Permit , CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00384
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2012
Parcel: 1 S135DB01600
Jurisdiction: Tigard
Site address: 11560 SW 91ST AVE
Project: Ramirez Subdivision: CHARBEN Lot: 4
Project Description: Replace A/C. Unit must meet 5' minimum side and rear yard setbacks.
Contractor: COLUMBIA HEATING & COOLING INC Owner: RAMIREZ, JOSE C /MARIA
PO BOX 230397 11560 SW 91ST
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
. FEES
Specifics: Description Date Amount
Air Conditioning 07/23/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/23/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/23/2012 $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: 41 Permittee Signature: DN 0A -/ ��7 7o-i
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.
07/19/2012 10: 04AM 5035980270 COLUMBIA HEATING PAGE 02/03
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City of Tigard
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N._- 4 13125 SW Hall Blvd., Tigard, OR 97223 JUI-• -
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Phone: 503.718.2439 Fax 503.598.1960 Plare Relies
D, VII n ate8y; Calm Permit
i I ( , ,, ,; 13 inspection Line: 503.639.4175 WY 1 It3h
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U New construction Ili AdditiOntalterationfreplacement performed. Indicate the value (rounded M the nearest dollar) of all
1:1 Demolition 0 Other: mechanical material, equipment, labor, overhead, and profit
Valise: S
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- and 2-Family dwelling 0 Commercial/industrial 0 Accessory building For special laftzrmation use McRae
0 Multi-family CI Master builder 0 Other: Description I Qty. I EaI Total
11111152 M1L7M 3 Til:7ZITIMEZI,773, , ,TMELI-5JEEIB ,
Job site address:
//56 CO /57 ,t (require; :keel= showing piecemeal) I 1 46.75
City/State/ZIP: /0;4 , , 0/1 o ft7 , Furnace 100,000 BTU (dare/vernal 46.75
Furnace 100,000+13Th (dem/vents)
54.91
Suite/bldg./apt. no.: Project " aine: . 70.1V 44)•7 I R,A2 Heat pump
(reetirtia wito plan showing plaomecal) 61.06
Cross street/directions to job site:
Duct work 23.32 • A. •
Hydronte hot water system 2132
Residential boiler (radiator or
hydronic) 23.32
—
Unit heaters (fuel-type, not electric).
in-wall, in suspended, etc. 46.75
Subdivision; Lot no.: Flue/vent for any of above 23.32
Other. I 2332
Tax map/parcel no,:
Other fuel appliances:
Water beater I 123.32
A Gas fireplace 33.39
/. ' EMCE •
... Flue vent for water heater or gas
fireplace 23.32
Log lighteruas) 2.3.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
IMF tm ; , g,=,:k i :2711 7 ,;17; . T.4:7f i g:.,TWU:,5;a77.7,' ..: H:2:1ME0 Chimney/brier/flue/vent 23.32
2,3.32
r••
Name: d' fRe2. itavtrOnniental exhaust and ventilation:
Address: 'Arco , 9/0- AP6 _ Range hood/other kitchen
eouiement 33.30
City/StateJZIP:.176*R.1 it' ' e rt212.5 , Clothes dryer ochaust 33.39
Single-duet - exhaust (bathroom
Phone: ( p ) : If.. • 2 y Fax: ( ) ._ _ toilet compartMents, WNW reoinsi 23.32
1111 .01 Rf'..tOtie ' ...s , Atlicicravdsixice fens 23.32
23.32
Humness name: Colombia Heating and Cooling, Inc. Other
Friel
contact name: Martens Meetlom 514.15 for first faun S4.03 for each additional
Ad F 1 1
clrem PO Box 230397 urnaca ,
Gas heat pump
City/State/ZIP: 97291
,. wall/suspended/unit heater
Phone: (503) 624 I Fax: : (583) 598-0270 WON heater
Fireplace
E-mail: eolumbhe@tekporteons
Range
---- ,.x',3; ,, m,..7,4,psza7p:;:s77 - : , :ni.t . 4. 7 1:1:1 -41 5 Barbecue
Business name: Columbia Heating and Cooling, inc. Clothes dryer (gas)
Other:
Address: PO Box 730397 — , ?;,., , , : •: 1 1 7. :4,, 444ift ..f;7177 T :- • • '
City/Stale/ZIP: Tigard, OR 97281 Subtotal
Minimum permit fey ($90.00)
' hone: (503) 6242704 l FOX: (503) 598 .
Plan review (25% of permit (ee)
i CCB tic.: 76359 • State surcharge (12% of permit fee)
1
TOIST E 61OFE
Thle Permit application tapirs" ifs permit is Mk obtained within too
Authorized signature:
daps after k has been accepted ea compine.
Print name: Marten R Moedom D • Fee entehodolosy set by Tri Building Industry Service Board
, , .... ,, ..A................,4 a wo. oh.. mono, ill aittAA ITT I il M7 trOMWER {
07/19/2012 10:04AM 5035980270 COLUMBIA HEATING PAGE 03/03
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HEATING & COOLING, INC.
P.O. BOX 230397 • TIGARD, OR 97281
(503)624 -2704
SITE PLAN P 111(4 6- a-
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ADDRESS: // o 6c) 9/j- / re .