Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00433
Date Issued: 07/30/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S135DA02702
Jurisdiction: Tigard
Site address: 11230 SW 90TH AVE
Project: Anderson Subdivision: GRAHAM ACRES Lot: 29
Project Description: Replace existing A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: COLUMBIA HEATING & COOLING INC Owner: ANDERSON, AMY
PO BOX 230397 11230 SW 90TH AVE
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503 - 624 -2704 PHONE: 503 - 928 -1870
FAX: 503 - 598 -0270
FEES
Specifics: Description Date Amount
Air Conditioning 07/30/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/30/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/30/2013 $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: i Permittee Signature: ®AJ- / e x%70
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.
07/29/2013 04:42PM 5035980270 COLUMBIA HEATING PAGE 02/02
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Mechanical Permit Annlf E D l ru; i)i h',i_a: \1: n,vl.l
City of Tigard I' I 2 Received w Pamit No
13125 Svi HMI Btvd,, Tigard. OR 97x33 L
2013 Ce1a Ste 4 �iJ� , . -043 — Oo j
Phone; 503.718.2439 Fick: 503.598.1960 D ins Ozher Parent: I
l ! ( ; \ a ! t inspeciitnt Line: 503.639.1175 CITY OF TIGARD Date-ReadyiBy: WM Sec Pees I for
Internet: www,tigard•ontov Notified/mohod: B)ippremeetar Itdbnaerloa
• BUILDING DIVISION
p � ,�
Y e j ! •' r'- k k 1: ii v wl ." I �'• ?i ' 1.:
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EC&���:k.���;�ra��f .�r, " ,., �:b'±,t ' ,.• �. n L�> �.-.. �: wa .�t:;r�•:..m.:�- `E�'�i�.�'I..�. r�.�"S„�c'c'• �01z:. .,
❑ New construction I! Addition/alteration/replacement per
W Mechanical P�+it fees• err based on a value of the work
mied. ladicate.the value (roundd to the nearest dollar) of all
0 Demolition i ID Other: auchw icai materials, equipmen ie bod, overhead, and pru17i.
e i • )i:- '''nsog ro{{��Jx,yyt��tacsr ,t � value +$
rt1 . rat• f rY1NIIad•. �-.(�., - , z , R ` ) , .! f 4 � �. J e: i '.. "i1
or. I- and 2- family dwelling ❑ Commercial/lndustrial Q Accessory building For speeta11#formorlon ea&mUist
❑ Multi - family ,tom ❑ Master builder 0 Other_ Description
t i', y t(tv ' u I 1 ? c ; 'A:. •., ,� Qty. r Ea. I Total
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Jo M j� Ae Air conditioning Job site address: • k I J 46.75
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City /Statc/ZIP: ~ d �� r� t� ` / Furnace 100,00013TU NuouJvetw) i 46.75
Furnace 1 00,0(10+ ITN (doete/vpUa) . 54.91
Suite/bldg./apt, no. / ' � r pub
'0.10.1i.1 i rcauirce •stte rah hckeingstnoah I 61.06
Cross strt et/dirlections to job site: Peet work i 2332 • . A,:
• Hydroaic hot water- system 1 23.32
Rcidcotial boiler (radiator or
hydronic) 23.32
• Unit heatras (fuel:type, notcletic),
I
in - well. in-d tuapended, etc: 46.13
Subdivision! lierallm Flue/vent ibr toy of above I 23:32
Tax mup/parcel oo:: Other ` 23.32
Other fuel appliances:
r _ l: } ._ { - ,7 � ",+ter ' Water heater _ .
2332 ..,n • �rr?c'is v 'c,-` , `"Mkt:t�;:.•' 3 ", r y'•` ��'�lAf
�' / S _ l =C/1. � ' ` G fireplace 33.39 `
f/ Film vent for water heater or gas
fireplace 23.32
Los lidliter (n ) 23.32
Wood/pallet stove 33.39
Wood fii.Elaoc /igscrt 2332
+ �-' a' o ii , t ""'-s .' - `" ii :� c � Chi „ irxi /(ludvent _ I 23.32
����I J if Other .. I I • 23.32
iifiila��i /1 r // / / . OA Eev rpeeetal exbaust and rerititati�,n:
a I iei , Range hood/other kitchen 33.39 _
1 equipment
1 t. / ��! * hear Clothes drYer exhaust 33.39
Phoni:: Eg 4 r . . . Single duct exhaust (buUrmruns.
_ toilet com�a , utility trams) 23.32
-�' ,' � a` 13 : . Ai ; a •g wl ace fans it � $�� ��l�Cr' . �b� =cvtu � f 1 2332
Rusineas name: Cniumbie Pleating and Cooling; Inc_ G 23.32
Frei pielair
Contact name: Mariana Meetlom 514.16 for first fear, $4.03•fo each addttloeud
Address: PO.Rsx 230397 Furnace, etc. I I
Gas heat pump
• CiglStste/ZIP: 97281 • Weill/suspended/unitheater I
Phone: (503) 624 -2704 Fax: : (503) 598 -0270 Water hearer
E-mail: eolumbb . Frrrplace
�teleport.com
. Range
— - iga: �isva: M r , oi' 21 _Batixue
Ciothea drys* (aac) - • ,
• 1st■
Address: PQ lin :230397 � � " . <,
- ' 4, � i61: S +, 1: e d a!•r • ,_� \�iC�{.'., dt+•';
cit /state/ZIP: Tig OR 97281 R Subtotal
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nom: (503) 524.2704 Fax: (503) 598 -0270 Minimum permit. (590.D0)
I v Plan review (25% o fee)
li CCB lie.: 76359 State surcharge (12%o . +ft fce)
V ' /`/y I • I1 TOTAL PERMIT FEE /00 ✓
Authorized signature: /J / {/' i / p� ®• 2 . M permit application espIi as if a permit is not chiselled arihi. 183
«c ����� III [! ��JJ dare attar it hes been accepted as com pleta.
Print name: Marina R Meadow Date: ' r,•« mcd+abrugy we by TA-C w:ay Btdldn,e Indusay Serviao gaud
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