Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2013-00601
Date Issued: 10/09/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S 09/201 1732
Jurisdiction: Tigard
Site address: 10255 SW KABLE ST
Project: Lucas Subdivision: HOOD VIEW NO.2 Lot: 31-32
Project Description: Replace furnace.
Contractor: COLUMBIA HEATING&COOLING INC Owner: LUCAS, MAURICE D AND PAMELA R
PO BOX 230397 10255 SW KABLE ST
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503-624-2704 PHONE:
FAX: 503-598-0270
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/09/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 10/09/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/09/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC b calling 503.232.1987 or 1.800.332.2344.
Issued By: i / .- Permittee Signature: O/� �/�G7 �/�Q
• Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
10/08/2013 04:19PM 5035980270 COLUMBIA HEATING PAGE 01/02
:
Mechanical Permit Application ,,t28) 1:0[1,OH.II;I: t1SI:ONLY
City of Tigard i _, , I/HMI:117A 1
opl .. 13125 SW Hall Blvd.,Tigard,0 ' 1.-:1-
3 Phone: 503.718.2439 F&N; 503.:-.. 960 iS 1
),'- EN111.1111MI Chhcr IWThit: .11.11111111
.,-,,.... ,,,, Inspection Line: 503.6399.175 0:--.\ Date Ready/By: km: el :se nee t for
Sup, . mai information
Internet; wunv.tigard-or.gov
ilV3I'''11.)0 Notified/Method: •
'::'"- '''''''-'77-''I:'"';''J.■'';''';k!-':.:M''''e.4.i.':'!',!.',-,jkiej'..-;..',..*,2 /'''s-0'-''''''1,4f.W.'/Zit0C,.!),'"Y-Mq1:=.; ','..,‘::;',. '''`' ' —l''''''‘'''''''''-'''''.4:4''L'71 "11152:12111
Mechanical permit fees are based op ' e value of the work
El New construction "I Addition/a !: . on/replacement peril:et:ed.Indicate the value(rounde.10 the nearest dollar)of all
0 Demolition 0 Other: , mechanical materials,equipment,Lebo overhead,and irocrt.
Value:$
:...114:!=:;'-'■.',.*77':7 ,:' ,* ::?Ttft' 'i"iit r"
. ...
RI 1-and 2-family dwelling 171 Commercial/industrial LI Accessory building For special Inforstation .e checklist.•
0 Multi-family 1:1 Master builder 0 Other: Doscription Qty. I Ea. •1 Total
.'''''''''''''24.-714-',,,tL,:`11-WWtrOtf#010tatogiiritottPilikiiiiiiggi;;W.51 '7;?,!7 '',N;::' ileatiTIPA001■11g:
Job site addre i-..),, -, ,•'..-,,,..i.:-.,..;,.------ ''".-'-',4'ill,-.:?'' " " '?"'7 " Air conditioning
ss10;55 10„? <Ct_bie., ..r5-1-; (requires situp=showing plasetnent) 46.75 _
Furnace 100.000 BTU(duets/yenta) 46.75
.7
City/Stale/ZIP: 7° at- : OR 7., q
e.: Furnace 100,000t-BTU(dueta&enia) i 54.91 -
Suiterbldg./apt.no.: project name: i„,(A,C,i9-,5 Heat pump
(requires site plan shaving plasernen_9 61.06
Cross street/directions to job site: : Duct work 23.32 •A;
. Mr:Ironic hot water system 23.32
. Residential boiler(radiator or
hydronic) 23.32
- Unit heaters(fuel-type,not electric),
iti-*&l.in-duct,suspended,etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
' . Other: 23 32
. _
Tax map/parcel no.: Other fuel appliances:
_ ,
Water healer 23.32
Gas fireplace 33.39
Replace- --I.Ar-na_c-e...._ Flue vent for water heater or gas
fireplace 23.32
• Log lighter(gas) 23.32
Wood/pellet stove 33.39
_Wood firepteee/insert 23-32
,, --- , ..:‘•"V-","• Chimney/liner/flue/vent
1,-. ;:/ ,".:;;.,/-1,.:-,;.0■ ,r.,;-; ...:*';47-11tit AV:.`,444d1L$Kri: ' ' l'.",'"1!..''''!Iiiii-,:;; '. 23.32
-.4..-4.114.tre.4.:.... , , ..:----,. ,.•-.. 4,•,,-L--:,--....2!- .-, : - ;.....,-: - , -..,' other 23,32
Name: pccni Z_vc c5 Environmental exhaust and ventilation:
Address: JO 05S SW . ka_Ale 5-1-- Range hood/other kitchen
equipment 13 39
City/State/ZIP: • 01" A c-d OR 9'9.2.ay Clothes dryer exhaust-- - 33.39
•.
Phone.(5-43) SI'.6 0 F- i Single-duct exhaust(bathrooms,
,toilet compartments,utility moms) 23.32
..1:••••";;;:::••••:•.-...AirrInKeTtayainalt :',' r.:,-.. .7s51.,,,:',. AttickraW1S_Mee floss 23.32
-,,
: 23-32
Busineea name:Columbia Heating 8!mad Cooling,taw. 0th -* . _
Fuelylping:
Contact name:marlenn Metnom 514.15 for first four;54.03 Mr eaen aleitioflal
. —
Address:PO BOx 231)397 Furnace,etc.
- _ Gas heat pump
City/Seate/ZIP:97281 Well/sus'ended/unit heater I
Phone:(503)624-2704 , I Fax::(503)598-0770 Water healer ,_
Fireplace
E-mail:columohegteleport_corn .
• -:::'.:'..4.44,WJAV.Zi?..L1':-Tg,'-:,,,,:44-,t•,,f,'..ie4sititil itililieje*-.., teite,:-. ::::',.•,-;j, ': :.:• :-...'i7.::',F,T Barbecue
,""%,,54 ,,,:,,,,,,i ,,e4t*.t-n,,'.kt.P,....::-4..:;.,:, , , ..........•.......,:.,.,.----Tisk,-*;.=‘,. ;,.2'F,',.;•'Tr, ':' ' 3-: ;.:•,-...;
Business name:Columbia Ideating and Cooling,inc. Clothes dryer(gett) - -
Other:
Addrtss:PO BOX 230397 — '"'"''..q,'''...;:c.,4:14......!,,4f,t,
. --
City/Stage/ZIP:Tigard,OR 97281 : Subtotal
• One:(503)6Z4-2704 Fax:(503)598-0270
— Minimum penult fan 1.$90.00)
CCB lic.:76359
Plan rtview(25%ot-permit fee)
State surcharge(12%of permit fee) _,
TOTAL PERMIT FEE /00 in
Authorized signature:„Ailfiklinik Thin permit application expires if a pertnit ie n01,6140.1(4 Mai.180
days nfter it has been Accepted as Campine_
Print name:Merlena R Meedom I Dale! 1-e:V0/3 ' Fee methodology so by Tri•Couuty Building bultistry Scrvice Board
t,1,.11,14...1DowvArolalgr-P•rvntethem nne nurnooin 4M4RI TT(11,117/r11411W;111