Permit r y CITY OF T I G A R D MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00595
TiGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/5/2008
PARCEL: 2S114BB - 13600
SITE ADDRESS: 16474 SW 104TH AVE ZONING: R -12
SUBDIVISION: SWANSONS GLEN NO.2 LOT: 077 JURISDICTION: TIG
PROJECT: HOLZKAMP
Project Description: Install gas furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN: •
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: •
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: • OTHER UNITS:
>. 10000 cfm:
GAS OUTLETS:
Owner: FEES
WAYNE HOLZKAMP Description Date Amount
16474 SW 104TH AVE
PORTLAND, OR 97224 [MECH] Permit Fee 12/5/200E $72.50
[TAX] 12% State Surch 12/5/200E $8.70
Phone: 503- 341 -5687
Total $81.20
Contractor:
THERMAL FLO
7236 SW DURHAM RD. STE 100
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 670 -8343
FAX 503- 670 -9064 •
Reg #: LIC 151847
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
• Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
Issued By:
•
Permittee Signature: Q C
Call 503.639.4175 by. 7:00 a.m. for inspections that business day.
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.
t • f.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: mec 200A . 006C REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date I By ✓ Code I Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill • 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG- Structure grading /footing 125 _ Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 ' A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 _ Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 .Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: • 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
X 699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
PLM - Plumbing
910 Sprinkler rough -in
Permit
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc, inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation . 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection: .
499 Final inspection . 599 Final inspection
I:\ Building \Forms \InspCard- AOP- Blank.doc 02/02/07
DE e /04/2008/THU 05:07 PM THERMAL FLO FAX No, 5036709064 P. 002
1Wtechanical Permit Application �, FOR OFFICE. use ON LA' ��
City of Tigard j Received
Date/By: . - .� Permit No.: •6 :.006- 6
" 13125 SW Hall Blvd., Tigard, Olt 97 3 � ` n %%-
f : Phone: 503.639 -4171 Fax: 503.595.1'60 O J `. , � OIherPerinil: iiiiii
TI GARD Inspection Line: 503.639 -4175 O� ((__mo�ww ; ` : , H See Page 2 for
lntemet: www.tigard- or.gov '``V` supplemental Information
,P r*" F,* r' t �rN:i f,lww t,, u i t ,.'a i c , ∎ M . .e: ` Ixl+ + r 5 �,,n u 0a n„ . " �t l� tilii i %7 " yc ∎∎ h C - "
41. �r r%t: ∎∎ . w'I ^nx.pr,rv... GNNVI , d .1 .. .,'�. 77,40 CR ' , �' . ... 1'. `.... : K'' t j >I.��,�'i l � W, x.. ,1'U ' , pp
El New construction Addition /alteration/ a * cement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition . ❑ y1 O y t � her: ry y / /y } / * mechanical materials, equipment; labor, overhead, and profit.
• �I 1,0. /w1x�f'2 Y 74,,, r .�1I'1 { .I' ' 1t VII. iCONUTA I.:I.. � I I t1�1' ''l . � i IN' ' pi I \ i� Value $ `II .
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory budding "' "`^ "" '` u "" ' " "' ""
f For special information use checklist.
[a
Multi-fami y�ryy O ❑ �77�} M r} as � ter bu ry may/ ❑� Other: Description Qty. 1 1;a. I Total
'
i LJ' .III .!� 1 { i M I 4 4 V' Ax ; Mio . di 11• , .
�Y ' A ttieki VNlf it I I II " f: ;..
.,Irt. ,r, ,, i. .:, . • , 1._ .. ,X . N e. lil 1 1 D Pleating /cooling
Job site address: J(04'14 6 w /174-'- Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP; � 04 91 , - ¢- Furnace 100,000 BTU (duets/vents) o
14.00 r 2
�rJJ Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt- no.: Project name: 41 / 24- 2 6 0 I_- Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no "" Other; 10,00
Tax map /parcel no.:
• Other fuel appliances
'�.w l Id i . w 144 4 ■r n l a i r i r r .I f . '
• i. ,F'F.1a n r} q., !..:u r'i x ! r n,nuP fair It'. re >i Water eater
„r,.: kr,. ., ».• • ev �. s_ G.. > ltzl� lfbl�'.'(; f. c " ...... " .... r .; Ix heater t0.o0 • Gas fireplace 10.00
Flue vent for water heater or gas
w ./ // Ong f fireplace 10.00
1 -� , 4L:/ ,, C• -- Log ]fighter (gas) 10.00 _
Wood /pellet stove . 10.00
Wood fireplace/insert 10.00
,c ' N , . a a . x „ * R' t ' l ulw ep Chimney /litter /fue/vent 1 0.00
kt yy A , w r $ Y �' .,? x
, azw kf Go- y� . n ,i n : I , vei
X19' maf Yrl9" S R�l/�p' f4'�Y d�� > E '.�„G:x,l'lll','I„"1:^I. . • w.,.t'�"'fy_ 4 rv m�r�-', rN�` �tii� ,9w::�,� �f ��I;I:,
(]tiler: _ 10.00
Name: Wayn e, I-I0 //j / "61inP Environmental exhaust and ventilation
. / Range hood /other kitchen .
Address: �,p, equipment • 10.00
City /State/ZIP: Vai)le. tie cJo c , , - Clothes dryer exhaust _ 1.0.0
f/ 4- _- ,569,67 Fax: toilet co e-duot rtm entt (bathrooms,
utility rooms) Phone an ( ) tilecompartments, ility rooms) b.80
t 'S: ',UJ a »x . n � r, 5 aai.» f 11r1i 1 1 , It:'! Attic/crawlspace fans 10.00
xl,lc. ,.x,. :s .,, lh� , i' ;X ..4.1: , ;, i ,I d,ll I p F .' ., , , ' C �� iCf ° � ,' Q i N' r ,w .
Other: 10.00
Business name: '
/ Fuel piping
Contact name: _ / 55.40 for first +bur; $1.00 for each additional
.: . 60 ,0 1 2 1 Address: 4YA�,/ Furnace, etc.
Gas heat pump
City / State/ZIP: Wall /suspended /unit heater
Phone: ( ) • Fax:: ( ) Water heater
•' j � A • Fireplace •
E -mail: 467 7 1/r a/ .lame • V�/m.„" Range
h �. r » r f 'd. ',M I I p. ' WCON iRACTbR'�I I '' »: � ' ' ! i I w
' , '. . f �i,. , �.' , ,w ' .. ,I'i J x,.., l i,. C •. , . I Barbecue
Bbe
T 7 /'/ / 1 r °f'� x Clothes dryer (gas)
Business name: , `rr ���� II 0 r" N/
� �a{. 1!N Othe
Address: r ,} � " !p0 „' ;,, ��,a °►l�L F li�fiC II PGR14�I3 iFD "
City / State/ZIP: flrt`��C . 7. z6J'' Subtotal if; OD
- Minimum permit fee ($72,50) 12.40
Phone: ��� � Fax ��/ b1p 1 Pl an review (25% of permit fee)
CCB lie.: ( /, . State surcharge (12% of permit fee) 13 '76
TOTAL PERMIT FEE �3( 2.6, Authorized signatu
/ T his permit application expires ira permit is not obtained within 180
days after it has been accepted as complete.
Print name: rerf . CeiMe /Cy Date: 12. ¢- 00 . Pee ntethodologyset by Tri- County Building Industry Service Board