Permit CITY OF TIGARD
I
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00465
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/12/2008
PARCEL: 2S 115AD -05100
SITE ADDRESS: 10763 SW RIVER DR ZONING: R-4.5
SUBDIVISION: DOVER LANDING LOT: 034 JURISDICTION: TIG
PROJECT: TRAUTMAN
Project Description: Replacing gas furnace and vent.
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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 0
Owner: FEES
MIKE TRAUTMAN Description Date Amount
10763 SW RIVER RD
TIGARD, OR 97223 [MECH] Permit Fee 91121200E $72.50
[TAX] 12% State Surch 9/12/200E $8.70
Total $81.20
Phone: 503 -535 -2665
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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: _ ∎� ,/
Cal 5 . 9.4175 by 7:00 a.m. for inspections that busine . ay.
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.
SEP -12 -2008 FRI 03:18 PM ROTiei ''' I 1/ E , FAX NO. 5032663478 P. 02
Mechanical Permit Application hoR OFFICE USE ONLY
S 1 2 2 0 0 18 Received , �,� .�. ' — .S
City of Tigard Dates ; _
4 13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.596.l% OF TIGAR II Date/By: Other Permit:
Inspection Line: 503.639.4t 75 BUILDING DIWSI see Page 2 for
Internet: www.tisard - I 9 � S0,1 Su pplemental Inrormadon •
...., ; `1 ' ,: TYPt. OF WORK' .'• :.. >': '' . COMMERCIAL:FEE! : SCHEDULE := :. USE CHECKLIST
❑ New construction ® Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
:. CATEGORY OF .CONSTR[IC ION•„ . Value: $
1 -and 2-family dwelling . RESIDENTIAL EQUIPMENT' l SYSTI: s.F.EES` ; `
IN 1- g ❑ Commercial/industrial ❑ Ac cessory building
For special information use checklist,
M ulti -famil
❑ Multi-family Q Master builder ❑ Other. Description ] Qty. I 'ku I Total
.: ' JOB SITE #NFORMATION :ANT) LOCATION Heating/cooling
Job site address: I O '' p p ,,.� Air conditioning or heat pump
1 r c � �"7 SW 9,\ V Z .r �� • (requires sire plan showing piecemeal) 14.00
City /State/ZIP: "1 and i 0e_ 11 '4' Furnace 100,000 BTU (ducts/vents) I 14.00 14, DO
Suite/bldg. /apt, no.: Project name: — - Furnace 100,000+ BTU (ducts/vents) 17.90
��?.(,L�(��7�q// 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
Subdivision: I Lot no.: Flue/vent for any of above I 6.80 In 40 .
. Other, 10.00
Tax map /parcel no.: • Other fuel appliances
DESCRIPTION • OF .WORK Water heater 10.00
r, , NAM n 1n A / Gas fireplace 10.00
1A S � L UA.X 1, L NAl�U 1 o . (A„+ Flue vent for water heater or gas
U fireplace 10.00
Log lighter (gas) 10.00
_ Wood/pellet stove 10.00
Wood fireplace/insert 10.00
.�?PROPERT'Y :OWNER; ... . ' : • I • • . : . . ' . : . " . . ' D. TENANTr '
Chimney/liner /flue/vent 10.00
Other: 10.00
Name: 1,,/1 y.. 11 6k,uc 7Y\ CU+e") Environmental exhaust and ventilation
i
( Range hood/other kitchen
Address: /�
6.m (in �, r4 \� equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
NCO 5 s ' Z � S toilet
Single-duct exhaust (bathrooms,
Phone: ) u Fax: ( ) toilet compartrt ments, utility rooms) 6.80
. ce fans
.. , ` ' r - .. ... ' []E PER :,„ Attic/c rawlspa _
Other: 10.00
Business name: "^
Fuel piping
Contact name: 1 $5.40 for first four; $1.00 for each additional
Address: Furnace. etc.
Gas heat pump
City /StatelZfP: WalVsuspended/unit heater ,
. V
Phone: ( ) I Fax :: ( ) Water heater
Fireplace
E -mail: Range
.
:. , ' . :
.:. .. ,':L • : .' :: :: ..., ..., .::.' .. CONTRACTOR . • •; :.. :: :.. : ". .... Barblcttc
J a Clothes dryer (gas)
Business name: X i Other:
Address : .. -. .•MECRANICAL PERMIT FEE.S�! . . ' ... •
s
City/State/ZIP: ( C i (I 13 Subtotal 1p. )
VD
Phone: (W3 ) 2,..k L(' Fax: 60> ) D, Lip, 4 —)c? Minimum permit fee ($72.50) 72.
Plan review (25% of permit fee)
CC6lie.: \ lip 8 State surcharge (12% of permit fcc) Y.14)
A `.,,p/ry1 '— �/�t f LJClt y� p TOTAL PERMIT FEE 'J.? Q
Authorized signature: \ W .1•c/Ilit . 'IIsis permit application expire, if a permit is nut obtained within 180
J JJJ� ! days after it ha* been accepted as complete
Print name: 1_Jr�lr Dat e: ((Z 1 Q • Fen methodology set by Tri- County Building Irulualry Service Board
r -1
I: tBuildina \ParrnitsW6C- PcmuIAi>n.anc cl /lulu) 440.4617r(II /O2 /COMAVEB)
y
CITY OF TIGARD ,
BUILDING DIVISION PERMIT # MEC2008•00165
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2000
Phone: (503) 639 -4171 Via. • ati
Inspection Requests (24 Hrs.): (503) 639 -4175 �'II�..
INSPECTION WORKSHEET FOR DATE: 1011/2008 TIME: 7:02AM PAGE 36
SITE ADDRESS: 10763 SW RIVER DR CLASS OF WORK:
SUBDIVISION: DOVER LANDING LOT #: 0 TYPE OF USE:
PROJECT NAME: 1 RAUTMAI+E
DESCRIPTION: Replacing gas furnace and vent.
OWNER: TRAUTMAN, MIKE PHONE # : 503 - 535 -2665
CONTRACTOR: ROTH HEATING & COOLING PHONE # : 503-266-1249
Inspection Request Scheduled For: Date: 10/1/20013 Pour Time:
Code # Inspection Description Confirm # Contact # Message ?M
699 Mechanical final 076/25-01 503.266 -1249 V
Corrections /Comments/ Instructions:
C-a. (L- se— _ \
/PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 2S Date: /OCi"6 6 Phone #: (503) 718- .?�..?3