Permit CITY OF TIGARD MECHANICAL PERMIT
! I COMMUNITY DEVELOPMENT Permit #: MEC2011 -00455
Date Issued: 10/14/2011
T!GARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1S133DC10100
Jurisdiction: Tigard
Site address: 13125 SW SHORE DR
Project: SAIER Subdivision: WINTER LAKE Lot: 29
Project Description: Gas furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: KEVIN SAIER LLC
PO BOX 230397 13911 SW HILLSHIRE DR
TIGARD, OR 97281 TIGARD, OR 97223
PHONE. 503 - 624 -2704 PHONE
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/14/2011 $46 75
Type of Use: SF 12% State Surcharge - Mechanical 10/14/2011 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/14/2011 $43 25
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 1.800.332.23-
_�. I
Issued By: — r Permittee Signature: _ G
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.
Oct 14 11 11:49a Columbia Heating /Cooling 503 - 598 -0270 p.2
Nlechanical Permit Application \A f'( }tOFE It USE .ONLY
(`itv o f Ti a [ F � " � ' � �
p::in:Na.: 5
13 1?5 syt,` liai e T iga rd, on 9 Q � \ Rate iD { ._. N 2jlll
Tigard, Plan Review C . Phone' ;03 639 41 71 Fax: 503.598. b.), .` \ ® el)atdlly Oilier pe'mit.
T:IGARD ln5jtrnhan Line 503.639 4i75 (6•' , \C \Q Ready lgy, Page i Tor
ale tuns: lit Sec Pa
Internet wuu.ligard- or.gov G � sa i� Nntifietl�7vlethnd r �, Supplemental leS utation
T YPE OF WORK �\ °� I ( COMMERCIAL FEE* SCHEDULE — USE CIIECKLIS't•
Mechanical permit fres are based on the value o the wcrk
.c••ti uil:i;-irlldtl'ft * odds 'ion.raltcration /repiaccment performed Indurate the value (wattled to the ne2Tesi dnllnn of 311
Demt ;litirn [; Other: mechanical materials_ equipment. labor. overhead. and profit -
CATEGORY OF CONSTRUCTION ., Value I -i
_ _. RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
i kJ - and 2 - family dwelling ❑ Comrnert.iai /industrial 0 Accessory building
For sk•eclal to /nrmcnorr tr. e chectlta
\ltzltt farally 0 'Master builder 0 Other: '
•
t1;� • ha lolal
l JOB SITE INFORMATION AND LOCATION Heatinglcoolin;g - _
Ay � Air conditioning 1
r e , r,h pile address la p- 5\5 ,-)., 1 t.t re plan stowueg_placemcut) . 46.75 1
• it'.'SI-rtel7.IP G Furnace 100,000 BTU d.ueis /vents; f 46.'5
sr --- + Furnace 100,0OIH- B n i tductv'vunts) 54 ,
I Coitc'l•14...apt •in : i Project name_ I ,P r Heat prep . 61 06 _
_
E'rr ttreet'direclions lo .10b Duct work 1 23 32 •• - a ob step, �- --
— — ! Hydronic hot water system I 23.32
Residential boiler (radiator or l i
-- hydronic) 23 3 2
_ _ _____ __ __._. Unit heaters (fuel-type, em electric).
. m -wall, in-duct, suspended etc 46 7;
_ - _ -- _.__ _ -- -. --- , Fluervent for any of above 1 23 32
' '- 1:-d•"
r<eo„: Led no„ ff
._____ _ ___ — _ —1 Other _.. _—_ _ __....- -. L _ 23112
map.parcc: no • Other fuel appliances — -
Water heater 23 22 1 '
DESCRIPTION OF WORK i
1 ties II:spi ce 3- 3q r _
act � 1 � I�iI►_� _�- l.C- r' lue vent for water heater or gas — t
fireplecc _..__ I i 2 =.32 1 -
- — - -- -- Log I fighter (p,as) :3.32 4
W ood/pellet stove 1 i 3. t o
2� i
Wood fireplace insert ,
_ Chinney /linerttlue i I 21.32
1 ROPERTY OWNER E ❑ TENANT Other 23 32 i i
1
'-autL- . x -- Environmental exhaust and vcatifat inn_ _ _
— -- - - - -- w 1— Range hood /other kitchen
�ldre — I3a1 i � 1 �" + 'd e• equipment _ 3? 39
�'� , fi r� / - Clothes dryer exhaust 33 39 I
i _ Single-duct exhaust (bst;7ra ;m1,
■ Phanc• (6o3) S. 76 Fax: ( ) collet compartments, utility rooms) 21 32
1 -- • 1.3 32 r •
I LI APPLICANT 0 CONTACT PERSON { A tnrlcr amspa_e fans _ _..
Other: — 21!2 t - 1
13 sine',; name' , Fuel piping _ —_
(; r .rc - name: 1 r7 l ))' / f r}-') ee i? , j 314.15 for first four�_S4.03 fur each additional
i Furnace, etc,
°cd`c e Gas hear punt ", - . _ _.... I ..
i €_i 'Si.ito2lP I Walls heater _, - ___�_ - -, I -
I 1 E Water heater
lt! n 3) 7,04 l Fnx: ` - - .> t• (— - --] � 1•trc i ncc
I - : Ran -e .
CON - TRACTOR . Barbecue_.__.
Clothes d er(;-as)
- t—
Pustuess name: * • —i
r • I III writ O t a ∎ *Of. _ Other _ , i
S 9 7 - MECHANICAL!ERMITPEES
i �.: >s•. ;., �.1 _ tae _._... - _ -
r Subtotal 1/( (p _7r
l it }_StateZiY. c '��f , � � . � Minimumperni; fee (590.00) I _ cti
Pilot' C. 6 ) 3 ( --�( e i `'�'"C.�a 5 r O l�
� — plan tc'•vicw(25 %ofpermii feel
CCP lrc_: r- q State surcharge(12 % ofpermitfeel l( 3 ,
L _ -- -- /tf1 , TOTAL PERMIT FEE
I Gib,
� ��� This permit application ihtptres it a permit is not obtained lit hi 180
Fn
Au'rized signature' days after it has been accepted ea complete.
_....
I 1 1 - - � i ' Fee nethodc4 p'u act b� Tr- Cnuntl Ii ulciine industry Scrv.c_ 13ea-d
Prtl1 1`7iTiE. / i'l Q ) �ftEe' (. .� -