Permit CITY OF TIGARD MECHANICAL PERMIT
F COMMUNITY DEVELOPMENT Permit #: MEC2013 00344
Date Issued: 06/24/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S105DD06500
Jurisdiction: Tigard
Site address: 13495 SW SANDRIDGE DR
Project: Alvarez Subdivision: PACIFIC CREST Lot: 41
Project Description: Replace A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance requirements.
Contractor: COLUMBIA HEATING & COOLING INC Owner: ALVAREZ, DAVID F & JENNIFER S
PO BOX 230397 14370 SW 92ND AVE
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE: 503 - 925 -3905
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/24/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/24/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/24/2013 $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: Permittee Signature: /9� ,O /OG ie
"`��� 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.
06/20/2013 01:29PM 5035980270 COLUMBIA HEATING PAGE 02/02
HECEKVED
14ecban.ical Penn t Ap r lieationJUN 2 ® 2013 1 ot.I - e_ uyl; OM.,
.
13125 SW Hall Bl d., Tigard, OR OF T9 GRRD I
w ' Phone: 503.7182 39 Fax: 503.598= BUILDING q Pp on1°`
r 1 t; A i z I) Inspection Line: 513.0539.4175 BUILDING D V S OP Date ReadyBy: ee Pape Lae
Internet www.b • d or.gbv 1Vaitled/Mni od: e .temeotai Information
-
Mechanical permit fees ;arc on: value of the work
❑ New contttruetion $. Addition /alterattonlreplacement 1 performed Indicate the value (ro to the nearest dollar) of all
In Demolition p Other: mechanical materials, equip/ten la... overhead, and profit.
g� � �y1 1.1� ,...
Value: $
r. Ry,V'�1 1 �L 1 +'. F b C . - ,,f; 6 tl 1 +�F 7 !: ' ' :t: $' x 1
YEMt. ., ,,. ten ..a,a.c ' '.ear. . .� ` ' '1 ' - , i • e 'alt w.. '' :kt*
NI 1 - and 2- family dwelling El Commercial/industrial ❑ Accessory building For special Information ..e diaekl
ID Multi-family ❑ Master builder ❑ Other, Description llgty-J Ea I Tota
l I 4. �_ �� - p ; Matt _coolin:;
' i;.„..._. : � .,, : . . yy C Air conditioning
Job site address: r ii W 74917;171,41.4 •;a►ra` f f �1 . .. .. . • • 46.75
- Furnace 100 000 BTU ducts/wile 46.75
City /State/ZIP: 0 f i • i _ . i i put a 100,000+ BTLI (deetsiventa) 54.91
Suite/bldg. /apt. no.; Pet:dra s-no: .i / n Heat u (rn n@ 61 • quirm ado plan showing pldoomes
Cross strcet/direelions to job -ite: Ductwork I 23.32 • A
F_lydronic hot mater system _ 1 23.32
Resklentiat boiler (radiator or
ti 23.32
' Unit hatters (fuel -type, not el ' - c).
in-wall. in-du sus 1 tied etc. 46.75 _
Subdivision: I Lot no:: Flue/vent for an of above ��
Other. 1 iM 2332
Tax map/parcel no.: i Other feel pUeaeer. I
mr�aa>>t' ::.ts
4 >re s w r a.aa'. Water heater — 23.32
'
Wr Gas fireplace 33.39
111111111111111111 I ! .. / . , F u p v c fireplace for water beater or gas 2.3.32
MEI I
lag 11R11ter (gas) I ! 23.37
Wood/pellet stove , - , 3339
Wood fireplace/insert 1 23.32
s i' , '' ,, • t Ch inn Aincr/ilue/vent I 1 23.32
'�' - C 71 . o r . �. - L .; ` ; ,fp s IY ey
j•' • - 4>� �. '�i =- � "•;Ipri °: Qd' � ■ 23.32
Name; Z r ►+ O. E nvironmental arhaas& a v ea2ti . a :
Range hood/other kitchen
t5 ■•=.. equipment 3339
City /State /ZIP: / :rg/ AreVj L'pt Clothes dryer exhaust 1 33.39
Single - dud. exhaust (hetttmnms
Phone: 1 ) Fax: ( ) toilet compartments, Utility mot 23 32
,: ; : .s - ° n tG+ -:l Attidcmvlspacet'arts I _a 2
-. 'Yrh ''`�:cag Other. .,I , 23.32 I _
Business name: Columbia H ating and C.04112., Inc- __ Fuel I
pip ng:
Contact name Mariana M , • om S14.151(11- first roan 403 fo each addltlonal
Addrer s: PO Box 230397 Furnace, atC, )
Gas heat pump I
City/Statd2IP :97281 j Wall/suspended/unitheater 1 I
Phone: (503) 6244/04 [Fax: : (503) 598 - 0270 water hearer I
Fireplace
E -mail: oolumbb rr oelepo coin I Ran:
y,.•,'.•`;:,,:1'`a'.:+i,.; % .Mj.. m0 :'r. EIF Barbecue 1 111 � �
Business name ring and Cnaling, Inc. Clothes dryer (am)
Other,
Addrms PO lint 230397 TA i. ,:: 1 �,�� .,�, fir,
- . .,.a •r wv� a4 fsiiet
City /StaterZIP: Tigard, OR ' 7282 I Subtotal
Phone: (503) 624 - 2704 Fax: (503) 598 - 0270 Minimum Permit (590.00)
Plan review (5%ofir nob fee)
CCB tic.: 76359 State surcharge (12% o "permtt fcc)
TrTAL Pk 013T FEE /04 4'0 '/
This w ant • pplteattan sipper i{ a p t is not obtained within 180
Authorized si y r / - `� days after It has Arrest as cumptete.
Print name: Marlena R. Mee. oin pate: _ a -, Fee anethodol act try Tri -Cot ty Boit tag Industry Snrvrco Boma
3 .w..11,41...ao..- •...0o1rr.13.T:. a...,M Melvin . 4(MA17T 111M17t'(iy/WFR11
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