Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00210
'
Date Issued: 03/26/2017
-F t Ga R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S133DD00600
Jurisdiction: Tigard
Site address: 11667 SW 129TH PL
Project: McConnel Subdivision:'ILLAGE AT SUMMER LAKE PARK NO. Lot: 45
Project Description: Replace Gas Furnace, Install AC
Contractor: COLUMBIA HEATING&COOLING INC Owner: MCCONNELL, EMESE
PO BOX 230397 11667 SW 129TH PL
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503-624-2704 PHONE: 971-998-7763
FAX: 503-598-0270
FEES
Specifics: Description Date Amount
Air Conditioning 03/26/2017 $46.75
Type of Use: SF Furnaces<100K BTU 03/26/2017 $46.75
Class of Work: ADU Type of Const: 12%State Surcharge-Mechanical 03/26/2017 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $104.72
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 que : •UNC by calling 503.232.1987 or 1.800.332.2344.
Issue. By: / /! Permittee Signature:
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.
CITY OF TIGARD RECEIPT
ilki g '. 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 409628 - 03/26/2017
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
MEC2017-00210 Air Conditioning 230-0000-43102 $46.75
MEC2017-00210 Furnaces< 100K BTU 230-0000-43102 $46.75
MEC2017-00210 12%State Surcharge-Mechanical 100-0000-24001 $11.22
Total: $104.72
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 616205 PUBLICUSER106 03/26/2017 $104.72
Payor: COLUMBIA HEATING AND COOLING
Total Payments: $104.72
Balance Due: $0.00
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