Permit •i
C ITY O.F TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT " PERMIT #: MEC2008 -00568
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/18/2008
PARCEL: 1S134BD-08200
SITE ADDRESS: 11618 SW PENN CT ZONING: R-4.5
SUBDIVISION: PENN LAWN ESTATES LOT: 010 JURISDICTION: TIG
PROJECT: WELL
Project Description: Replacing gas furnace, gas piping and venting for tankless water heater.
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: 1
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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
KUHLMAN, ROSE L Description Date Amount
11618 SW PENN CT
TIGARD, OR 97223 [MECH] Permit Fee 11118/20( $72.50
[TAX] 12% State Surch 11/18/20( $8.70
Phone: Total $81.20
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 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: .! 4 01011111iMPI r Permittee Signature:_[ "5/a*
Call 39.4175 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.
il. .
Mechanical Permit Application NN E CEN . - FOR OFFICE USL OM.Y
City of Tigard Da e i"ed f / 1FM Permit No.: M ke
• 13125 SW Hall Blvd., Tigard, OR 97223 8 zo n ew Other Permit: I
s Phone: 503.639,4171 Fax: 503.595.1960 NO \,1 1
TIGARL) Inspection Line: 503.539.4175 Dale Ready/By: hair 65 Sec Page 2 for I
Internet: www.tigardor.gov CITY pgTIGARD Natified/Method: jj I Supplemental Informat j L.I
�IILDIN`r1 DNIS10A1
TYPE OF W I 'COMIERCIAL,FEE SCHEDULE - USE CHECKS[ 1
Mechanical permit fees• are based on the va:ue of the work {+
Q New construction ❑ Additiom'alteration/replacement performed. Indicate the value (rounded to the nearest dollar; cf all
❑ Demolition 0 Other: mechanical materials, equipment. labor, overhead, and profit. .
• CA73CORY OF CONSTRUCTION Value: $
..:,RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
CI 1- and 2-family dwelling ❑ Commercial/industrial 12 _
Accessory building For special information use checklist
❑ Multi- family 0 Master builder ❑Other Description I Qty. I E a. 1 Mini `:
i
•
JOB SITE INFORMATION D LOCATION Heating/cooling
/ l �_/ nn / Air conditioning or heat pump 4 I ■
ob site address: ` g / C:,jd ( (requires site plan showing placement) 14.30 1
City /StatetZlP: / Furnace 100,000 BTU (ducts/vents) • / 14.00 11 /� •
Furnace 100,000+ BTU (duc:s/vents) I7.9r.i
Suite/bldg./apt. no.: I Project name: ej( Gas heat pump 14.00 ...
Cross street/directions to job site 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, in -duct, suspended, etc. I 10.00 .
Flue/vent for any of above I 0.'30
Subdivision: I Lot no.: -
• Other: I I :O.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00 1
Gas fireplace 10.00 I
�°
/J 1p.-.e•-_ �i G 4 & L
,v'-' 7.14,,r-_, Flue vent for water heater or gas , AA
/ I J ,y, fireplace 10.00
7 �.0 / !i ./, i // / C.. C "`.71._/2/ Log lighter (gas) 10 00 , i
h-e :"1 J Wood/pellet stove 10.00 I
Wood fireplace/insert 1 10.00 •
�/ Chimney /linerlfluelvent 10. 10.070 y
I��ROPEATY OliNER 1 ❑TENANT other. 10 - i
Name: / / 1 Lt 2 // Environmental exhaust and ventilation _.__
Range hood/other kitchen I I
Address: equipment • I 10.o0 :
• City/State/ZIP:
Clothes dryer exhaust 10 -
Single-duct exhaust (bathrooms,
Pbone: (5j •1 _5' a 1,f 7 p 6, _ Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑CONTACT PERSON Attic/crawlspace fans 10 co lO.GU �
Other:
Business name: Fuel piping
Contact namef , 'DR r b }/ S5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: ; G heat pump
City /State2IP: Wall/suspended/unit heater I
II'' '1 Water beater i �
Phone: c6,3 ) 1 / D F ax:: ( ) S i- Q (� ' Fireplace
E- mail.: Range I i
1 •
CONTRACTOR Barbecue i
yR 1
(� 1 I. U'7 hi 0., N.t C.JI (',p'(7l / v Clothes dryer (gas) ` •
i i
i.
Business name: Other
Address: g )3 o X .23 0 3, 7 MECHANICAL PERMIT FEES* i
City /StaterZIP: / ' < if i el n ei72..v/ Subtotal II ‘,� '
Minimum permit fix ($72.50)
Phone: (J e 4 3 `l -.* 7 il Fax: (9 ) ,'V? -0:=-70 _ Plan review (25% of pemtit fee)
CCB lie.: 07 k 3 -r -- 9 i State surcharge (12% of permit fee) � __
S J TOTAL PERMIT FEE t)
This permit application expires if a permit is not obtained within I BO
Authorized signature: days after it has been accepted as complete.
I Print name: ) .agialy Date. /7 /fi/6 } mm` • Fee methodology set by Tri- County Building Industry S4N.CC 110410
Z'd OLZ0 869 DNI1b'3H VISWf lOO 8 1.9 :80 80 81. AoN
CITY OF TIGARD
BUILbING DIVISION PERMIT #: MEC2008 -00568
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/18/2008
Phone: (503) 639 -4171 zz.
Inspection Requests (24 Hrs.): (503) 639- 4175il�
INSPECTION WORKSHEET FOR DATE: 11/26/2008 TIME: 7 :00AM PAGE: 37
SITE ADDRESS: 11618 SW PENN CT CLASS OF WORK:
SUBDIVISION: PENN LAWN ESTATES LOT #: 010 TYPE OF USE:
PROJECT NAME: WELL
DESCRIPTION: Replacing gas furnace, gas piping and venting for tankless water heater.
OWNER: KUHLMAN, ROSE L, PHONE #:
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503624 -2704
Inspection Request Scheduled For: Date: 11/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Egg Mechanical final 078528 -01 503524 -2062 Y
Corrections /Comments /Instructions: y/ �
/ �/ • .t ' .S Y 6 t �— `' Z S� ✓ - drs: . . _
ii/V- -"As.} -tom
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
El FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: // Phone #: (503) 718 - <0
E'
r,,-.-
CITY OF TIGARD
BUi,LbING DIVISION PERMIT #: MEG2000-00568
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1812006
Phone: (503) 639 -4171 �u gl l�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/21/2008 TIME: 7:00AM PAGE: 30
SITE ADDRESS: 11618 SW PENN CT CLASS OF WORK:
SUBDIVISION: PENN LAWN ESTATES LOT #: 010 TYPE OF USE:
PROJECT NAME: WELL
DESCRIPTION: Replacing gas furnace, gas piping and venting for tanldess water heater.
OWNER: PHONE #:
KUHLMAN, ROSE L,
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-6242704
Inspection Request Scheduled For: Date: 11/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 076357 -01 503 - 5242062 Y
Corrections /Comments /Instructions:
( ,, -. , �.�. '/ �... K e ,-zz t. r1 _ � ,�_,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: //- 1 — is Phone #: (503) 718- 74- 4-�J