Permit C ITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00044
TIGARD DATE ISSUED: 1/27/2009
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103CD - 05600
SITE ADDRESS: 11630 SW TERRACE TRAILS DR ZONING: R
SUBDIVISION: TERRACE TRAILS LOT: 011 JURISDICTION: TIG
PROJECT: WEYRAUCH
Project Description: Replace 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: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WILLIAM WEYRAUCH Description Date Amount
11630 SW TERRACE TRALS DR
TIGARD, OR 97223 [MECH] Permit Fee 1/27/2000 $72.50
[TAX] 12% State Surchai 1/27/20a $8.70
Phone: 503 -341 -8830
Total $81.20
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. 203
TIGARDRD, , OR 8 97281
REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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: /' Ii 1 Permittee Si gnat e:
L LL/ g
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.
y . ,
Mechanical Permit Applica>RECEIVED FOR OFF ICE T SE UNI..1
C i of Tigard and vv Received ✓✓ Yetmit No.: Q q
ty $ Date/By: / 27 09 fix Hteke -coo
• 13125 SW Hall Blvd., Tigard, OR 97223 ""� ry 20 09 P Review
Phone: 503.639.4171 Fax: 503.598.196te)AN /
Date/By: Other Permit:
TIGARD Ins Line: 503.639.4175 Date Ready/By: Juri • ® See Page 2 for
Internet: www_tigard - or.gov CITY OF TIGARD Notified/Method: t(`� Supplemental Information
BUILDING DIVISION
TYPE OF WORK COM FIERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work 1
❑ New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all 'I
Q Demolition Q Other: mechanical materials, equipment, Tabor, overhead, and profit.
. Value: $
CATEGORY OF CONSTRUCTION.
RESIDENTIAL EQUIPMENT i SYSTEMS FEES*
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. t Total
JOB SITE LNFORMATION AND LOCATION _ Heating/cooling
li 3 � Air conditioning or heat pump
Job site address: r f �/(/}ilQi' G r--- 7 , 7 1. ad ,f!O (requires site plan showing placement) 14.00
City /State/ZIP: 61),0? Furnace 100,000 BTU (ducts/vents) _ 1 14.00
Furnace 100,000+ BTU(duets.'veets) 17.90
Suite/bldg. /apt. no.; Project name: LC Evy (\f. C H Gas heat pump 14.00
Cross street/directions to job site: Ductwork 14.00
Hvdronic hot wafer system 14.00
_ Residential boiler (radiator or
hydronic) 14.00 '
- Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00 i .
Fiueivent for any of above 10.00
Subdivision: `Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIP'T'ION OF WORK Water heater 10.00 .
ZL Gas fireplace l 0.00
_ l _^ 4 . _ Flue vent for water heater or gas
�Fn fireplace 10.00
Lby (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert , 10.00
Chimney/liner/flue/vent
PROPERTY OWNER 0 TENANT Other 10.00
Name: �' - I' Environmental exhaust and ventilation _
' v G'�.�" ^ Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00 _
' Single -duct exhaust (bathrooms,
Phone: 5 , 3 341 Q' 19 Fax: ( ) toilet compartments, utility rooms) 6.80 Attic/crawlspace fans 10.00 f
V
• ❑ APPLICANT ❑CONTACT PERSON Other: I 1 10.00 .
Business name: Fuel piping 1
Contact names 1. , 7 g j b ) $5.40 for first four; S1.00 for each additional
Furnace, etc. I
Address: Gas heat pump _
City /State/ZIP: : Wall/suspended/unit heater _ _
I ( • Water heater
Phone: �3 );} �Olf Fax:: ) S t?' ' J ��(� Fireplace
E -mail: Range
CONTRACTOR Barbecue
1 � m h/ � 1- { I f) _ Clothes dryer (gas) I
Business name: / /42.4.16/7 ( y0 c�"Yt
l/ J5 Other:
Address: "Fe 3 Ox .23 0 3 9 -7 MECHANICAL PERMIT FEES'
� Subtotal
City /StatelZIP: l , G P R d /,r 972Y/ Minimum permit fee ($72.50)
Phone: 6/3) 6 ` 1 p 7) Fax: ( 5 5 )9 . f I�Y7d Plan review (25% of permit fee)
CCB lic.: 74 3 5 / State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application minis if a permit is not obrained within 180
Authorized signature: (�� _.� C- minis days after it bos been accepted an complete.
i 44 Print name: , ! s i ate: / � • tee methodology set by Tri.County Building Industry Service Board
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Z 0LZ0 ONLLV3H b'181/11fl Q3 dL9:Z6 60 LZ uer
CITY OF TIGARD $1-
BUILDING DIVISION / P RMIT #: +Ii'C2009.00044
13125 SW Hall Blvd., Tigard, OR 97223 rY` E ISSUE . /0712009
Phone: (503) 639 -4171 ISO (� D Inspection Requests (24 Hrs.): (503) 639 -4175 � (��3 � GV�i ��
INSPECTION WORKSHEET FOR DATE: 2/4/2009 TI 7 :O0A PAGE: 24 ,
SITE ADDRESS: 11630 SVV TERRACE TRAILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 011 TYPE OF USE:
PROJECT NAME: WEYRAUCH
DESCRIPTION: Replace gas furnace.
OWNER: VVEYRAUCH, WILLIAM PHONE #: 503.341 -13830
CONTRACTOR: COLUMBIA HEATING & COOLING INC 1 PHONE #: 503.6? ; ,,PHONE
g: 3
Inspection Request Scheduled For: Date: 2/4/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Mes g :1 �j
609 Mechanical final 080248 -01 503341 -8830 Y q/
Corrections /Comments/ Instructions:
EL $ V1 Q37
J
,)4dirtci rEr-
\r -- ( 4,A-is
'A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
q ) . (A 2> f Z 1/ Inspector: Date: � ,(� Phone #: (503) 718-
CITY OF TIGARD .= .-*
BUILDING DIVISION PERMIT #: MFC2009.0044
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1127/2009
Phone: (503) 639- 4171n'9H�iiq�" ��
Inspection Requests (24 Hrs.): (503) 639 -4175 ' W '�' I..
INSPECTION WORKSHEET FOR DATE: 2/212009 TIME: 7 :OQAM PAGE: 19
SITE ADDRESS: 11630 SW TERRACE TRAILS DR CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS LOT #: 01 TYPE OF USE:
PROJECT NAME: WEYRAUCH
DESCRIPTION: Replace gas furnace.
OWNER: WEYRALICH, WILLIAM PHONE #: 503 - 341 -E3830
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 603- 624 -2704
Inspection Request Scheduled For: Date: 122/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 000146-01 XO3 -624 -2704 N
Corrections /Comments/ Instructions:
OK) ` S I Z� G 8 -' c ,
N n A
1 I PASS ig PAR L ❑ CANCEL 1Q ACCESS
FAIL 1Z' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ ---- q'Y
Inspector: A �_ Date: 7/ b Phone #: (503) 718:1. 6
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