Permit • CITY OF TIGARD MECHANICAL PERMIT
11114 COMMUNITY DEVELOPMENT Permit #: MEC2013 -00176
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/01/2013
Parcel: 2S110DD02800
Jurisdiction: Tigard
Site address: 10580 SW CENTURY OAK DR
Project: Maddy Subdivision: SUMMERFIELD Lot: 35
Project Description: (1) water heater and (1) flue vent
Contractor: COLUMBIA HEATING & COOLING INC Owner: MADDY, JOAN F
PO BOX 230397 PO BOX 230260
TIGARD, OR 97281 TIGARD, OR 97281
PHONE: 503 - 624 -2704 PHONE: 503 - 502 -0575
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Gas Fireplace 04/01/2013 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 04/01/2013 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12% State Surcharge - Mechanical 04/01/2013 $10.80
Stories: Minimum Fee Adjustment - Mechanical 04/01/2013 $33.29
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: Permittee Signature: CIO . U'C-1 c fib 1 _
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.
03/ 29/ 2013 09: 39AM 5035980270 COLUMBIA HEATING PAGE 02/02
Mechanical Permit Apnlicatilt3ECEI VE I
City of Tigard A ll 1 2013 10112111171kal
"p ,_- . 13125 SW Hall Blvd., Tigard, OR 97223
° Phone: 503.7182439 Fax: 503.5%1960%
81711 °D Plan Review
Deral3y: Other Permit
T W AItt) Invcctin o Line. 503.639.4175 G DIVI Date Ready/8y. km, El Sae Page 2 for
Internet: www.tigard-or.gav G .1. 1 NotifiediMertxxli i I (4' Srrimlemcatel laformettas
MIIIIII■ZgiL. * g.5,73;", '.... '''`. : %,:i:i.`ii ',..''.: r :IrtV1 , :li. - Z - 1 = - ..IMIMIl'..':. ; 1;Lctif.! .
1k/tech/mini permit fees* are based on the value of the work
0 New construction 8-eardition/olteration/repl ace mont perforracd. Indicate the value (munded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, tabor, ovorkead, and profit. _
Value: S
INE MPV I ERAL I EM - MN.Zi r eig. "4" trAffi /21.4 ''' ot -- - -
- • ' - , , ',ft:: „ -
0 dwelling 0 CommerciaVindustrial 0 Accessory building For speddinformertlen use Cif ealta
0 Multi-family 0 Master builder 0 Other. Description I Oly, I Ea I Total
7`.. s'it47.71"..s briw
e. - t . ;7 . 74..(.:),Kui , ilcatlag/tooliug:
''. ',' 'r - '.‘ ''.". --.. ' _• "),,,, Aor" . •`' S iaa‘. 1 " ' ' ' . " ' ' ' 'W. ''' 7 ' . ' ' Air conditioning
Job site address: I 8 0
c...? ce"1 , -7- 0 4 c . i e , . (raluing Sac plan showing placement) 46.75
* 100.000 BTU (wet
City/Statc/Z IP: ( # 4.,(„0 -
• . 1 , , 9- Furnace s/vents) 46.75
Furnace 100,000+ BTU (duers/vents)
54.91
Su itrJbl dg./apt. no.: Project name: /OA I n Heat pump
(roamer late plan altqwing placement) 61.06
Cross sUe et/directions to Job site:
Dna work 2332 • A,
Hydronic hot realer system 23.32
—
Residential boiler (radiator or
hydronic)
Unit heaters (fuel not electric).
in-wall, in-cluct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
--- ether 23.32
—
Tax map/parcel no.:
Other fuel applianeet:
it.:. 44: Water heater I 2332
Cai•J Ll E 7 et-ECA" C 1-0 CA-r Gas fir 33.39 —
eplace
Flue vent for water IICAttr or gas
WAIT' EX-- /-A-TEL. nreplece 1 23.32
I...144 lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fir lacense 23.32
23.32
,, .. ::, ., , +7`;..*: -.P:':.
- Other 2-3.32
NMI: 7 ' /) 4 ,Z Y Environmental eibattat and ventilation:
ddr R &list hoovVothein
- Aess:
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct. exhaust (bathrooms.
Plicitit (5 ) • — 0575- PLC( ) toilet compartmen(s. utility rooms) 23.32
"' . Ti Attieicsawlspirce fans 23.32
,.., w. , r, ,........ i ..
Other 23.32
Business name: Columbia Helaine and Cooling. Inc.
_, Fuel pipI ng:
Contact name: Marlene Meedom 514.15 for that four; 54.03 for each additional
—
cur
Address: PO Box 230397 lier..., etc.
Gas heat pump
City/Stale/ZIP: 972iii
Wall/suspended/unit heater
Phone (503) 624-2704 Fax: : (503) 598-0270 Water heater .
Fireplace
E-mail: colunibbe(g.teleporLeoln
Range -
• .*;; :,.. .: i ':i.:!;;, i:.,la 7ite-re"r1:44gp,M1),g,t111..i ‘: ?.. 4 i'i4 : '''' . 1':'"Is' .. Elubecue
g
Business name: Columbia Heating and Cooling, in . Clothes dryer (as) c.
Other;
Address: PO Box 230397 .•?, -, i,,i'.:.....;"2...;.•.:'•
City/Suno/ZIP: Tigard -OR Mill
Minimum Subtotal
imum permit fee (590.00)
MOOG: (303) 624-2704 Fax: (503) S9/3-0270
Plan review ps% of permit fee)
CCB Ho.: 76359 Suite surcharge (12% of permit fee)
—
TOTAL PERMIT FEE i(t) - 8
Tau permit application expires Ito permit is not 9004,4 wirbla lap
Authorized signature:
days after it Mu been accepted as consolvic.
Fee methudolotry sat by Tri-County Building Industry Suvice Board
I Print name: Marlena R Meedoni Date: ?.. - Is
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