Permit a CITY OF TIGARD MECHANICAL PERMIT
114 2 -. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00118
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/06/2012
Parcel: 2S 109AB09500
Jurisdiction: Tigard
• Site address: 14258 SW 132ND PL
Project: ERNEST Subdivision: RAVEN RIDGE Lot: 24
Project Description: Furnace replacement.
Contractor: COLUMBIA HEATING & COOLING INC Owner: ERNEST, LARRY R & SANDRA A
PO BOX 230397 14258 SW 132ND PL
TIGARD, OR 97281 TIGARD, OR 97224
•
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES •
Specifics: Description Date Amount
Furnaces < 100K BTU 03/06/2012 $46.75
•
Type of Use: SF 12% State Surcharge - Mechanical 03/06/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/06/2012 $43.25
Occupancy Grp:
Stories:
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•
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 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639. 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.
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Mechanical Permit Application 0 5 2012
FOR ot:Ficr 1 . Sl F. °NI.)
City of Tigard CITY OF TIGAHD
7 - 13125 SW liall 8Ivd., Tigard, OR 97BUILDING DIVISION leaffign! 4 ,111MI Pennit No.: A IF 0 o b i i el
Plan Review
' I Phone' 303.639.4 Fax: 503.598.1960 Office Permit.
DaleflAT:
T1GAP.ID Inspection Line: 503.639.4175 i DWG ReadYSY: -----'—' kris ' 93 Sr Page! for
Internet: www.tigard Notifirailtskelhod: 1-Tr.-6, Supplement.' Infminntinn
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T . YPE.OF WORK - COMM FEE
ERCLAL " SOTEDULF , - USECRECKLIST
-. ..._. ._..............._ ..
Nok tainstructitin T.Idirinnialtcration/replacement Mechanical permit foes' am baste on Lie value t:J die work
performen. Indicato tho value (rounded to die nearm: dollar; nf nli :
El Detr.Plilion 0 Other mechanical maim ials. equipment, labor. cverhetiland
CATEGORY OF CONSTRUCTION... .-..:....:- . :'.:- ,... 1. Value: $ p
•.RESIDLINTIAL EQUIPMENT / SYSTEMS FEES* I
: - ‹71d 2 dwelling 0 COMMercialfindustrial 0 AccesSory building I ' or .rpecial riformalion use checki:s; . —.......
■ 7 NIniti-'amily 0 Master builder 0 Other:
1)ostriplion i cll.. I la 1 Thral :
1 JOB SITE INFORMNITON AND LOCATION ..!;15 ..__
_
.1 o h site aidr : i fy 6 2, 8 Sc...) /'J" s 46
,,,,, A-PE Air condicionl g
ireouire sire I SbOWLII: pluament) .. i .13 1
. r-
Lftlytfitvic/71P: TAAAV cre- 7L4' Furnace IOU, 1 13111 tduetersenist . "."-7-1 6. 7 .5
i
-----' Furnace 100. )+ BTU Wes/seats! 54.91
1 Slekildpiapl. nil.; . Projec:. name; EWA/ E.) f •
•_____._—___—_—_1___ I I I ME= •
t Cross street/directions to job site: Duct work 23 32 -.._,
' Hvdronic hot tinter system _L23.32 •
Residential boiler (radiator or
hydronic) 1 23.32
Unit heaters (fuel-type, no: electric), l 1
in in-duct suspended. etc. • 45. '
— —
03i, ision 7luelvent for any of above 23.32 i
-: Lot nu.:
_..—._ ..—. Other: 23.32
1 inapipareel -lo.: • Other fuel appliances •
I DESCRIPTION OF WORIC - --: - - • Water heater --1--
. j 23.3;
1 1 I Gas fireplace -1
• Flr.1/Z-A) A 2.P,CASC.E.-/)&./s/ r Flue vent for water heater or gas
__
23.32
_______-- 2.,ali.g.1Iter (o...____L_2,2_4____.. . 1
• rod/pellet stove
33.39
. ' Wood fireplacchnsen 23 :
l Chimn 'flinerfllerivent 23.32
I-- MAIrOPERTY OWNER • . • 1 - • '0 TENANT . ' Other: 23.32
;2111c. LA R.2 Y I FAN" / 64 Ell r Environmental exhaust and ventilation
Range hood/other kttelico
A kidrcss . / V rg ‘ ,5 - C.J /./c2A Ai/6 •ui• ent 33 39
City:Sta P: le/D 7- 7 6 A R c7,2_
617 ( t i . i e (bath • me, 33.39
1 2
Phone: 0)3 1 v 705'8 Fax: ( ) toilet compartments. utility m 12
roo
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D APPLICANT' • ' 0 -cor4TAcr PERSON , AttictrawispaCe fans _ 3 ). 32_4. _
1 3 3 1
1
Rosiness name: Fuel .i.in._
ry - S14..15 for Dent four: S4.03 fhr each additioa al j
Cor tact :lame: / g ,-- - - 4 • - • NpA .
1 Furnace, etc. I _--._1—..—........
_—_______. _ .._ Gheat uto
— as . n
1 c•t.../Slate./Z.IF: 1 wall/sus ded/unil heater
— — 1 1 .
. " 53) tprgi. Q 70 4 I Fax: :66 551 B -0a7c i Water heater
1-mali Range
• 1 -- 1 ----:
• . -
.. coNTRActoti.. . • .-,;. . • - • .... • - ... Barbecue
Clothes d 'Cr .:: ) ___-1.-__+-_-------1 -
I:1115MM: name: i l _ i u ,f..... iv . ..... L 41.•
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O
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Ad 9q6e t23.a39:_z________. „, .• - MECIIANICAL•PERMMFEES*. : • -
......._.
: Subiothi 1 % ;.
i Cit. IStute • I 0 ,-. 7-7
, . Minimum permit fee ($90.0(i) e r
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/.. II, -- a - 6 Fax: P ( 5- .-. _0.. 0 Plan review (25% of permit fee) 1 _ 1
. 1 CCT) lc.: 7(4 35-9 - State surcharerrah fee) 4" 1
TOTAL PERMIT FF.E __ g_V -
This permit application expires if a parrnti Is. nal nbtaind wit in IV
Authnrized ;ignaturcLit.tlipAinr days after tt bos X•itii aCcepted a7 compiete.
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i Prilli iinme: ' . • ' Tee methodolo gy = by Th-Cvunty Building Intlo wy Seivice Board
- .7_,sr 47 _ ____I Date: ,i: . ,_17 - 2 1
1 rii,,mirioJi./rmeemscferrniiApp.riee Ivo um ....io-46111 rtiraveomvsm
Z'd OLZ0 6upoo/6uReeH equJnioo 8 E0:80 Z l 90 J8/11