Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00322
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/12/2013
Parcel: 2S 111 AB04600
Jurisdiction: Tigard
Site address: 14435 SW 92ND AVE
Project: LIEUALLEN Subdivision: PENMAR TERRACE Lot: 13
Project Description: NC installation. Placement of A/C unit must comply with manufacturer's clearance requirements.
Contractor: COLUMBIA HEATING & COOLING INC Owner: LIEUALLEN, NANCY S
PO BOX 230397 14435 SW 92ND AVE
TIGARD, OR 97281 TIGARD, OR 97224
PHONE: 503 - 624 -2704 PHONE:
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
• Air Conditioning 06/12/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/12/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/12/2013 $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: Permittee Signature:
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. •
•
06/11/2013 03:00PM 5035980270 COLUMBIA HEATING PAGE 02/02
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Mechanical Permit Application I f il: t,l l.l,'1. I tit (,\,,
r
City of Tigard Ir• V .. i -' A �L
-� • 13125 SW Hall Blvd., Tigard, OR 97223
I Phone: 503.7182439 Fax: 503.598.1960 JUN 1 1 � ` Other Permit
, i , ; , \ii ,, InspeCtionLine: 503.639.4175 •_ 1 -
lrttaneL' aww.tigard- or_gov i FM Sit t
CITYOFTIG ! y _ :i
.. ..afli. ' o, , , ,vS:�": - tytliP i:'•i'q, 'of r'i i'q 'l :' j :r I• Ei71 � T -Ct f;443yxq•-. �� 1
.... " »,,—. _ .NA ' • = ,4,-„ , � <;. : c in ".:tiC Y i:�...c'TF .c,42 &,.24: I .r y ,-A � .i-!% .; 17
i r.i ---- '�_+�'7i•':aS�Y na:•1�
❑ New construction e'71; dition/alterationlreplacernent Meth ice! permit tees' ate based on the value of the wort
perfo ed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: 1 mech Teal materials,
equipment, labor. overhead, fit. • its., " . tig r � rr. t.r> zv� .. , r-?} � tC;q .c x w
Value: and
profit.
, .rl: :•J -4 , F J +J 7tv :. '' rr' k 7;. . (' x r:. {1v,.?.� 'i.4' . mac ,
. . .sex:; H .. . m i l . r. . A .,7 ack ;.r % ... ,I a ,.1 . , 0: . ,,' � h ' i , s , ^
and 2-family dwelling ` s
B ❑ C:omme rcial/ m dustrial ❑ Aecesaory building i For rpedalInformation aseottentryt
❑ Multi - family ❑ Master builder
[] Other. i ■ : 1•t
_ _ _ i Qty. Ea. t Total
Lti t]`...i ..•- ,J "`' t - r.••tst; s•T ^•,>; ry:a
.........1r1?-1';'41.... , ufs2FvZu'llo 1- it t' S �. ' I' I S.. : 1. : !y c":t 11 nnui::
U �` - - Air t: e _ • it .1a n : � • �.. g
Job site address; 7 � � hie A e /� � ., ni ., site � Ia " . tteelnem i 46.75
City/State/ZIP: r OR, V � ^ ,
Form 100.000 BTU (ducts/vents) 46.75
f!L ' Puma • 100,000+ BTU (euetrieent 54.91 I
Suitebldg. /apt no.: Project name:
Rc► �
_ Heat •• trap
Cross street/directions l0 job aita froqul - aitc plan ahowtnptacement 61.06
Duct ork 23.32 • A
! Hydro . is hot water system 2332
"' - - • Reside ■ gal boiler (radiator or
I hyd • ' c) 23.32
---•i Unit h - (fuel-type. not electric).
in - wall in-duct, st . • - • • etc. 46.75
subdivision: -------- — LLot no.: I Flue/v t for any of above 23.32
Tax Map/parcel no.: Other 23.32
�,� I Other eel appliances:
,� • •, r j 7.,N „r;, . • :e x•_ :1r q
•:•,' �' k• .r2f %. Az.eda ?i” .. dx ..%iiK•zl ' ;
a• � u . , P...k. _ • Wa ter ,•< < . ,,.. . u ,��• �� . ater - ter 2332
/1 ) • (.') A C Gas. lir place 33.39
Flue v t for water heater or gas
firepla • - 23.32
—
• : li :i ter (.: • 23,32
Wood/ lief stove 33.39
Wood replace/insert 23.32
9 ' a a" .., fie, d•. s,r,- : �o�'.� r. :: • Chinn • R'
ry t,sLi)" `M .t.4 :;' j�� �.�,�1�, u a � c u ' •.' q ?: 1 trierfltrelvent 23.32
/�' � 1 / '� tip_ ^.�•~S:�IrJ•!Lfwa�fi7!Sls ''9•,
Al AI N 4 r I F VA Gt. F. COW' T3,2
Name: _ Egvl , mental exhaust and vet7t:tstioa:
Address: Range .. • other kitchen _
equi . I 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
Sink oatexhaust bath
Phone: 0 ) - - �. / Fax: ( ) . toilet ( t»roo
• .. .. : — 1 n ' °nis ' "` a 4 •h: :9` ji"k•= * .5:�.te�• `�g.`•� r - ..
•• partrnents, tth7ity rooms) 23.32
. , .. :�.-- ' t.. �� c. :rtlLr:� �, t ;':�..�c•: •: x.cti.:. ..� • .
•
a: i b ytrcs fora 23.32
Raciness name Columbia Heating sod Cooling. lee, ate` ( I
Fuel, i ;loww
Contact name: Martian Meedom 514.i$ for first form 54.03 for adOltional
Address: PO fox 230397 I Furnace etc.
` I Gas - • pump
City /Staur/ZIP: Wan/ : rended/unit heater
Phone: (503) 624 - 2704 Fax: : (503) 598 - 0270 Water h er
F -mail: col nmbbc(@teleport com
Fitepla
. , ,.. �) = '
�':r1 �` °T %S sC. . mo . • 1 Range
Husinevs name: Columbia Henttug aqd Cooling, Int I Clothes rya (gets)
Address: PO tins 236397 OUler
City /State/21P: Tigard. OR 97293
— I Su
Phone: 593 6 242704 Minimum permit fen ' 1.00) .f d.c.0
( ) Fax:
CCB fie.: 76359 I// Plan 'review (25% of . t ke)
i State surcharge (12% of • - t fee) t D. D
— TOTAL PERMI FEE r t)Qc Sex
Authori2ed signature: I T1114 . it .pptte.ttoa expires If a psrmit h a I obtained within 180
drys after it hie been accepted as • minter -
Print name: Marlene 'R Maedom Dale: 6.'.. 7 '' 1 j • FCC ins hWolnyy sex by Tri -Count/ Ouiitling 1 • wry &na:e Bumf
. . u... ..re.....wu.r_e....- :..w.... •,el•...•e f
aJJl. 17T /1 AM RTV,wFR1 ;
. I
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
14435 SW 92ND AVE, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
06/27/2013 00:00
MEC2013-00322
PASS - No C of O
Violation Summary:
Inspector Contractor