Permit 114 a If CITY OF TIGARD MECHANICAL PERMIT
t or, COMMUNITY DEVELOPMENT Permit #: MEC2011 -00518
Date Issued: 11/17/2011
T1GAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S114BA02200
Jurisdiction: Tigard
Site address: 9830 SW SERENA WAY
Project: Alexander Subdivision: PICK'S LANDING NO.2 Lot: 117
Project Description: Replace gas furnace.
Contractor: COLUMBIA HEATING & COOLING INC Owner: ALEXANDER, STEVE
PO BOX 230397 9830 SW SERENA WAY
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE: 503 - 516 -8577
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/17/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/17/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/17/2011 $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 1.800.332.2344. /I
Issued By: � / - Permittee Signature: dr,t P/'L/ (4-770
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.
Nov 16 11 01:39p Columbia Heating /Cooling 503 - 598 -0270 p.1
Mechanical Permit A pplicativ -c TOR ()r i iC t: t. SC•. ONLY
City of \
Tigard \ Received ,
� �. 1 DatUt3y i/ / 7 / .4., ._ cirri[.[° /V>�C //— OO57.
l3: St L' fall Rlvd., Ti;ard, t `. A piznRevitx
C Phon 502.639.4171 fax: 503. '8.s9 \ A eJ 0.1_ i Downy- I Ot'.rerPerrnit:
inspection Line: 503.639
TIGAR 1? v � G 9 N' ' date Ready/By: r lung. - Ri See Page 2 for
- Intern:[. www.tigard - or.gov OX 9�1 1 Notified/Method. 1G Supplemental Information
TYPE OF Wit jjr I COMMERCIAL FEE" SCIIEDiILF., - USF,CIIEC'KL[ST
CO. ct n ;Inictitln rlddittonlaltGrationirep1ecemcnt Mechanical permit fees' are based on the value of the or
I performed Indicate the value (rounded to the near t dollar) of all
Demolition ❑ Other: mechanical materials. equipment. labor. overhead. and pretit
CATEGORY (bF [CONS RUtCflON ' . - . _ -._ Value: $ - ._
1 . RESIDENTIAL / SYSTEMS FEES'
I - and 2 - family dwelling Commercial/industrial Cial /indial A buildin Y �
g ustr D ccessory E I 2'or special information use cbeckh,cr.
Multi - family
Master builder O l_)escnpuon i `fit\. l l.a. T nrrl •
JOB SITE INFORMATION AND LOCATION , [[eatinWcoohint; _
site n! s address G Air conditioning
; � �� (requires rile Lrian slow ng_,lau men[) I 46 75
i t' it c `1 aa m Pu ice 100,000 BTU (Jvv
ceccnts; ‘ i 'r o. 75 ;
I— - - - - --__ ([�l.h x �r1- -- ` 100,000-+ BTU f duddvco :sl I $4.9t
I SaitellIdm. r,o. ! Project name: r:_,... um 61 Oti_'_
CrC»= sircet; directions to job site: ; Ductwork ' i 23:2
-- -.-_- -.. _. _ Hydronic hot wafer system i 23.32
I Residential boiler (radiator or
l __ ' h (Ironic 1 .. _j 2L32
__ - — ... -. i Unit heaters (fuel -type, not electri 2
c),
in -wall, in- duc. sir 'ended. etc. 1 46.75
dl aion: .-. . Flue/vent for any of above 23.32
--- - - Other �_.... I 23.32
. I as map /parcel nn • t Other fuel appliances
1 Water heate i 1 23.32
I — DESCRIPTION OF WORK �
Gas fireplace 33 39
1• t • • Fleplaect for water heater nr gas f
- ..... 23.32 I
y
-- -- (Log lighter (has) 23.3 1 •
Woodi.ellct stove I 33..39_1
Wood 6re.lace/insert ; '3'2
- - -_. I 1 23.32 1
�_himn • /liner /EluJvent
_ PROPERTY OWNER " '❑- TENANT - I
Other I 23.32 1
; :;•t,. A eV 1\1 Environmtntat exhaust and ventilation I
\ ' Range hood/other kitchen
�1Jdre''s: v n l g -� 'Y1C - A VN S cl eoui.meni 33.39
l iie'StateJZJP:' � O cri aa�- . J Clothes dryer exhaust 313
-- - Single -duct exhaust (bathrooms.
Phone: Fax: ( ) toilet com.artmetrts, unlit • rooms ) 2132 ;
t Atti l crawispats facts '' -1 32 .
I El APPLICANT - ' ❑ CONTAC PERSON
—_ 1 Other: 23 ,2 _l
' Rii..-iiess name: Fuel .i.ine I
r,, lame: r S!4.15 for first four; 4403 for each additional
—
Furnace, etc. - —____. _- .
ul dre >S:
— - Cis heat soon
i C'ityNate'ZiP. �'aiUsus ndedfunitbeater — - - _L -- __-...
•
r _ p o _ 0 -� ate' heater - — __ ; .
i„t n #� 1 / �� j Fax: 3 s1 / J GV
` vim
_._ -- - - -- 1 "ircp ace
•
F.-n1311 Range . •
C ONTRACTOR : i Barbecue - ; ,
• Clothes dryer (gas)
I Business name; /
t + � j
i . �_ / .err E r 1 a _ et i.► w _ Other__ _
Addre res.'s � ) .. MECIIANICAI, PERMIT FEES* -
� �Ox �.� � 7 - .
C' I :, , State 7 J P: O Q . . .1 I Subtotal
Q Minimum permit fee ($90.00) y0 , tom)
!,one: 63) 10, �� `� Fax: (, ( ) L] f P) - C,a7 Plan review (2Snio of permit fee)
; lie.. /t ()W-- -9 4 — - State surcharge U2% of permit fee) /0 ?'D
TOTAL PERMIT FEE
g i / , l j 9 - / This permit application t has b_s if permit is not obtained within 180
A111 'nod red si nailtC D days after r it has been n accepted as complete.
f
mint na "c: rI Date: 4 Pee methodotog± set b Tri- Corals t3urlden e industry Sc -r cc Been: I
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