Permit j , ! q CITY Y ®� TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00741
' TIGARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/20/2007
PARCEL: 2S104AC - 10800
SITE ADDRESS: 12996 SW 133RD AVE ZONING: R - 4.5
SUBDIVISION: HANDY ACRES LOT: 034 JURISDICTION: TIG
PROJECT: WEINANDY
Project Description: Gas piping to dryer, cooktop, bbq, and woodstove. Future use.
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 4
Owner: FEES
MIKE WEINANDY Description Date Amount
12996 SW 133TH
TIGARD, OR 97223 [MECH] Permit Fee 12/20/20C $72.50
[TAX] 8% State Surcha 12/20/20C $5.80
Total $78.30
Phone: 503 - 579 -8660
Contractor: •
RAYBORN'S PLUMBING
19990 SW CIPOLE RD
PO BOX 69 REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Contact #: PRI 503- 692 -4139
FAX 503 -691 -2328
Reg #: LIC 87852
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: Ir- t _ " (
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.
-'-r- ' D ec, 20. 2007 8:23AM Rayborns Plumbing No. 9698 P. 1
M es i aa,aat a, .1. vi inn r'► l
�� } FOI [,11 FILE llSE Ll
City of Tigard R . 1 d
13125 SW Hal} Blvd,, Tigard, OR 972' E CEV Date/By: i / A Pe rmit No , , .
Platt Revie '
Phone: 503.639.4171 Fax: 503.598. ''6tt - -'` � -
Inspection Line: 503.639.4175
i ,ae.�ij1`, Date/By: Other Permit
Internet: tvww.ci.tigard.or.us t. t __:. -' ;, Date Ready /By Sea Page 2for
DEC % 0 21 ° f Notified/Method:
Sopptemental Information
� � , �...r f ��,�.1 ' ' .� t.] S1� s � j . . - i T � J J'. �7� -L'• i y�l `f
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❑ New construction � A . - r a ton /rep acement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) (gall
❑ Demolition 0 Other:
n ,
r
mechanical materials, equipment, labor, overhead, an profit.
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1 and 2-family dwelling ❑ Commercial /industria $ ?$ -4 : - J : 7 - ) 3 E� , r t 4 -, `£ , ; y ':
❑Accessory buildin
❑ Multi - family 1:1 Master builder ❑ Other: �or spec;al;nforrmration use checklist.
Jttl' , r " rs ' '� " '!•'i tin �° "' .,�,"}✓ �- •'�" "T- *rte.. -�-- ^-3't; t,
Description Qty. Ea. I Total
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�...5•L:,..1d.:4a.r T.� � nFJ IinR
Job Site address: .� Air conditioning or heat pump
(rcguires site plan showing placement) 14.00
' cgs 5 2 Furnace 1000 BTU ducts /vents 14.00
. • . , Furnace 100,000+ BTU (duds/mite) 17.90
Gas heat pump 14.00
Cross street/directions to job site; G � -
/ A 9 ( s s-fro `:' -.... Duct work 14.00
Hydronic hot water system 14,00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, iii -duct, suspended, etc. 10.00
• Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel a r 'fiances
.����£rt �L f``- ' °F .��t �t titli4l � �lX'� �? r iPi r 'T a r � � y
r,'1 'YFi�ltni...iigi ".t3r'. :...� ,.��: ^.--"` t�� {}!'ls^ t xil.:i C .fai1:.0 - a , r '�7 i ' 7 ,1 Water heater io 0 0
..� ..,� ,• .,.,,__ Gas f aro r lace
10.00
�t_-_ i 4.. Flue vent For water heater or gas ■
,,_ .4.A .
lc, / 4
fire. lace 10.00
Lo: li:hter :as 10.00
Wood/. eller stove 10.00 .
