Permit CITY OF TIGARD MECHANICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit#: MEC2012 -00354
T i GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07111/2012
Parcel: 25103AD04700
Jurisdiction: Tigard
Site address: 12900 SW 107TH CT
Project: Wilcoxen Subdivision: PATHFINDER Lot: 37
Project Description: (1) A/C replacement Must be within minimum 5' side yard setback and approved rear yard setback
Contractor: COLUMBIA HEATING & COOLING INC Owner: WILCOXEN, DORIS M & MICHAEL J
PO BOX 230397 12900 SW 107TH CT
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE: 503 - 620 -2222
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 07/11/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/11/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/11/2012 $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 1.800.332.2344.
Issued By: Permittee Signature: al 4P0--/ 64 / Dld
____ALAILs&Alet____ 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.
07/11/2012 11:49AM 5035980270 COLUMBIA HEATING PAGE 02/03
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• RECEIVED
•
Mechanical Permit Ap „4„z(),7„,,.,.,,,,,.(,,,,
Olication
JUL 1 1 2012 1
City of Tigard
il .--- I 3125 Sw Ha Blvd., Tigard OR 97727. .
CITYOF TIGARD EMEMM
4 I1211 P
, pi,c,,,„ 503.718239 ax:
1 131JILDING DIVISI0f 55111111111111111111
Inspection Line 503.639.p75 Date Rceay/By:
(nternet www.tigad-or.gov NotKed/Motbod:
- ...- - .. -- z.- .., 4 Al.-, 7,:, -- 7;i4,.U. F' ,cLc.:. -
. .
0 New construction 1340itiontalteratiou/replacement performed. IndlesteAlte value( . • -.lathe natant dollar) of all
0 Demolition 0 (Zither: Vtduet S
t sr' ....'• - -"iTr,:trr ,- t%F.,"2.7'1 - 9:.::',f1rx1. 0. 1 - ..L.'z' ,. .7,-.P.:.7:-VM7 ,,,-.- .,..,----.*,,- o's -117 '‘',-. , -3- . ''-'•z• .!--.-
E .4 1 ' ii- ' '' L02 1 ii1
roi • and 2-family dwelling 0 4ornmerclalAndu.strial 0 Accessory building For wectal Itsjormattan - eitect104..
0 Multi4amily 0.01Esster builder El Other: Description. I Q. MIMI Total
- , '7 ■r•--:-.-s7 Rea • : eooli ...
agaita...M77 M13,5,076,4 '''-.!,,Cskl Airconditioning Imo
Job site address: c a 1 lai 647-11 =aims :to • • lam '• ,1 • -;eat MEI 0.
Furnace 100,000 BTU dices/vents I 46.75
City/State/ZIP: 7 —, 0 , 4 4 , ode- ci9U ti urn= ' '''''' BTU C.31-=1.1111 54.91 Mil
Suite/bIdgJapt no.: Nakasone: ( 0 • ---,...j Heat pump
xt - • ditt .163 ab . ' ,, ,tateaseat lill 61-06 .111
Cross street/direotions tojob sire: i Duct work um 2332 ME
. H . onic bot water — HIE 1112
. Residential boiler (radiator or 111 2132 1111
U1111 Ileatcq (fizni7t ilCateWific)7 111111E11
• in-wall in-clueLsOs ,....,., - .
Fitteiveill Ibr . ' a above Mt 23.12 111.11
, SubdiYiSinTr. ■ . LOt a0,:
• other MN 2.332
Tax map/parcel no,: . . I Other ttrel_a• ,. Ea eest
W Water held& MI 2332
Bas In- tace IIIIINIFEE
q /c,. ge . ERiiiiiiiiiIMPRI
• mil 23.32 INN
' .
LO . IL. ter . 13
'
Wood/. let stove IBM 33.39
1 • _I 2t32 MIMI
ch3 gnier/A4"nt. 1 111111 .1 32
Name: /)02./.1 Lit ¢coser-AJ t _ ....„ ntidtxhi-usiwia:4.61. . •
Address: Ia,lo 51,,j I (M r Cr. Rani% hood/other kitchen
r•oi , reed 1111
CiV/State/Z1P: .7(6,4/ ; Oit- q • Clothet d er =baud MI 33,39
none: 0 ) EWEERMI IIIIII 23.32 IIII
'• ''• Ain 47.F0-:!•,, TF..,, Atli - . ' =Auer ' . ism Ei.32
:- .•;:,;,--. ... -..... ...,.,. :,d.,:ii,..4..w.1.1,. --,:_.:„,- ..4...•.-- ....J.,. • ‘._=0.---- - .-- - '
. Met: 11.11 2332
Business name: Columbia Heating Out Cooling; Inc. Riot . . .. . .
Contact name: Marlene Meedom ! MI5 tor tint burr 54.03 re wet addItional
Address: PO BOX 230397 i . Furnace etc. 111111
heat . . 11111 . MN
City/State/ZIP: 97281 ' . WaIV • . ...... dedItiaitheater 111.
Phone! (S03) 624 :1503) 5913-6270 IMMEMMIIIIIMIIIIM
EMITMIIIIIIIMIII. •
E-mail: colembluOteleport.com . .
'M
' '.7. .•::-,,...=5:r . ..i. - - r.■/"1
INMN "2,01:i4 Elltrbct MIMI
s — I=
business name: Coiumola Heating alust Cooling, Om Mute d gr ,I19
Oct lh: -
Address : PO Box 230397 i • Ziki., ir2.0107:=.7 •-:
- -
City/Stste/ZIP: Tigard, OR 97281. ! ' Subtotal. IIIIIIIIIIII
hfirlimmil ', -(300-00) IIIIIIII
- Wm: (383) 624-2704 :
.
. rruc; (50).) 598-0270 •
• Plan inview 7.5% o ,...* . Hite) M11.11
CCB tic.: 76359
.
.
. State '. , - • (12%. 1.-
TOTAL- P ' '
Authorized sigiatutc: jfaktinik_ i ., Iv, opplIcattcm expires if a v. to aot obathmi4vitItta too
days it bask= - - 1 ' is comPktr•
print name: Marlon R Meedom ■ Pate: - ; - • Poo alochodetett• rat biTri:Copty B!li • ;otiosity Scrvic Boca
lAntater.02....0.11tilir.14,Tio it...U. 69/1)130111 1 440.1fil7r (111ATArnmtwun
07/11/2012 11:49AM 5035990270 COLUMBIA HEATING PAGE 03/03
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HEATING & COOLING, INC,
P.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
SITE PLAN (,..) i [. C a y e iJ
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ADDRESS: J?-1CO Z-G /07' cr.
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