Permit v CITY OF TIGARD MECHANICAL PERMIT
a ; COMMUNITY DEVELOPMENT Permit #: MEC2013 -00194
T f GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/10/2013
Parcel: 2S104CD05900
Jurisdiction: Tigard
Site address: 13685 SW WHITE CEDAR PL
Project: Wisener Subdivision: HILLSHIRE ESTATES Lot: 59
Project Description: (1) gas fuel piping for BBQ 10'
Contractor: COLUMBIA HEATING & COOLING INC Owner: WISENER, PENNY
PO BOX 230397 13685 SW WHITE CEDAR PL
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE: 503 - 524 -4953
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Fuel Piping 04/10/2013 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 04 /10/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/10/2013 $75.85
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 bycalling 503.232.1987 or 1.800.332.2344.
•C
Issued By: a ,1 (/ /� , {� 1 /1 "1 L Permittee Signature: D i A-FP c4
u-11 DAi
/x^ -
Call 5503.6 by inspection b 7:00 a.m. for the next available ins ection 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.
04/10/2013 08: 43AM 5035980270 COLUMBIA HEATING PAGE 02/02
RECEIVED
Mechanical Permit Application 1012 011 It 1.1 `,1 t".1 .\
City of Tigard APR 1 0 2 013 Ric`fv" 4- to 15 S( Permit No.: mge...„3 -
I q-
, - .4 .. 13125 SW Flail Blvd., Ttgard, OR 97223 Phut R
Phalle: 503.713.2439 Fax: 503.598.1960
II
eview
Other Permit:
CITY
OF TIGARD
1 1 , ... ) Inspection Line; 503.639.4175 1 Date Readylly
Nte/By:
Ala RI See Page l for
Internet www ligard-or gov BUILDING DIVISIO ,.„,....
, /6 Suppiesbentse intermatioo
r
• ..*- 3 ‘C .4; -f mi,ptimmmiwr,,,,,,, .':‘ ; ' V.'. 337177 1 ;111;1, p I ikt'
. ' .. - " •:::• :- .... ■ •• '. s'N'' ` ,,,f;tic:.tz ',iiCt?..-.I.i1+2MZ. :i;:eteth ' ' "., ' ,-, .: i',. 1:: - it ''''' "r-rth"k" '-'''''''''''" *--"- --"---". " - - -
Mechanical permit fees* ere based on the value of the work
0 New construction 1;1-edaition/alteration/replacerricnt Performed. Indicate the value (rounded to thy nearest dollar) of all
CI Demolition El Other: mechanical material; equipment, labor, overhead, and profit,
Valuc: $
c ' e1 `f -M.. .7e.f4 H:7111 ::tiett - Tavai l L7A.MH" -1 7 - dazi -11 1,7atiFfH 5 7...., I TOttilti,. 4 .air. - '''' 7.!-5 ' i...` . el . ',... rrlrni
ar-cui 2-Ihroily dwelling 0 Commercial/industrial 0 Accessory building Fr spaded frriprmaihm me eaeckfi4
0 Multi-family U Master builder D Other: Description Qty. I Ea. I Total .
— •
.., .;..:. ' - Ai bo
Job Site address: /5 re 61 ci L jki / 7 (Wele et,. (..,...4,4,, plan ahowmtpheement 46.75
City/Statc/ZIP: T 040 0 i da h
7 / • • % puraaw 100,000 BTU (duos/vents)
Furnace 10.000+ 13TU (duets/vents) 46.75
54.91
Suiterbidgiapt, no.: Project name: 1",li S e/t/ et_ Heat pump
(fCCIlliTCS Sit plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32 • A
--
Hydroroic hot water system 23.32
--- _ Residential boiler (radiator or
h dronic 23.32
Unit heaters (fuel-type, nut electric). III
in in sus ded etc. 46 75
Subdbision: Lot no.: Flue/vent for any of Above 2332
— Other 2332
Tax map/parcel no,:
Other fuel appillaces:
, • ' , . ,' 'fp; ' ;','-. ,,' '77 - y '''''' .i,,„*- Water haler 7332
. . • '. ,, Y 1 ..1. , 2-,:.iTh - -1.0.glilieg.',.,A.. A- -,, - mmotlta.i . +,,
/# irc gi G14/ 0C- 8.4°Q Gas fireplace
Flue vent for water hear or gas 33.39
fireplace 23.32
Log lighter (gas). 23.32
- ------ Wood/Wood/pellet Move 33.39
,___
-
. Wood tireplaerJinuert 2332
23.32
-''.. .., :-, • - 4 , .4 • • e t a .• ri aa ■ 7 , - i s i ,..t... ..,
, • . - -- • ' .,..h.s.. .,4,:t4.7..m t
' Other: 2332
Name; / / V/U 5 14) I cce4) e 4-- euatrultmeutat exhaust and ventilation:
_
— • -.-
Address! Range hood/other kitchen
--.-------__. ., equipment II 33.39
City/Stata/ZIP,
Clothes d r exhaust 33,39
Phone: To ) 5-7a - . -4161111 Fax: ( ) Single-duct exhaust (hathmoms,
toilet compartments, utility rooms) 23.32
32 '-:' '. ) '.' - in Ilfrnff - - :-...r: ,,, .;', Attie/m.1 DIM 23.
_ . ... _ ■ ..A04...e--.• ,..' ' i.,i . ',. t antri:4-: .,;.,1 • .:;..! II: ' ?c lt ‘",_,
er rfftl
Business name: (:olumbia Heating and Cooling, Inc. Oth
_ - Fuel pipliy:
Contact name: Marietta Meedom
$14.15 for first four: $4.03 for each additional
_. -- —
Address: Po Rex 230397 Furnace, etc.
Gas hoar r um .
City/State/ZIP: 97201
NVallIttriit heater
M
Phone: (503) 6242704 J Fax: : (503) 598-0270 Water heater
II I
Firephi
E-mail: columbhe@teleport.com
.7' 7 -:EZAMMUre f iffietr , '"," ) 4 1 'i. , ..,..,, - :! -. .. 2 - 7 Barbecue
1111
ISusiness name: Columbia Heating and Coolln$, Inc. Clothes dryer (km)
—
- Oihoa. 1
Address: PO Box 230397
:
_._ ..
Cily/Statel.ZIP: Tigard, OR 97201 _ Subtotal
. .
Minimum permit fee ($90,00)
Phone; (503) 624-2704 Fax: (503) 598-0270
-- — - . _ Plan nsriew (25% of permit fee)
• CCB lie.: 76359
State surcharge (12% of permit ke)
— —
TOTAL PERM1TFEE
Authorized signature.. 4 __ Thl. powlit. appitestiew expire, if • rbeneit hi not obtained Mann 180
--- days After it hos been leeePted l3 complete.
Print name" Marlette R Meedom Date: / C • Foe inedetikielmg etg by Tri AtAiblinis Inclasiry 3:n now
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