Permit C ITY OF TIGARD MECHANICAL PERMIT
1� DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00726
f�l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/31/2005
PARCEL: 2S103AC -05100
SITE ADDRESS: 12775 SW 113TH PL ZONING: R - 4.5
SUBDIVISION: HUMBOLT CREEK ESTATES LOT: 002 JURISDICTION: TIG
Project Description: Gas line to range.
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:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
RICHARD WINGEIER Description Date Amount
12775 SW 113TH PL • [MECH] Permit Fee 10/31/20C $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 10/31/20( $5.80
Phone: 503- 639 -2241 Total $78.30
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Phone: 503 -650 -9550
Reg #: LIC 120277
Th is 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:
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.
?6/2005 20:35 FAX 5036501220 KOEHLER CONCEPTS 001/002
Mechanical Permit Ap.plicatiolD -
C i t y of Tigard , k L - P ° D a t e / S y 1 023]/DC P J Permit No.: & 0 ' , C I O 5 - 0 7 4 co
13125 SW HMI Blvd., Tigard, OR 97223 Plan Review
Phone: 503,639,4171 Fax: 503.598,160 9 1 205 /i cr , +,�,� I r�; J � Dote/Hy Other Permit:
Inspection Line: 503.639,4175 �`, 5 •i I Dole Randy /By: -WIC - ® Soo Page 2 far
Internet' www.ei.tigard.or.us D Notified/Method: Supplementallnformadon
l^11Y OF TIGA� nN ye
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Mechanical permit fees* arc based on the value of the work
❑ New construction ®Addition /alteration /rcplaCement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ Other: mechanical materials. equipment, labor, overhead. andprufit
i „ {,r r ,,,,��,, , , , - '; �.;� ",��'.� i , Y { ,� u, 'Value' $
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,� r
® 1- and 2- family dwelling 17 Comtnercial/industrial 12 Accessory building ".,,( ' "� II � Eg � '
For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea, 1 Total
. . _' , .) .r , JOaIgriiG 'INFORMTTM4Nl:0OL''kA,1* Vd' I ".,'i ,!': ii;,,:i • •1 ,i1 , , i {' Heating/coaling
Job site address: 12775 SW 113" PLACE Air conditioning or heat pump
(requires site plan showing placement) 14,00
City/State/ZIP: TIGARD OR 97223 Furnace 100,000 BTU (ductn/vnnt,) , 14.00
Furnace 100,000+ BTU (ducts/vents) 17 90
Suitc/bldg /apt, no.: Project name: WINGEIER -
Oas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00 .
Residential boiler (radiator or
hydroni . 14.00
Unit heaters (fuel -type, not electric).
' in -wall. in -duct, suspended. etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
.. Other; 10,00
Tax map /parcel no.: Other fuel appliances _ _
,, ... nE s t� Oo " I r' ,e,,t
,;;j , „ i ,;, ; °6;•111„ , Water heater 10.00
'� °„ ` r';" .it:. �;i''f r � i 1��i�'� , �� "�; "'� .,� a l „. a .i':.':.!!1:;:.
