Permit CITY OF TIGARD MECHANICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00432
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/20/2012
Parcel: 2S111AD19600
Jurisdiction: Tigard
Site address: 14909 SW 88TH AVE
Project: Ganry Subdivision: LADY APPLE Lot: 20
Project Description: Add 30' fuel piping for pool heater
Contractor: COLUMBIA HEATING & COOLING INC Owner: GANRY, SANDRINE
PO BOX 230397 14909 SW 88TH AVE
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE: 971- 506 -2625
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Fuel Piping 08/20/2012 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 08/20/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/20/2012 $75.85
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: O• PLI eA-C1.0
_A4AiezFjAaLL__ 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.
08/16/2012 11:24AM 5035980270 RECEIVE COLUMBIA HEATING PAGE 02/02
Mec.
Mechanical Permit Application
I OR f/I I It I: I..NI: ONt.1
City of Tigard AK] 16 2012 R
;� • !3125 SW Hall Blvd., Tigard OR 97123 �I� I ( - Permit No «ELt4Oj ��c3y
Plan Review
Phone: 503,718.2439 Fax: 503.598.1960 CITYOFTIGARD Date/By;
r 1 ) Inspection Lute: 503.639.4175 nil Date/By; ;
Other permit:
Internet: www.tigard -0r.gov BUILDING DNISIOP+I� ;Ready/fl Jun W See Po 1 toy
TIC. C. Supplem ental rnrormatio
' , r 1;ir ..t17.1-,,:',:',.:". X1 ! 7 " _ �. a YA t o'r,,;�, _,.r.- t - n
..::. . t . �,••;,,, ir•Yt �� 1 z 'E %.ECKLIST
_ . .
y 0 New construction
C. Ad . 141 fi teratloNreplacement Mechanical permit rtes* me based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of i
❑ Other
mechanical 1
µ tea! materiels, labor overhead, and torn.
,� ?a VIZ T ..6 �� 1 '" Y (1 ... t r, ":;::C1,1 . �', i r
Value; s
;.¢ ;'::1 f
5 �ti } •'� xL P d a�� �i'
■:: 6 I - and 2- family dwelling ❑ Commercial/industrial "' `' =' �•-: special
El Multi-family ❑ Master builder ❑ Other: building Fo ap al use ebecklLrc
ccesso b m
r - ther: Description For
... _ I Q� Ea. • I
u - r •.: =.'' ,; 1.�n�!at. y (, � ,. r A i ,, .: i ( .: r ., �,i 4 r '}Yy y: H - 'coral
Job site address: • . �(� A cond
�/--� + w' • + ' (require. site plan showing plat nnent) 46.75
City/State/ZIP: ! ��e t qt -� g q Furnace 100,000 BTU ldueta/ve ) 46.75
/,'Oso� Furnace 100,000+ BTU (ducts/vents/ 54,91
Suite/bldg /apt, no.: Project name: 6A-qJie Heat pump
Cross street/directions to job site: re sires site tan ahawing place
DuG W ork
23.32 • A
Hydronic hot water system 23.32
Residential boiler (radiator or
_hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: no : Flue/vent for any of above 23.32
Tax map /parcel no.: Other: r 2332
o Other fuel a iances:
�'i,c i 1 1 t F (1' ' s.t .. ,_ d" n ., a ii ' ' iY p
.._ , . �.. Gas heater 23 32
—
ti
• L• / I t Of /Lf di� as � fireplace 33.39
e1 ' Flue vent for water heater or gas
, Hro re/L _ lrcplace 23.32
Lo li ter as 23.32
_ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
= 1 yj °i t :'' Chimney/iiner /flue /vent 23.32
.. .. . _ .. . _ ., , � s.(_. , _.... � Other: 23.32
• Name: , ,�j11�11 A N Z
E nv i ronmental exhaust and ventilation:
Address:
Range hood/other kitchen
City/State/ZIP:
equipment 33.39
Clothes dryer exhaust 33.39
Phone: (9 5.00- cotr Fax: ( ) Single -duct exhaust (bathrooms.
or
_ toilet compartments, utility rooms) 23.32
i E T Nai i.'; 11":;.,:.. : ' a - . . , r l - 1 I , 11 V „ 2•;. Attic/crawispace fans 23.32
r.:
Business name: Columbia Heating and Cooling, Inc. Other: 23.32
Contact name: Marlene Meedotn _Fuel pipin
514.15 for first four; 54.03 for each additional
Address: PO Box 230397 Furnace, etc. _
City /State/ZIP: 97281 Gas heat pump
Wall/suspended/unit heater
• Phone: (503) 624-2704 Fax: : (503) 598 -0270 Water heater
E -mail: columbhc ®teleportcom Fireplace
')'f 9y°"`Yt�: - 1 Range
1 a:'„ ':' ' ' ` _ Barbecue
Business name: Columbia Heating and Cooling, Inc. • + Clothes dryer (gas)
Address: PO Box 230397 Other. L _
• Ci /StBle/21P i:ri : : ° ....' S ^''. ," -7 ,. _,.va t :a.a. ::r
tY : Tigard, OR 97281
Subtotal
Phone: (503) 624-2704 Fax: (503) 598.0270 Minimum permit fcc (590,00)
•
Plan review (25% of permit fee)
CCB IIc.: 76359
State surcharge (12% of permit fee)
Authorized signature: j • b TOTAL PERMIT FEE 16F )
This •
11 ' .. permit applic MN it • permit la o Obtained within 1841
days after It hat been accepted as complete,
Print name: Martens R Meedom Date: ( — r- /).., 1 r Fee methodology so by Tri-Coemy Building Industry Service Board
I:, BuiidingthaminamEc- renti,App- doe 09fi9n0 44Q.ee17t•tr1m7n wco.