Permit CITY OF TIGARD MECHANICAL PERMIT
9 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00081
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2012
Parcel: 2S112CB04700
Jurisdiction: Tigard
Site address: 8287 SW ASHFORD ST
Project: SCHUCK Subdivision: ASHFORD OAKS NO.2 Lot: 61
Project Description: Furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: SCHUCK, EUGENE R & MELISSA K
PO BOX 230397 8287 SW ASHFORD ST
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/14/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/14/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/14/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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
Issued By : 'ermittee Signature: � j ,
Call 503.639.4175 by 7:00 a.m..forthe. 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.
Feb 10 12 09:29a Columbia Heating /Cooling 503 -598 -0270 p.2
Mechanical Permit Application FOR OFFICE LSE ONLY
t Purort Nn.: � " ■ City of Tigard ID ;�aterBy- %� — - 0 d- . t 111111 - , 13125 SW Bail 131cd.,'i igard, OR t. =� , Plan Resits. Other l'anr.i[
Phone: 503.713.2439 Fax: 503. 3 "�i Q�4 am rt3y
f I G A. It : D ` :nspectien Line: 503.639.4175 r ." f 1. Date Rcady+By: 31:rir. Ff See Page 2 for
Internet: wwwtigard.or.gov . �Q ® Notified %'.tetrad: T - S !,. SupplcmenteIlnfermnrion
-
V ' \C'f � t ^R\ /� •
TYPE OF WO Kr'( Or ��\ `� I COMMERCIAL - FEE* SCHEDULE - USE CHECKLIST
k<\ i Th � `, G,' V I Mechanical permit tees* are based on the value of the work
[] Nev construction itiOnlaltera{i.HnpJ Jbc�rnenl perfbnned. Indicate the value (rounded to the nearest dollar) of all
El Demolition ❑ Other: `��yyw mechanical materials, equipment, labor, overhead. and pruit:.
Value: $
CATE OF CONSTRUCTION. . • ... „ , RESIDENTIAL EQUIPMENT /SYSTEMS FEES'
C2-t'a'nd 2- Tamily dwelling ❑ Commercial./industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea I 'foal
r JOB SITE INFORMATION _AND LOCATION Heating/cooling:
¢ •T Air conditioning
Q
Job sde address: V�CJ� � W 1(1"0 . 5'/ 12 (r. trc, si :e p!te, shu vei placen!aN} A I 46.7
Cit ;Stale %7rP:
Tfol otz- `7P762aS, Fttt7)ace'C 0(Ill[1711(duas;rcnrs; f� -t 6.75
l Furnace IOl UOOi BTU (dltcu:vents I l 54.91
Suite'bldg.iapt. no.: Project name: , c) ) Heat pvtmp
(rcau vcs 5110 131011 s]lman._ p lacemen' 1 61.06
Cross sheet/directions to job site: Duet work 2332 • A.
I l I.drouic hot water system
23.32
Residential boiler (radiator or
I • hvdronie) 23.32
lieu heaters (fucl -type, not electric).
in -wall, in -duct, suspended. etc. 47.75
•
Subdivision: . Lot no.; F1uc!vent for any of above 23.32
• , Other ! 2332
Tax map/pared nu.: r Other furl appliances:
»F.SCRIFTION'OF WORK t • Water heater i 23.32 I
/"
Gas fireplace 33.39
_ cflN oc6 it-otA C. C44 Cif/ j j =lue vent for water Treater or gat
'fireplace . 23.32
Log lighter (•as) ' 23.32
Wood /pellet stove 3:.39
�-FR�� Wood fireptaccrinsert 1 23.32
t_I OPERTV OWNER I • Chimney 3iner.!Eluelvent I 2=.32
Other: 1 2:1 32
Name: �' r N F
��G �L,(i U Cf c _ I Environmental exhaust and ceutilntion:
Address: 5 6/7 e,.3 S-Fti3V/Ziel : Range hoodiother kitchen,
equipment 33 39
City1Statc/21P: 776.
/6 A.QQ c,e_ 9 01.7 Clothes dryer exhaust 33.39
e -d
Sinpluct exha st u (bathrooms_ I
Phone:5Q ) 9 e-/ 9 . if Fax: ( ) toilet compartments. utility rooms) 3 23.32
I APPLICAI T 0 CONTACT PERSON 'titre craw'lspace tans r 23.32
Puniness name: Columbia Renting sod Canting, Inc.
011rr. i 23.3'7
—. _.._...., Fuel piping:
Contact name: hlarlena Meedom 514. IS for first four; $4.03 for web additional
___
Address Pt) Box 230397 _--- - -._ ._ --- __
Furnace, etc.
as (scat pump
City /St;ac /2TP: 47281 Wullfsuspendctfiun it healer — :
Phone: (503 ) 624 -2704 Fax: : 1503) 598 -0270 water hearer
Fireplace
E- malt-: columbbc a telcporf.com Range
CONTRACTOR . . Barbecue •
ISusiness name: Columbia Heating and cooling, Inc. Clothes dryer (gas)
Other.
Address: PO Hov 230397
MECHANICAL PERMIT FEES*
ritv1SO.1e:21P2 Tigard, OR 97ZSf l Subtotal _-
i Minimum permit tee (buO.00) I r /U, C.)()
Phone: (143) 624-2704 Fax; ($93) 598 -0270 I Plan nwiew (25% of permit tee)
CCI3 lie.: 76359 _ State surcharge (12%a of permit fee} id, de}
TOTAL PERMIT FEE /_____ -
Authorized signature: jlitathrIA fz —This permit applieation ¢ipiren if :1 permit is not obtainer! within Igo -
day after it has been accepted as complete.
Print name: Marlene R tfeedom ;l D.• - ) C' fZ - Fee triritio lultgV set' by rri•Coinil' Builahnp hr :dtutry Sersicc Ruud
i .,,.. i. .e- R...r. -. vor•_L.r,.,,.Anw As• (4, ,f,
1.1et 1.51.,1 T, in I Y i.Vt.m