Wood fire .lace/insert - 10.00
Il ` " r t h � � Clilmne /liner /flue/vent 10.00
r d,r ir'. :z x trt� >. ' ltil ,t:r'?d xir<ti w,..r,. +r.�.� g- 111N"!'I•V�. 17} } �,. z:
t......,at. -. .m �.... „, Outer: 10.00
Name: U ' / t 4 e t ;'t4 Environmental exhaust and ventilation Address: 3 E,-, 7 l Range hood/other kitchen
l 7t .J7� equipment 10.00
City /State /ZIP: lr CIg c Z,3 Clothes dryer exhaust 10.00
( ) S 7 - F ax : Single -duct exhaust (bathrooms,
Rhone
S i 6 CO ( ) toilet compartments, utility rooms) 6.80
� �, t = }} L r .t ; _ 37'TT.'""Y `'. , ' dfi'^---"t' �.? x r
. 1 451r 4, Fir'4 of ciii1; .. 11.5. t,4,4 .1fhli�.jry �1 m't ri a3 �'. t'illt Attic /crawlspace fans 10 00
Business name: . - is. '/ elicrx/x rr7C. Other 10.00
Fuel plplmmft
Contact name: , '/� S fi S5.40 for first four; $1.00 for each additiona
Address: P 0 6 . Furnace, etc.
-y� _ s- �p Q ` Gas heat pump
City/State/ZIP:
Gt!, •!h / D t't / 7�F3 Wall/suspended/unit heater -
Phone; 3) 69._939 I Fax; :( )6,1-..73At, Water heater
Fireplace
E-mail; S
n1:4s r / d OYv1 S Ce177' n Range j /
r t- t r e k F>Y �? 0 e % c Ct a ist.,7 A t i� t a< -t i' c F1 , 1
U� :L mti 7 x. tr-tTayl�blt•t� }ti.r .-2!.:, t<iIi 4y,1*�'. ! {-i3` Barbecue /
Clothes dryer (gas) 1
♦ /.._ . ‘ t • .S • / l_:.• . G. -
Address: 14 if-ea 6 / p
'' Other
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City/State/ZIP: LPL fh 9706-2-) ^ - __.. .,. xt - s. a r i. :.;
q, `
� ,/ /2 Z I Minimum permit fee ($72.50) "7 5 r
Phone: 003) 4� 3/9 Fax: 52 3 )67 a3a�` -
CCB lie.; 8 76,5- �.- � Plan review (25% of permit fee)
r State surcharge (8% of permit fee) , Fr_..;:
PERMIT FEE ( 2 J
Authorized signature, d This permit applicati expires If a permit is not obteleed within Ise
days after it has been occaprad as complete.
Print name: / . ii ;.—... Date: '2_ - 2., — G 7 - Fee rnethodology set by Tri- County Building Industry Service Board
\BuiIdieg■erminlMEC -Par ■ App.doc 12/03
440-40171 (I I /02/COMM'$g)
CITY OF TIGARD - • ,,
BUILDING DIVISION
.A. PERMIT #: MEC2007-00741
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2007
Phone: (503) 639-4171 ,.-aillti'\ MCC ,C 0 7 -- 0 0 7 W
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/31/2007 TIME: 7 PAGE: 31
SITE ADDRESS: 12996 SW 133RD AVE CLASS OF WORK:
SUBDIVISION: HANDY ACRFS LOT #: 034 TYPE OF USE:
PROJECT NAME: WEI N ANDY
DESCRIPTION: Gas piping to dryer, cooktop, bbq, and woodstove. Future use.
OWNER: WEINANDY, MIKE PHONE #: 603-679-8660
CONTRACTOR: RAYBORN'S PLUMBING PHONE #: 503-6914139
Inspection Request Scheduled For: Date: 12/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
i .. . 0 062341-01 603-6914'139 N
C. 1 9, 'i . 7 - 2( -- "T
Corrections/CommentY Instructions:
V 4/
ls
JLD
V- 0
V ‘).
X PASS EI PARTIAL APPROVAL 11 CANCEL fl NO ACCESS
I I FAIL 1 CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
Inspector: CTO \41-4,..A \ k\ vs. Date: 1 i to") Phone #: (503) 718-