RUNNING APPROx 10 FEET OF GAS FUEL PIPING TO RANGE LOCATION Gas fireplace 10.00
Flue vent for water heater or gps
fireplace 10.00 _
-. Log Iightcr�os) 10.00
Wood /pellet stove 10.00
Wood frreplace/insert _ ,. 10.00 •
1i ( , ,;b „ ,,, i, : , "' '., ,0,,,1 • w . ;ci'r'i Chimney/liner /flue/vent 10.00
ins ; 1': I ,, . t.7, , :.".., i •, ; 1„ ■1
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Other: _ 10,00
Name: RICHARD WINGEIER Environmental exhaust and ventilation
Tll • Range hood /other kitchen
Address: 12775 SW 113 equipment 10.00
City /State/ZiP: TIGARD OR 97223 _Clothes dryer exhaust , 10.00
Single -duct exhaust (bathrooms,
Phone: (503)639 -2241 Fax: ( ) toilet compartments, utility rooms) 6.60
+;' ' C3' ' ;e' "'' �,'I, . ace fans 10,00 Ani c/crawls
t, ^i i'■i;i'I+IjCpki' "t �, °i , „i!IIi iii° 'i # P
Business name: KOEHLER CONCEPTS LLC Other; 10.00
_Fuel piping ,
Contact name: TODD $5,40 for first four: $1.00 ror each additional
Address; 10772 SE HIGHWAY 212 Furnace, etc. - _
Gas heat pump
City /State/ZIP: CLACKAMAS OR 97015 - Wail/suspended/unit heater
Phone; (503) 650-9550 , Fax :: (503) 650 -1220 Water healer
Fireplace
E -mail: TODD®.KOEHLERCONCEPTS.COM Range I s A0 -'-b
,; '1:' `;,,.i :''l': , ; ;, , r ,, . ; :r,, ,, :,i, ; , ,'t'' ; ','!;,b,61 rvP,r' 1 ;';,i,,; Barbecue
Business name: KOEHLER CONCEPTS LLC Clothes dryer (gas)
Other.
Address: 10772 SE HIGHWAY 212 ' " " ' ; 'I';� i,'�!rpi ,e0«; °.;i ;11, !'
IiP: ' ' 4 6iv „t1
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City /Stite/ZIP: CLACKAMAS OR 97015 Subtotal 5 4-0
Minimum permit fee (172.50) 7 L_ `50
Phone: (503) 650-9550 Fax: (503) 650 -1220
Plan review (25% of permit fee) ko
CCB lic.: 120277 • State surcharge (8% of permit fee) 5. $b
TOTAL PERMIT FEE 7
signature: This permit eppIIcatton expires if a penult Is not obtained within 160
Authorized si
g T�� days after It has been accepted am complete,
I Print name: TODD KOEHLER I Date: 10 -26 -2005 • Pee methodology sat by Tri- County Building Industry Service Oourd
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CITI('OF TIGARD 6����� - 05--Its- ' � J � _ ��
BUILDING DIVISION PERMIT #: MEC2005-00726
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/31/2005
Phone: (503) 639 -4171 /v�4pmlpigl� i
Inspection Requests (24 Hrs.): (503) 639 -4175 ... I
INSPECTION WORKSHEET FOR DATE: 11/3/2005 TIME: 7:06AM PAGE: 62
SITE ADDRESS: 12775 SW 113TH PL CLASS OF WORK:
SUBDIVISION: HUMBOLT CREEK ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: 1MNGEIER
DESCRIPTION: cCas line 94afits. .0_ may/ ,, zri
OWNER: WINGEIER, RICHARD PHONE #: 503-639-2241
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503- 650.8550
•
Inspection Request Scheduled For: Date: 11/3/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 020204 -01 503 - 6392241 N
Corrections /Comments /Instructions:
K PASS I 1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAI ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4111 .
I
Inspector:. Date: `/ 0 Phone #: (503) 718-
w� � �w -� DDl1
.CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00726
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/31/2005
Phone: (503) 639 -4171 , my
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/1/2006 TIME: 7:06AM PAGE: 71
SITE ADDRESS: 12776 SW 113TH PL CLASS OF WORK:
SUBDIVISION: HUMBOLT CREEK ESTATES LOT #: 002 TYPE OF USE:
PROJECT NAME: WINGEIER
DESCRIPTION: Gas line to range.
OWNER: WNGEIER, RICHARD PHONE #: 503
CONTRACTOR: KOEFILER CONCEPTS LLC PHONE #: 503.650 -9550
Inspection Request Scheduled For: Date: 11/1/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 019978 -01 503- 630 -2241 N
Corrections /Comments /Instructions:
_1t 774
PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 2kkt/A Date: / � / Phone #: (503) 718-