Permit L
i
CITY OF TIGARD MECHANICAL PERMIT
. . , '>•- COMMUNITY DEVELOPMENT Permit #: MEC2009-00480
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 09/09/2009
Parcel: 2S112CA00800
Jurisdiction: Tigard
Site address: 7895 SW GENTLE WOODS DR
Subdivision: Lot: 0
Project: Muter
Project Description: Replace gas furnace
Owner: FEES
MUTER, REGINA Description Date Amount
7895 SW GENTLE WOODS Furnaces < 100K BTU 09/09/2009 $14 00
TIGARD, OR 97224 12% State Surcharge - Mechanical 09/09/2009 $8 70
PHONE Minimum Fee Adjustment - Mechanical 09/09/2009 $58 50
Contractor:
COLUMBIA HEATING & COOLING INC
PO BOX 230397
TIGARD, OR 97223
PHONE* 503- 624 -2704
FAX' 503 - 598 -0270
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp•
Stories:
Fuel
Fuel Types
Gas Pressue:
Total $81.20
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 -0100 You may obtain a copy of the rules
or direct questions to OUNC by calling 503 246.6699 or 1.800 332 2344.
Issued By: �km Rl+' .„0 Permittee Signature: IN- ♦ 11 /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
#'..Se 09 11:40a Columbia Heating /Cooling 503- 598 -0270 p 2
Mechanical Permit Applications �� >i`ic i SL,OM:
City of r-1 R.`e"e ,y r �
`.7 b Fl��./+ Dote
ve �c m:tNo y {�riC/ a(�R' �y6
' r 13125 SW Hall a1vd., 'rant d, 0 1 3 Platt Review
,3 � Phone: 503.639 4171 I rx 511 i 5yA " 1 0 9 96 Dcte/g +Jthcr t'crmri
rr Y:
.•Ft . AI,UD' Inspection Lin:. 50J 63r1 4i')S p,: c 1tcadyil3y. turn N7
Internet: www,ti�;atd- ot,l;ov FT�O ''llonhed./Moth/1d l S Page 2 for Suppletnent.l l ifunnatlui.
COY 0 V 6 to - - —
TYPE C0�1�lERCLLL FEE SC1rF_ntli.F — 1181
CO
{] Nov,' construction / /f - Additi •n. /ttl:eratiott/t ep'acen:em 5t4 1. utical pertnn fees' arc based on the val•tc of the work
^erfonned. Indicate the value (rounded to the nearest dollar) of .11
u Demolition E C}th(r: mechanical m ntcnals, equipment, labrr, overheat, and profit '
CATEGORY OF CONSTRUCTION • Value $�DUJ
•
' RESIDENTIAL EQUIPMENT i SYSTEMS FEES`
'1- and 2- 1t:r„tly dwe ling ❑ Commcrciallindus:riai ❑ Accessory butld.ng
For special rnfarmauon use cltecAits
❑ Multi- farr,ity ❑ Master builder ❑ Other i:escriptton I Qty E4. Li ota '
J013 SITE INFORIYIATION AND LOCATION' I lea tin� /cnottrig
r i rr J Alr ronutionmg or hea p ump
m b site address: 7 q � 1,..../ 6 � fps ° ( site olan s [ 14 UU
Ctty /StatelZ1P: t t t vt--O Furnace 100,700 BTU (ductsrvenis) I 14 00
Furnace 100,0004- S:'L (duots)vent_s) i7 00
Sutte/bldg.rapl no Project name:
Gas 1 pump 14 0..)
Cross street/directions to Job sire: Duct v. 14 00
D drnnic hot v. systcrn 14 01)
Residential boiler (radiator or
hvd:onic) 4 0L
• - ---- Unit heaters (fuel -type, not clectno), •
it -wa11, ta Cue'., susper.ded, etc 10 -00
Fl e.nt for any of above 10.00
' Subd,vision: Lot no.:
Cdter 10 00 1
T ax man /parcel no Other fuel appliances
' DESCRIPTION OF WORK ',fate heater 10 00
I ti.,L,,,. ti;u 5replace 10 00 _ l , Flue vent for ater heater or gas J lireplacc l0 UU
Log hg•oter (gas) 10 00
v.'cod,'pelletstove 10.00
V<'aod fireplace/insert L 10.00 .
PROPERTY OWNER k ❑ TENANT Ch.t•tey /tir.eri lue /vent 10 00
Dther, 10 00 !
L Name: L / i 1 i e " ' re 1;nvironmental exhaust and ventilat
* � l:an hood/other kitchen
1
Address GYt -n i t-10 equipment 10 OU
C:tyiStateiZlP. ' + C1cthe dryer exhaust 10 00 _
1 Single-duet exhaust (bathroo ns,
Phone Fax 5 5 Fax ) toilet compartments, utility rooms) 6 hC — _
❑ APPLICANT ❑ CONTACT PERSON _A.:tcrcrawlsp fans I 10 00
Other' ' 0 00
Business name:
Fuel piping _.
Contact name( `7) R I b y 55.40 for first four; 51.00 for each additional
l
Furnace, etc j
\dd eSS: l Czs heat pt,mp
Cay /SlateiZ1P. ' Wallisuspentedlun:t heater 1
Ph one: Water heater
� b3 ) �J 7 Fax: ) S "T � � J
Ftreblace
El -mail: Range _-
CONTRACTOR Barbecue
zi 1 J f t.rr2 hi �, / " //- -0( (- _ Clothes drve (gas}
Business name: c
r Other i i
Address: (F j p x ) 3 0 I -• W MECHANICAL PERMIT FEES`
1 �
I Clty(StatelZIP: l r U / 7 ca,e) e' r2-- 1-7 2-- ,I>"
,, _ � tvliniau m petrtit fee (572 50) `
Phone: ( J u �--��••� J) ( 2 Li ~ ) p - 70 Y // `:ax: l � � 5 r 5 ) S y ,? -r 6. 3-- - 7 d
( 2 5 % FLEW
CCB lie.: k 3 ! i
/ State surcharge (12 ° bf permit fee)
TO um_ PERMIT FEE . - — Sr
This permit a)tptiea don enpi ifs peruut n uvt ubtaiued vothSn 15
Authorized Signature: days after 11 has been accepted as complete.
' Fee rrethodolc set h Tn- Ca•.tnly Building Industry Service BoarJ
Print name: Date: y' 8