Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00413
T i C, A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 25111 DB08700
Jurisdiction: Tigard
Site address: 15430 SW OAKTREE LN
Project: Buckley Subdivision: SUMMERFIELD NO.10 Lot: 548
Project Description: Replace (1) furnace
Contractor: COLUMBIA HEATING & COOLING INC Owner: BULKLEY, RICHARD L
PO BOX 230397 CARRISH- BULKLEY, SHARON A
TIGARD, OR 97281 15430 SW OAKTREE LN
TIGARD, OR 97224
PHONE: 503 -624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 08/06/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/06/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/06/2012 $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. y�/ n ,/� /
Issued By: ‘1� ` ti 00 DU Permittee Signature: A D Po el)- - r D LJ
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.
HEATING
PAGE 02/02
08/03/2012 12: 01PM 5035980270 COLUMBIA
:•;:.::
Mech anical p A licationRECEIVED
........,; City of Tigard Received • •
A UG 0 6 2012 wt. 7 c lf)- Sr _ _ _
Permit No.:Affift. 0W/- o
514 ...---- 13125 SW Hall Blvd.. Tigard, OR 97223
—.__________.
•
• . g ' Phone: 503.718,2439 Fax: 503.598.1960 Plan Review
.,,
Other Permit:
. I ! ( , A I: 1 ) inSpcction Line: 503.639.4175 CITY OF TIGARD 1 ;:r t Y . : a — dy m - ic — , —
Internet: www.tigard-or.gov
BUILDING DIVISION Notifi 1 1(e ed/Method: kris: "I 18 See Page! for
Supplemental information
. .
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Mechanical pennit fees' are based on the v - ue of the work
0 New construction C Addition/alteration/replacement
pc/lb:med. Indicate the value (rounded to the nearest dollar) of.
0 Demolition 0 Other: mechanical materials .ui.ment, labor. overhead, and • rofiL
, ' 11111mifigy.4i7.•;.",,‘,4::,.-s....,,,,:::;, . -, ,',..;-;', ', ':'' l''• c :';'.' ,- . -',...-:.' ''. ',••7•7:,,•, . ‘,• , ..,.. _ , .._ _ . V , al ... 4 us: ,. S . .
t - ,,. , ..1L••••■• - r_s••,..!:‘ , • •: - • '..•: , ,... - L'• ••• ' • • _ ' . .:‘ •,.. ••• • , • ., .. - :. r•', - . :, ", .• . ..,.•,•• : •,i•It..71:27 1:,3,4 TIKES* .•
•-•::: At 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder ID Other Description Qty. Ea. Total
. lidElarg ,?.'!',.',:'',! j .... ':
e°°Iin
. -:.''...,.: -,'-,,,.`,..- ...,.,- :-.:".!
•', Air conditioning l!ili
Job site address: 5 - 0 (...) CAleraGE LA"- • uirog size • an shoo/in. • !segment
Furnace 100,000 BTU (duets/vents) Ii■IM 46.75
City/Slate/ZIP: 0 AAD OA 99 02621 Furnace 100.000+ BTU dueis/vents 111111 54.91
Suite/bldg./apt. no.: Project name: Heat pump
.•
r • uires site 'Ian showin .. • laceinent 61.06
Cross street/directions to job site:
Duct work 1111.0211 • •
H dronic hot water s tern 23.32
Residential boiler (radiator or
h dronic 23.32 - Unit heaters (fuel-type, not electric).
in-wall in-duct, sus. - ded. etc. 46.75
Subdivision:
Lot no.: Flue/vent for an of above 23.32
Other: 23.32
Tax map/parcel no.:
Other fuel a , .11aneest
11111M1W ., ';t„i" Water heater 23.32
• ISTEITIMIll MI
At yet t.4-Ce-m 6,v
Flue vent for water heater or gas
fi dace 23 32
MI.ITMMIIIIMM 23.32
wood/. Ilet stove 33.39 -
Wood ti - ace/insert 23.32
IIME7; l ' T ••?•"•.‘ ',•: ''....,••=•••'!. ••.•, . • '-'::!. ‘ Other , ., : c •-.,. . )]. 16EMMTI 23.12
23.32
Name: P-( CIC 0 S/14 /2aA) i oz_JCL CY Environmental exhaust and ventilation:
Address: Range hood/other kitchen
- ui . mcnt 33.39
•:,.. City/State/ZIP:
Clothes d er exhaust 33.39 - Single-duct exhaust (bathrooms.
Phone: ( ) Fax: ( )
toilet com • artrrients, utilit rooms 23.32
t 1111MIC75:117:'.7.t :::..: ,-: ,' 7 .:' ., ''.:":.;, Attic/crawls 'ace fans MI
Other 23.32
Business name: Colombia Heating and Cooling, Inc.
•
Fuel • i .1
Contact name: Marlene Meedom
$l4.15 for first four 54.03 for each additional
••••.;
Address: PO Box 230397 Furnace, etc.
•
Gas heat 'um.
• City/State/ZIP: 97281
Wail/sus. dcd/unit heater
. •
Phone: (503) 624-2704 Fax: : (503) 598-0270 Water heater
r0=1 —
E-mail: coin mbhc@teleport.com
111TM=.111.
....• KAMRF '...: '.': '' ','" . - .:, ' I: , '''',:, ,.'• ''-'. ''. ' :,' : _ .' ''-':'::' : ' •, -1-' .' ' . ':-:. :!--,:: -,.'''''' ' ... Barbecue
Clothes d at
Business name: Columbia Heating and Cooling, Inc.
Other
Address: PO Box 230397
-."•?:',... • .. .1. y.,-.,: .:?,,,e_f.1.■1' l - ,.- 0. , • ' .' ..
City/State/ZIP: Tigard, OR 97281
Subtotal
•
Minimum pemiit fee (590.00)
: • Phone: (503) 624 Fax: (503) 598-0270
Plan review (25% of permit fee)
CB tic.: 76359
State surcharge (12% of permit fee)
TOTAL PERMIT FEE ' / ' '
This permit applieeden expires if a permit is not obtained within 130
Authorized signature: 4 ki , . 1 / a ° , ., . . .' 1 _di/ days after it has been accepted as complete.
Print name: Markna R Meedom '' - - A. • Fee methodology set by Tri-County Building Industry Service Board
, LituasizintertnitaKC-PermitAno.doe 04/09110 444M TT t i ifil711"niAND%
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