Permit CITY OF TIGARD MECHANICAL PERMIT
3 COMMUNITY DEVELOPMENT Permit#: MEC2013-00046
T[G A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2013
Parcel: 2S 103DD01700
Jurisdiction: TIGARD
Site address: 10990 SW GARDEN PARK PL A
Project: Wrench Subdivision: GAARDE PARK Lot: 1
Project Description: (1)gas furnace installation and(1)gas line
Contractor: COLUMBIA NW HEATING Owner: WRENCH, DAVE&BARBARA
PO BOX 622 3550 SW BOND AVE,#1804
SCAPPOOSE, OR 97056 PORTLAND,OR 97239
PHONE 503-543-3624 PHONE: 503-688-6826
FAX (503)543-6285
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 01/23/2013 $46.75
Type of Use: SF Fuel Piping 01/23/2013 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 01/23/2013 $10 80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 01/23/2013 $29 10
Stories:
Fuel
Fuel Types.
Gas Pressure
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /� 1
Issued By: W jJ- Permittee Signature: om. , . LjCf-fi/d 14
�� Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application E D a rOR O11 I( h 1 S1:()NIA
City of Tigard a>euJBy Permit Na NiCe Jot3-av0,-4,
13125 SW Hall Blvd„Tigard,OR 97223
Ph"*: 503.639.4171 Fax: 503.598.1960 JAN 2 2 2013 liffliiii Other Permit:
T I i.i Inspection Line: 503.639.4175
Internet- vrww.tigard-or,gpv Nnii R�Y�Y Infix:/ H See Page l far
CITY OFTIGARD ' "f 1 j to Supplemrentallnfirmation
LDIN DIVISION TYPE o)!t COMMERCIAL, FEE• SC'11F ILE-TJSE cTaBCKLIST
0 New construction a'AdditiOnia1} gtion/iplac t Mechanical permit fees'am bused on the value of the work
❑Demolition 0 Other:
performed.Indicate the value(rounded to the nearcat dallnr)of all
mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION _ Value:$
'1-and 2-farnil dwelling Accessory building — RESIDEN77Ai.EQUIPMENT 7 SYSTEMS FEES"
y tug (]ComntetcisaVuMustTfai Ace
❑Multi-famil y ❑Master!milder For spectal7rrfarmatinn use checklist,
❑Other: Description Qty_ Fa Total
JOB SITE IKFORMATION AND LOCATION Re a ing/
Sub site address: /0?4o SW 6.41wEizi PAS fL ¢`A Air conditioning
(spires site plan showing placement) 46.75
City/Stain/ZIP: 7-Z[,' y�'jr) a'Z 477a?.73 , 15trnaee100.0 BTU leu tuna) _/ _ 46.75 Y6.?5
Suitelbldglapt_no.: "` Project name; Furnace 100,006+BTU(decarocma) 5491
Heat pimp 61.06
Cross street/directions to job site: Duct work. 23.32
. — Hydronic hot water system 2332
Residential boiler(radiator or
bydronic) 23.32
— Unit halm(fuel-type,not electric),
ift-wall,in-duct,suspended,etc, 46.75
Subdivision: Flue/vera for any of above 23.32
Meer 2132
Tar map/parcel no.: far]appliances
Other n / ,�/�DEESCRRIP`TIION OF WORK Water heater 23.32
Gm fireplace/zus �7{-� t,Ti` ? TLII� g ( CTT.C� Flue vent for water heater or gas 33.39
L 7—/UC fireplace 23.32
7,ou liR h tar Cayes) 2332
• Wood/pellet stove 33.39
Wood fr plaeefinsert 2332
Dir PROPERTY OWNER ! 0 rlsrarcr Chimney/liner/Bile/vent 233z
Z.X7 Other; 2332
Name: /��/�tc Envlsoamerttai exhaust rend ventilation
Address: 35.56_546// I?O9 Range hood/other kitchen
�y� /�q tJr -- t+`� equipment 3339
City/State/ZIP: r ORT l/j� az 9 7,23? Clothes dryer exhaust 33.39
Phone: /r Fax Singleduct exhaust(bathrooms,
ap iv" big% Faax:( ) toilet comitarttnnents,utility rooms) 2332
® APPLICANT El CONTACT PERSON Attielerawlspnce fans 23.32
Business name:Sante as Contractor Other 23.32,
Feel piping
Contact name; $14.15 for first Saar,$4.03 fin'each additional
Address: / { l�f.C
Gas heat pump ,
City/State/ZiP: WaWsuspended/una heater
Phonc:( ) :( ) Water heater
Email Fireplace
CONTRACTOR Barbecue
Business name:Coittmbia NW Heating rC1otltes thyer(gas)
Address:PO Box 622 I
MECHANICAL FKRMJT FEES* . .
City/State/ZIP:Scappaose,OR 97056 Sebtodl 'o.qp -
Phone:(503)543-3624 Fax:(503)543-6285 Minimma permit fee($90.00) Ter.Od
CCB lie.:61947 Plan review(25%of permit lbe) —
State sarv*rge(12%of permit fee) /0.YO,---�
TOTAL PERMIT FEE L_
Authorized signature: It" t +,i `5 t, II' Thix permit spplkstlew expIrkw it obtained within 150
days otter it ter beta
RPrint name:Gerri Jacobson
17�ate: /..,22-` ( Fee methodology sat by 7ri•Ccacsy Building lndwrtry Service Board
uneilding‘PrmlitafEC-Pe nennup.doe tOOi/0t 1 441w617T(IIMP:004 MBB)
P.O. Box 622
Scappoose, OR 97056 Columbia NW Heating, Inc.
503-543-3624 (Phone)
503-543-6285 (Fax)
Fax
To: City of Tigard Building Dept From: Gem Jacobson
Fax: 503-598-1960 Pages:3 (Including this one)
Phone: 503-639-4171 Date: X43
Re: xT CC:
O Urgent 0 For Review 0 Please Comment 0 Please Reply Cl Please Recycle
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10990 SW GARDEN PARK PL A, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
02/20/2013 00:00
MEC2013-00046
PASS - No C of O
Violation Summary:
Inspector Contractor