Permit r �
a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00538
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/31/2008
PARCEL: 2 S 103AA -01901
SITE ADDRESS: 10585 SW WALNUT ST ZONING: R-4.5
SUBDIVISION: COTTONWOOD PLACE LOT: 004 JURISDICTION: TIG
PROJECT: HELMER
Project Description: Replace gas furnace and repair gas line.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
GARRY HELMER Description Date Amount
10585 SW WALNUT
TIGARD, OR 97223 [MECH] Permit Fee 10/31/20C $72.50
[TAX] 12% State Surch 10/31/20C $8.70
Phone:
Total $81.20
Contractor:
WILLAMETTE HVAC SERVICE
3075 SW 234TH AVE. #206
HILLSBORO, OR 97123 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 628 -6841
FAX 503- 848 -2597
Reg #: LIC 56951
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: i / � �f Permiftee Signature: r 0 -63 L i e Ci'77\
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.
e Me l aanical Permit Aara o
Ecb 4t® FOR OFFICE USE ONLY
T r,.
City of Tigard OC 1 ' ) Received / �/ Permit No G I �/
•J g Date/By: f 0 3 O d HTiC� O "15 q
13125 SW Hall Blvd., Ti ard, OR 97 2 H
Phone: 503639.4171 Fax: Plan Review
g
C one: NM. �I!!t p
'tl a (��V Date/By. Other Permit:
TI G A RD Inspection Line: 503.639.417 not* OW MI Date Ready/By: MI ® See Page 2 for
Internet: www.ligard or.goJgth„ l Notified/Method: Supplemental Information
TYPE 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 CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi-family ❑ Master builder 0 Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
' Air conditioning or heat pump
Job site address: 10585 SW / rr Ave � � v r1 t —y , lu �
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97223 `' Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg./apt. no.: Project name: Gary Helmer Furnace 100,000+ BTU ( ducts/vents) I 17.90
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: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Replace 5 ton 70% gas furnance with 90% 5ton furnace • //era / r' 4 S / Flue vent for water heater or gas
a 4.5 f l 10.00
4.C.<-7%. Un (� � / P i /10 Log lighter (gas) 10.00 Log Wood /pellet stove 10.00
Wood fireplace /insert 10.00
� PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
' Other: 10.00
Name: G �./ 4 /� e Environmental exhaust and ventilation
c / / CO -} Range hood /other kitchen
Address:
!0 , S 3 ` �06 t (A ye equipment 10.00
City /State /ZIP: �`, a i' , 9 7 a, ' Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 4 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc. 1
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: 1 ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: Willamette HVAC Clothes dryer (gas)
Other:
Address: 3075 SW 234 Ave Ste 206 MECHANICAL PERMIT FEES*
City /State /ZIP: Hillsboro, OR 97123 Subtotal
Phone: (503) 628.6841 Fax: (503) 848.2597 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 56951 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: � ���� -- / v1 This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Michael Malstrom Date: 10/29/08 • Fee methodology set by Tri- County Building Industry Service Board
1:\Buildineermit$MEC- PermitApp.doc 01/19/07 440 -46t7T (I I /02/COM/WEB)
CITY. OF TIGARD ,
BUILDING DIVISION PERMIT #: MFC2008.00538
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/31/2008
Phone: (503) 639 -4171 Vi i
Inspection Requests (24 Hrs.): (503) 639 -4175 -- I !
INSPECTION WORKSHEET FOR DATE: 11/512008 TIME: 7:01AM PAGE: 16
SITE ADDRESS: 10585 SW WALNUT ST CLASS OF WORK: 1
SUBDIVISION: COTTONWOOD PLACE LOT #: gm TYPE OF USE:
PROJECT NAME: HELMER
DESCRIPTION: Replace gas furnace and repair gas line.
OWNER: HELMER, GARRY PHONE #:
CONTRACTOR: WII..LAME.TTE HVAC SERVICE PHONE #: 503.628 -681 I
Inspection Request Scheduled For: Date: 11/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 077674 -01 503-422-1991 Y
Corrections /Comments /Instructions:
KI PARTIAL APPROVAL III CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • s Date: //_ ¢•—c & Phone #: (503) 718- 5 ---