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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00220 13 125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/20/2011 I1GAR Parcel: 2S102BC08300 Jurisdiction: Tigard Site address: 12730 SW WATKINS AVE Project: Walters Subdivision: ERICKSON PARTITION Lot: Project Description: Enlarge main gas line from meter to basement to 1" black iron. Extend 1/2" gas line to dryer. Contractor: COLUMBIA HEATING & COOLING INC Owner: WALTERS, DONALD & MARY PO BOX 230397 12730 SW WATKINS AVE TIGARD, OR 97281 TIGARD, OR 97223 PHONE: 503 - 624 -2704 PHONE: FAX: 503 - 598 -0270 FEES Specifics: Description Date Amount Fuel Piping 05/20/2011 $14.15 Type of Use: SF 12% State Surcharge - Mechanical 05/20/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/20/2011 $75.85 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas 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: r / Permittee Signature: © g/0/2 / 6-7-770v1 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. May 19 11 12:02p Columbia Heating/Cooling 503-598-0270 p.2 Mechanical Permit Applicati . • FOR 014K1', I'S E ()NI . , City of Tigard I Received : my ' : D'Ilfc/ar sg 0 *V 7' ''''''`' N° "/ I tgroZt i lk - '400o 102 0 I, i , m 13125 SW 1 Tigard, aF 97223 , Au :: Plan kevie ' . ' 2 . Phone: .503 639.4111 fax: 503.59E19601AM 1 1 9 2011 041C1 NT ma: DAWFly TIGA10 Insptcction Laic: 503.639.4175 R 1 Date .eady/By: ha, - 63 Sec Pagel rer , Internet: www ti gard CITY OF TIGARD NottfuuliMethod: Svpplem,out I ofo,m.tioo I BUILD 1 23 TYPE OF WORK - COMMERCIAL PEP SCHEDULE - USE CHECKLIST 1 Mechanical permit fres arc based on the v atm' of [Ix work ?Z : , pm:termed. indicate the value (.7UUrtflVi V the nearest Oollan of all [7:1 Dental ;lion Li Other: 1-heehaw:al materials, euu i ment.,labor .,... _ CATEGORY -OF !COlsitSTRUCITON ' • . ::::. -::- . •• - ' . , Value: ! .. . ------ I : :. RESIDENTIAL EQUIPMENT / SYSTEMS FEES* j / 1g,..1-• and 2- family dwelling 0 Commercial(industrial 0 Accessory' building Por scecinl trft use ch . r- 1 Mufti-family E Master builder 0 ()ther: ' L•escrip;!on Qrs. 1-a. -- i JOB SITE INFORMATION . AND LOCATION € lea EiRgleaating Air conditio.ning • • . Job Ile ii'druss: (2_ - - - 1-- ... 3 Q 5 1 U., 1 11 i ii - I N (require& site plat: showing Fiacernent .16, ' . ( --r 6, A--)0-0 q72-"Lf-{ Furnace 100,000 1371.1fdoetsi:eats) 4,....'5 Furnace 100,000+ BTU :cructsivents I 54.91 I 1 Suitc.lidg.lapl. oc.. 'Pro name: }-',eat pump h i .05 C, cireCtidirCtit1D11S to job site: /4/41 los.,? t i T Duct work: . . 23 32 . 1 Hydronic Ism water system 2112 Residential boiler (radiator or I hydronit) 23 32 ...., Unit heaters (fuel-type, not clxtric). , in-all, 1n-duut, sus I ended, etc 46.7f I - Fluetvcnt for any of ahcve 23 32 I ! sul ision: I Lot no.: Other: 23.32 i VW. Irapiparcel no. ' Other fuel a 4 lianecs I DESCRIPTION OF WORK -' . • '. - - Water heater 21.32 Gas fire.lace 33.39 . eNE....re34, jA A-% "1 C its (..,‘ Al C riLo #:„..-- rt., Eirt---4. Flue vent for water heater ur froplece 23.32 • : lit 13A3 V 7 17 i " etil 1 l Z 0 - '-- kli - kW $) ' - . i 1.0n ii ahter (gas) ---- -- ---- --- I • ‘, . k 6 f r2 , pfi-.),‘,2- ______J w stovc 33.3‘.) ' Weed fire lace/insert 23.32 .• , -1 Churine• elinerilluelvent 23.32 : g(PROPERTY OWNER : ' - • • - ' '0 TENANT , Other: 23.32 ; ss:anle: 1/J?rtir61---5 D i y1,&4..2._ Environmental exhaust and ventilation Ramp hoodiodicr kileben I ..1/4...mr,..,, 33 19 e.ui.meat z ;‘ 4 - 9 ------ P* - 0v - E 33 39 ! Cu s '.State/Z1P: ! Clothes &yet exhaust : ! !:- - ---- , - I Single-duct exhaust (bralnuorm. ' Fax: ( ) toilet com.artments, uol it; toom,) I 2231 . , - 1 - 2 7 3 - 3 - 2 . . AttiCorawls•sace fans 1.2 APPLICA,NT . 0 . CONTACT Pf:RSON .. , Other: ..,, 23 12 I .. .. _ Pirs-r n -s< ame : . , d I- t. 0 3 I /4- f--Pr ,sv 1- , Filo ii in• _..._ . . ..... c 1 for firm four: 5.4.03 for each additional C entze: name: f r - / , (2.i ._ /. /-j Furnace. ctc. 1 1 1 . bc.Itit%•.s?.: I ' ...__ _ .._______....--- Gas heat .untg 1 ! Ci: WaIlisus adediun a heater ! 1 ...___ ,. •,_____ . _ 1 hone: .,f_i 3) / r.94 0'7 Fax: ; ---, 5 -O;-)--70 Water heater _ - ta • -------- ••-: I Fireplace I Ran -e -- - I - 1 - ..._. .. .._ . .; . CONTRACTOR - • . • , .. • . • Barbecue • - i k i , Clothes dryer (Ras) 3usincss name axactigiLh_ fic ! I ---- Others Hicircs... :ci .7 ---• . -• • .. • MECHANICAL PERMIT FEES*.. * • • - i - c i t ; ,'S t ate/211 P: 716....6tAn (:),.., T7(-3 I subtotal 1 i i Minimum 1t fee perm (5)0 ll i'orte:! 1 f -Q I C dt ■ I FaX: II" L D ii , - ,0)_-.7, - Plan review (25% of pemsit fee) -.-- .._ 9t1-17:1!'7:B State surcharge, (12% of permit fee) 1 /0-. r , O i TCYFA L P E:R M IT FL EJ AV „to i ._e-- This permit opplicAti o on explr if m permit i., not obtained i- him 18C ' A lithnri z .:1 signabitzlititill():/eY_T Date:144 [1 days after it has seen accepted as complete. Pit: r I tne jr ' Fee methodology sei by 1-.-County it Wi ng Industry Servi:el3oard tt ; n :fi-- ./::) MI 5 ,,,.---- • ri.i:1,-,,, drir. F.:•..re•J•uo .i4u- Fr (7, !.'n..C.OMAS'Eli)