+BTU(ductsh+eeta) 54.91 Suite/bldg./apt.no.; Reject name: Hai pump 6L06 • Cross on:at/directions to job site Duct work 2332 _ Hydro roo hot water system 2332 Resident ial bailer(radiator or hydronie) 2132 ---- - Unit heaters(fuel-type,not dectic), in-wall,in-duct,suspended,etc. . 46.75 Subdivision: —I Lot no. Flue/vent for arr�rof above 23.32 Other- 2332 Tic map/parcel no,: Other hid appliances _ ' 1 • DOCREPTION OF-WORK water Lcmtcr . 23.35 T gas ��l � ` A- 4� - -•-•�•64.• - � C)as fueplace 33.39 , lam_ s_ [r A Flue vim for water homer or � / eE fireplace 23.32 z f` Log light(11* 2332 Wood/petlet stove 3333 I L Wood fireplace/men 2332 ]P1Lall°LtR'!"lF,:O Eill' :;' © Tt3t!rht1Y1' i. t :mey/limer/#luelvent _ 2332 �'. : ...'•: ;.. - £9 y Other _ 3332_ Names _ vt jf e __ , Environmental exhaust and vents Sidon p�(J� Range hood/other kitchen Address; 1) LJ 1 y i atir equipment . 3339 City/Static/VP: tie I Y 9 7. ? clam..., ,. exhaust 3339 ■ Single-duct exhaust(bathrooms. Phone ( 6irg___2� Fa:c( ) toilet meoperunents,utility roams) 2332 ® APPLICAiNT .• . .. .•. .'Q tJONTACI• 1PERso1v Attidcrawlspace Ams 2332 - — Business name:Same as Contractor - 2332_ -4 _FM u$i _ Contact name: Sin 5 for first fear;54.03 for each additional Adder: k , 1 /41.15 Cos]teat tamp _ — City/SmtQ ZTP: WalVsipe+dedlmrit heater Phone;( ) FEC:( ) Wafer heater - / ' - Fireplace E-mail: . • R!ldLTO ., •Barbecue Business name:Columbia NW Heating Clothes (mss) Other Addreae:PO Bic 622 '••:.lYI LC IANICA�L mr..mrr Pus,_ City/State/ZIP:Scappoose,OR 97056 Staotat ciO -Mimimamn permit fee(S90.40) i ire,.pa Phone:(563)543-3624 i Fa=(5113)543-6205 Plan review(2596 of permit Re) — CCB lie.;61947 State surcharge(12"6 of permit foe) !C7- '3 1/241) ' TOTAL PERMIT FEE �JLd3 Aznhonaed signature This pernrit applicathm fir„g■p••*4tt+weeniK.cnea nethla 1110 dapa it hes bee*accepted as complete. 1 Print name'Cirri Jacobson One: / _43 I ' Fec methodology as by Tri-C wady Building Iadu•ny Service Boehd 1113dIdeiglnu+ AM6C-Pcee.'tApp.det IceIla9 4E-.6h7rttlanmoavwr) P.O. Pox 622 Scappoose, OR 97056 Columbia NW Heating, 503-543-3624 (Phone) g a 503-543-6285(Fax) Fax Um City of Tigard Building Dept From: Gerri Jacobson. Fax: 503-598-1960 Pages:3 (Including this one) Phonee 503-639-4171 Date: Il�e:�Y C 1 ,L�d4G _PERlit7T cc: 0 Urgent 0 Far Review 0 Please Comment 0 Please Reply ❑Please Recycle