Permit v CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00651
Date Issued: 12/10/2012
T 1.(.; AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 2S111 DC09700
Jurisdiction: Tigard
Site address: 15700 SW OAKHILL LN
Project: Stark Subdivision: SUMMERFIELD NO 10 Lot: 560
Project Description: Relocating furnace, water heater and dryer (1) duct work, (1) new flue for furnace and water heater and (1) fuel
piping
Contractor: COLUMBIA HEATING & COOLING INC Owner: STARK, JAMES D
PO BOX 230397 15700 SW OAKHILL LN
TIGARD, OR 97281 TIGARD, OR 97224
PHONE 503 - 624 -2704 PHONE 503 - 922 -3324
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Duct Work 12/10/2012 $23.32
Type of Use: SF FlueNent For Any of Above 12/10/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/10/2012 $10.80
Occupancy Grp: Fuel Piping 12/10/2012 $14 15
Stories: Minimum Fee Adjustment - Mechanical 12/10/2012 $29.21
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 '' 11 /�
Issued By: Permittee Signature: i'l3 f PPL-1 C' 4 DAL
AL
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.
12/10/2012 09:14AM 5@3598@270 EC EIVEDLUMBIA HEATING PAGE 01/02
i
■ DEC 110 2012
CITY dF TiGARD
LDtNG MIS • .
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Meeha n ai Permit A - i I! h i, t i t I I i I t •• I (
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City of Tigard , i MEIESI
J Ili 25'SW Flail 131v4,, Tigard OR 97223 than Review
phone: 503.718.2439 Fax: 503.598.1960 lues/Sy: Other Permit
is t , inspection Line 503.63914175 Date Realty /BY. new 121' - pane 2 for
Internet: umrw.tigard- or.o■ I NetI6cdtMethod: Sup • lementel lnrutmldion
1
t
i �pp l � t t t N ir 4k ,�' w I t �e' t 4, �` a • . ^ 91 "11 pOR ` -A?,,
3 :. ,,s ; ., z'- 1 ..2 v in s. li;, ., 'aa M pemlitfew ar b ased on value of the wort;
(3 New construction .181, Additi on/ altorati • tlr alecernent performed. Intl htte;tht: value (mond to the nearest dollar) of all
D i?eruolition o tither mechanical mate}iele, equipment 1: • • : overhead, and profit
Value: S 1
't sr cY ^' ���: -i! I � tir 'W3';'Q' }r f5 7 r. i. 1'ro`° i , 3=
�w.. ! i! �:�`F.� ',.�D :S:S�' -. �+;♦ - 1 1 " '-- �' ��' �? -
3 and 2-flintily dwelling 0 Commercial/ind stria! 0 Accessory building For wnlal/rifomrrnlon . - 024kl�t
0 Multi- 2'emily ❑ Master builder 0 Other: Ocic iption Qty. E. y Total
:,f:, r�-r ��e �5► t ,.� •��= -'F. 3 1�+'�ttingJ0001'11TQ:
r�:�t'��.'._riyC= 1^E°Y� ' `
:..��• � .c .75:: `- e�Q'o0l1dit10111n$
Job site address !�'1 ire mites Ottylatt .ip�plecetaeot) 46.75
Cit /5tate/ZlP: ��' • ter'�e Furnace 100.000 (00.000+ BT U t ( tams 54 -91
•. l ttrrtitce $T (dhx+�tvettn) 34.91
Suite/bldg./apt, no.: • Project na : ICS Z' / r Heat Pump .l+n :' • ieeeeueat 6100
Cress street/directions to job site: Mot work 1.11111 01111111,111
I R dronic hot wafer r 111 l
Rcs4dcada! boi[cr (radiator or
:.. hydsopic) 23.32 _
Unit heaters ilbel- tytfe.netelechnc).
I in-wall, imduS suspended, etc. 46.75
Subdivision: I tot no.: �F1eelvent for any of above 1 23.32
Other I 2332
Tax map/parcel no.: Other niel appliances:
,t,
is�ht — . -..r: i 41: t' : 0 :4 „�� , S � e � ;1 • �t� �Y; - Water heater 2332
� 4
5 11 , r/ r( � t � L / 1 A, � I rueplac 33.39
�� �.. i' Flees gent for ; under heats or gas
r�� :rark�!7 5 :,� = "mDIBCe 23.32
L. .1
tyV /�` � ( d/ • ll : - 23.32
�j1�a•l��(�fs �a a �� Wood /pdtetstove 3339
Wool fueplaoefirism 2332
• : 7: "` � `�rt ' °� 'se `. ' ;ai
,,,, -� : Chimncy/lirieeUelvenk 2332
9nii�� '�.'`' s:''' :�ti."�!�;�iielUrc.i�R ?.� ��xrn�C:�;Js�.�
�9 Other: ssmental,exhaYeattuitl e4dls.:
�i, r Raba twodlother kitchen
;� + � *�1�;1 ��(fl � equi vtrt ent 33.39
City/State/ZIP: f if, , 0 id a / ) � ! Clothes dryer exhaust 33.39
♦ ! Singlc- urtcxhauat(hmtlrooms.
t,0 � � toilet compartments,utili'tyrRoms) 23.32
SZe 7 W l 7 r ti r '' Attic/crawispece fa 23.32
e r� 4
l3uslne.o name: Columbia treating ating an0 COOK, 114 . Other 2332
1 Feld tlInilsg:
Contact name: Marlene Meedom $14.15 for that fpar . caaa add eionat
Address: PO Box 230397 furnace, etc. - I .
-- Gas heat pump
Cie,' /Statc/Z1P: 97281 Wan /suspcNtedAusitheater
Phone: (503) 624 - 2704 P - : (503) 5 - 0270 Water hover 11=--
F- -mall: columbemgedeport_com Fireplace 1111-
M.,`y�.�x ;fig Ran a
"`' � `y 4" "iaial7.t:Wu ts3: r 82becue
business name: Colutubfa Heating end Cooling, I Clothes dryer (ace) III
Other.
Address: Pe 150x 2311397 a : °tttsw" a r am. r
+E' „hit ,.k... •r - '„
City/Slate/ZIP: Tigard, OR 97281 1 Subtotal- —
Phone; (503) 624 -2704 F'• . (503) 598 -0270 Minimum v� 090.00)
Plan ievieu! (25*%o - ' fee)
CCB tic.: 76359 State surcharge (1 2% o pennit fee)
TOTAGPE IT FEE
Auth01 ized signature, / Tap ps�le •peaitalMon nrpirse rev pc ', Blot ohta:ned withra ISO L. 4 i ! ! _ j _ _• . - tlaysatter it hasten aecep • as complete.
Print name: Marina R Meedont Date . wimp= • Fa ti�
rnaodutuier awl by 7rf- Cbuat} HIri1• nglinfo try st Meg B.,wtt
71o.hw... 1.... 4∎AL1,e.,e...:. o.w M.. no_u,.. n,neG,77 (I torryi-Thowpjr,