Permit r CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00512
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/27/2007
PARCEL: 2S114AD -00800
SITE ADDRESS: 08967 SW WAVERLY DR ZONING: R -
SUBDIVISION: WAVERLY ESTATES LOT: 007 JURISDICTION: TIG
PROJECT: ERVIN
Project Description: Install gas furnace.
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:
REPAIR
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
BILL ERVIN Description Date Amount
8967 SW WAVERLY DR
TIGARD, OR 97224 [MECH] Permit Fee 8/27/200i $72.50
[TAX] 8% State Surchar€ 8/27/200"; $5.80
Total $78.30
Phone: 503 620 - 6983 •
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 �s
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 OU NC by
calling 503 246 6699 or 1.800.332 2344
Issued�y: - I /� , Permittee Signa ure:
Call 503.639.4175 by 7:00 a.m. for inspections th usiness 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.
Med iiERInical Permit A lication FoR (..)111cF. Is F. ON IA'
--- 4
City of
13125 SW Hall gar Blvd , Tigard, OR - r r r - --,-rw, - , Received e
DniclOr, / alto 7 PerrnIt No.: Ed ,.. , a „, 7 57
97223 clil -,-, ‘ %., --.
Plan Review
Phone: 503.639,4171 Fax: 503.598.1960 :,; t.t ' Other Permit
A. ilt Dote/lay:
Inspection Line: 503.639.4175 4 .1.14,.."411
Duke Iteadyflay, I/3 Sea Page 2 for
Internet: www.ei.tigard.or us4 / (--i(to?-74,1 Notified/Method. ill an Supplemental information
I OpeikilD ,
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1 , .. ,, : i:. ;;j1.. ! , . .:: ..:!::.:. :: ,.., 4 . 4 „,-,,ralt . ..... .. , : ," 2 , , , .: ,. ,!, r ____,.... • ,.... . : ,, commER . GIAL . ?YEE *.'-scnouix..:-
fl New construction Addition/alteration/replacer' miff AVM r... ii Mechanical Fermi l fee b
s* are the e value of th work
performed Indicate the value (rounded to the nearest e clullur) of all
17I Demolition 0 Other. 4 g Z I I/07 mechanical materials, equipment, labor, overhead, and pmlit.
;. '''''•1.';:;;:!■,;'::,-5,..,'1,:i..";;:!:..1'. '.10.NTEOORY..t0P.0C_EINST4ECTP,DIN; .:' i.:; ■,:il ".. . , Value: $
,. : ;`
I - and 2-family dwelling 12 COmmurcial/industrial CI Accisory building
g
Description For special information use checklist,
Multi-family D Master builder 0 Other:
LQty. I Ea. I Total
30-11 `gr#,::INFO*4 AND JuOt* ; j;:` ;:: :' '1; ' ;'-;'), , ;!;: :, ileatin: coolin.
Job site address; ri 6 7 5 W) u30, i n,,i ,
ve_hia) Air conditioning or hea pump
rc.uircs 50.0 . kin ShOW iii . hiCrill eft( 14,00
City/Slate/ZIP: '- r - rOtal.1441 eIK 9 - 7 2_ 2_ Furnace 100.000 BTU (ducts/vents i 14 00 111-0
Furnace 100,0004- 1371.1 (ducts/veats) 17.90
Suite/bldgJapt. no.: Project name:
Gas heat pump 14.00
Cross StreCtidireGilOtiS to job site: Duet work 14.00
Hydronie hot water system 14.00
Residential boiler (radiator or
hvdrouic) 14.00
Unit beaters (fuel-type, not electric),
in-wall. in-duct, suspenderl. etc. 10.00
Flue/vent for any of above 1(1.00
Subdivision: Lot no.:
Other. 10.00
Tax map/parcel no.: Other fuel appliances
.' •
I A'; 4 k:' :: , :u7.4.1':13.0sciurAtiN:;(*.iwoilx....,!.! '.f L ". 0 .1;' : ;' I''.'' '''':'1,...;::',• ;17: ':1 Water heater 10.00
Gas fireplace 10.00
6 4$ FvENtoi c_ e IN Tii 4— Flue vent for water heater or gas
fireplace 10,00
Log lighterigas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10,00
I (ion ChimncYllinerMucjvcriI
• ', ' Other 10.00
Name: A; 1 ( E72-Viri Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10,00
City/State/ZIP: t._) Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: SC53 ) '2.0 — 1 Fax: ( )
,c;i
toilet compmtments, utility rooms) 6 80
Ms;'0'..1; 1:1"*E1/17Agri:#103e.07tt,',V,fR:Ilti Attic/crawlspace farts 10.00
Other 10,00
Business name;
— Fuel piping
Contact name: 55.40 for first four; $1.00 for each additional
Address: • Furnace. etc,
Gas heatpump
City/State/ZIP: Wall/suspended/unit heater
.11
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail:
Range
.1'1• ' ''''''''''''''''''' ' ' "'''''''''''''''''''' ‘.11i; . '' . ..Y''. '''.. '4+ Barbecue
Business name: C,1
Pq';'4.K:-.4'.-.1.',c;i.4'..:'! "1 .. 7 s „ • t... !. . ,....., . , „„ ,. , , „. ,,, „,..„ .. . . , .. Clothes diyer (rds)
/7 rti_
1 '
Address: pb 1 8 - 4 ._. / 210 _5 , :.. 1 ...:; i ,.. , , .:mEclikciAimprOttritii0:':
City/State/ZIP: ett,Vi ,,y /3 C 3 ZO/ 3 Subtotal 1E4,00
—
Phone; (50 itp(0 ..-4 241
Fil (5g5) a6z.,---
....3/(-", ... Minimum permit fee ($72.50) 72 - 5 ep
Plan review (25% of permit fee)
CCB lie.: / Zit COd/ State surcharge (8% of permit fee) 4. g 0
r, TOTAL PERMIT FEE 1 g ,
Authorized signature'/' 0
This permit application cxpiri if a permit is riot obtained within 180
e; .a11/4
Print name; t s at ‘ 6,1 rYLO'l—
i
Date: f 4.9 /0-- Fee method days after It hal been neceptcd as complete.
* methodology act by TH-County Building ladustry Service Board
i:maiidoig\reneintoe.ronmAp 12/03 4 (11/02/COM/WPS)
0 'd 8LVE99e£09 'ON XVJ ONIIVEH HION Wd 9i2I INd LOOz-V-ofl v
CITY OF TIGARD
MEC2007 -00512
'BUILDING ®IVISION PERMIT #: 8/27/2007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 AA,
Inspection Requests (24 Hrs.): (503) 639 -4175
8/30/2007 7:00AM 17
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
08967 SW WAVERLY DR
SITE ADDRESS: WAVERLY ESTATES 007 CLASS OF WORK:
SUBDIVISION: ERVIN - LOT #: TYPE OF USE: '
PROJECT NAME: install gas furnace,
DESCRIPTION:
ERVIN, BILL • 503-620-6983
OWNER: ROTH HEATING & COOLING PHONE #: 503- 266 -1249
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 8/30!2007 Pour Time: •
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 054902 -01 503- 266.1249 Y
•
Corrections /Comments /Instructions:
/ .mod 1/ 4.-1 ndAX- - 1.1 1- 5 - /3g 96 L/t 'ljW�' r T
•
•
r ,
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:. 4./ Date: g 30 — d 7 Phone #: (503) 718- '_'4`4/