Permit CITY OF TIGARD MECHANICAL PERMIT
'! ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00578
• Date Issued: 12/14/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 1S136CA90461
Jurisdiction: Tigard
Site address: 10900 SW 76TH PL 46
Project: Ward Subdivision:GARD WOODS, A CONDO COMMUNI1 Lot: 45
Project Description: Replace gas furnace.
Contractor: COLUMBIA HEATING & COOLING INC Owner: WARD, JONATHAN P & CHRISTINE AS
PO BOX 230397 10900 SW 76TH PL #46
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE: 541 - 602 -3727
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/14/2011 $46.75
Type of Use: MF 12% State Surcharge - Mechanical 12/14/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/14/2011 $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 1.800.332.2344.
Issued By• — �J Permittee Signature: —
Call 503..3. • r '.. • 5 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.
Dec 14 11 11:24a Columbia Heating/Cooling 503-598-0270 p.2
; CEIVED
Meehamcall Permit Apj)lication FORI./FFICI:. I 'SE ONLY
SW Hall Blvd
, city of Tigard
; .- • 13125 .. Tigard, OR 9'727,3
lh DEC 1 4 2011 Reeaive<I
Dstrmy: . z.gyAral Perrnii hin ://eei .
Plan Review :
PhCm: 5°1 I 5(33 OF TIGARD 0,110 Fel ink
nctrilly:
TIGAP,O. In5.pection Ltne. 503.639A I 75
..--
BUILDING DIVISIO g D R'dY(BY: Alf15' ' 0 See Page 2 ler
Interne sinrsiktigard NotifirchMeiN01.1 Nutrimental information
■ TYPE OF WORK - . .
1 COMMERCIAL FEE* SCE/EDI:LE - USE CITECRLIST I
; Mechanical permit fccst arc based on the ahue of the work
ortimt:u.r.tn A Adtlitioniaiteration/reptacement
performed. indicate the value (rounded to the nearest dollar) of an
E. Der ( j Other , inethanical materials, equipment. labor, overhead, and profit
CATEGORY. OF C01`11STRUCDON , ... ::-.:' -.: • - • . l — . Jalue: $ I
--;
. RESIDENTIAL EQUIPMENT/ SYSTEMS rEss. •
N3..5.- and 2-family dwelling ID Commercial/industrial D Accessory building
or specral caformatosii use chee(i; 0 ■
-iii.ti E Master builder 0 ()titer: - • . ,
Description Qiv, I La, . 1 ol.ii
.........._ -__,__i_ •
JOB SITE INFORMATION AND LOCATION II eatizialcuotirig
—
Job ile aijdres„: / Oq 00 a # 41.0 Air conditioning
(cultures sue pian sluming placement) • 4 (1 75 i
CI t: ili i __ • 7- _„.J• FltrrEICZ 100,300 BTU Cenci...N.:05) [ J6.1.5 I
Furnace 100,0(Yr ETU A
(-acts/yenta) 54.91 1 :
Siilte.^ no • Project name: ' o r Heat pum:2 . 61.06 ;
Cross stree/directions io ob site: Duct work 23.32 i
Hydrorsio hot -water system 23.12 1
Residential boiler (radiator or I :
hydmnic) 23.32
(J heaters heaters (fuel-type, not electric).
in-wall, in-duct suspended, etc. 46.75 1
-- - —1--
- - Flucivcr t for any of above j 23.32 1
3 l, iston: Lot no..
_____ Other: 2 3.32 i
I - -IX Fur:Jo:part:a/ no.. . Other fuel appliances
DESCRIPTION OF WORK-- .. . Water heater ; 23.32
l_...... _... . (o
rI-LALC-k
PlAID Gas fireplace
NW vent for water healer a r gas
fi ir.plucc I 3'1 3P
._...__. .
- - - Log lighter 4.iis) 1 , , ;-:-
- I ‘- - -
Wood/pellei stove , li 5c)
-- :
--" -ll 1 Wood fireolace/inscrt
1 23.32
S PROPERTY OWNER .. . -- ' ' - ' Chimney/line:IA/vent 21.32
_. Other l 23,32
____ L_ Environmental exhaust and ventilation
--- ----
- Range hoot.Voilter kitcia 1 T
C. ii
7 ,,,f equipment I
Clothes dryer exhaust 33.:ic
P: {
1_:13 Single-duct exhaust (harhrocnrs.
1 Phoric-541 14 ....3727 Fax ( ) toilet compartments. utility roorns)_j_ 23.32
_ .
___
i ------ . . Attieccrawlspace fariS 23.52
.
-
L 0 APPLICANT . . ,.EI. CONTACT PERSON
Other: I ....
---- -- Other: l2...i.32
RI sinoss'
Foci pining
,
ce:r.tac! name: /2- ,,,-- /.. /2- per-7071 $.4.15 for lint four; 54.03 for each addition I .
Furnace. etc. _ __......
.'l.di:1ress:
Gas heat pump
0.12csiinteiZIP: Walltsuspanded/unit heater
/ Fax: : f .3 , B _o D 0 j . Water heater I .
l'Imno ca 3) / _ _14. 7 5
1 ,_
4-j . : Fireplace ________,__._...
I.--iilail I Range i I
-1
1 . CONTRACTOR:. -- .-,.: .-..-. - . . - --I : Barbecue 1 _ ! I
• _____
1 ilucine5, nmne. a ILLaaileezri ijr.......a2c)L...i Clothes dryer (gas)
i__....—.___ .. yther.
.
! A tidr_eFsf0 .. 42 . 6/ 9 7 • :.. .. .MECELANICAL PERMITFEES*..- .- • •
; c."itislaireIZIP: 776-142,f) Olk,._,, T"70/3/ 1- - - i i _subtotal
---- iietflTilliftl perrnit fee (S90 XI) I
FEM! (5:8) ,....53 _ Ci..170 Plan rtreiew (25% of permit fee) 't -------- ,
,
I CCM lie.: WO ca.C7 State surcharge (12V of permit fee)
TOTAL PERMIT FEE- LM,/e/2_,W
Thu rmit application sap it iri if a petm im not thinintaiwithin lAi)
A.ilh.nrireci signature ' _ / 0 AI ( . is days after it Mis free accepted as complete.
, Pri n i -..arrie:k" i ''' . / • ° :lo ll 411741.i. Date: :: . _lg.._ tj i . Pee nu-Anna :Autry set ti c 11.uildiug Indusiry fier,ec T3 and •
.........__. . _
1 a.. anc !raniprn 4.10-ealr(lliinzico\t-wr033