Permit n CITY OF TIGARD MECHANICAL PERMIT
IN
a ,.. COMMUNITY DEVELOPMENT Permit #: MEC2013 00065
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013
Parcel: 1S133CD02800
Jurisdiction: Tigard
Site address: 13705 SW ASHBURY LN
Project: Atencio Subdivision: COTSWALD MEADOWS Lot: 26
Project Description: (1) gas furnace replacement
Contractor: COLUMBIA HEATING & COOLING INC Owner: LESSNER, CRISTINA ATENCIO
PO BOX 230397 13705 SW ASHBURY LN
TIGARD, OR 97281 PORTLAND, OR 97223
PHONE: 503 - 624 -2704 PHONE: 503 - 504 -1126
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/29/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/29/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/29/2013 $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:
AbA by Permittee Signature: OA rl PPt,e --r / .i . L/4-4-al Q
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.
01/28/2013 05:16PM 5035980270 COLUMBIA HEATING PAGE 02/02
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Mechanical Permit A , lira - j \( r �' � • • I F< pi: OFFICE l'S1 - , ON_.1
City of Tigard �,�; 1 3 S'' itNa' _ 13 - oGb(�
12125 SW ME d., Tt. OR 97
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Phone: 503.71.8.'7A39 Pa7 303.598.1450 �t�'
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�.� 1111..1 /� t /requires she matishvwing=ripest) 44.75
' I ! / I _ - ! furnace. 100,,0.00 BTU (docd/vemai 1 46.75
I Furnace 100,000+ BTU (dutl4lvcon) 54,91
Suite/bldg./apt. no.: 41
Er .. nalrfe: ! ! :'> I f� Hsat P !P • (fenv6rsa aka �w4vlax piaeethentl 61.06
Cross Strt e t/disvotiona.to job site: i 11111111111111111 Dact Work . 2332 •1t_
I I I Hydronic hamster-system .. x332 •
Residential boiler (radiator or
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' I hydrotiic) ?3.32 • .
Unit heaters (fuel -type, nottNzbSc). •
in +wal induct, Srispettded.t 4.6.75
Subdivision: I LOO DQ I Fluetveitt for. an , of adore 23.32
Other'
mapipareel not. I i Other foel.ep lances: - .
v r ry t .m amp. -u +'imp a- t r..a. 1 ^�� t.'��
y {" y �- RFIZM 4ZIM h s 1st f $P.; .I Waterbeale 2 332
it �J d• rf Gas Grcplace 3,3.39
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111111111011 fuepaco l _ 23.32 •
'Lott iilthter (3 23.32
Wood/pellet Stela _ • 33.39
• Wood fuepl>celpisert . • • 2332
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3 ritrAria/vent _ 23.32
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`>+1 for m1 Bali Enviroiimeatal .cstt96statid•veetayadbn: . ,
� , / Range hood/other ' Kitchen
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• :'• . L� _ equipment I 3339
City/3ttttuJZ P: 1 0 / iss Clothes dtye exhaust dryer. 33:39
te "e (lat s dry r.exh u (beR3frofxfls
Photo: .j.: 3 • miler eumptatanteats, utility rooms) 23.32
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Business na�me:.Cortriabia Heating a Coaling; n . Lb I Other: -
Contact mints: .Marietta Meedoin . situ foi- tt .atkoriSf1.63•farcachddditionat
Address: PO Box-230397 I ' Fwttace, etc.
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Gas hear pump _
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City/Shim/2)P: 9721H : WnitrsuspendedPoni�hceter
• Phone: 03) 624.2704 l Fa7C :' (503) 598 -02' 0 Water boater •
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-mail: eolnmbhc( telepOrLcom • ; I • R®n ��
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Clothes dryer (sae) i3tstineggnamt: Cytl�Ota.itfeaNns e,. , Cooling, roc. . ,.
Other: . . .. . .- •
Address: P(3 Box 130397 — I - ., ,
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• City/Sfet&JZ1P: Twerp. OR 97231 I Subtotal:
Phone: (503) 6244 - 2704 1 Para (503) 598:-OZ7I I Mi P permit fee 100 tie
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CC6 lie.: 76359 I • State aurcharge• ofpemlit Ice)
l TOTAI, PERMIT FEE / (TD •O • t
Author'ized'si + / .0 j r I Thirpeapplicatien expires Botlarmat 'ie not
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