Permit IP1 4 CITY OF TIGARD
'r ° MECHANICAL PERMIT
C O MMUNITY DEVELOPMENT PERMIT #: MEC2008 -00570
TIG DATE ISSUED: 11/19/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639A171 PARCEL: 1S134CB-10200
SITE ADDRESS: 12454 SW EDGEWATER CT ZONING: R-4.5
SUBDIVISION: MILLVIEW LOT: 002 JURISDICTION: TIG
PROJECT: VARNUM
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:
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:
Owner: FEES
STEVE VARNUM Description Date Amount
12454 SW EDGEWATER CT
TIGARD, OR 97223 [MECH] Permit Fee 11/19/20( $72.50
[TAX] 12% State Surchai 11/19/20( $8.70
Total $81.20
Phone: 503- 277 -8094
Contractor:
COLUMBIA NW HEATING INC
PO BOX 622
SCAPPOOSE, OR 97056 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -543 -3624
FAX 503 -543 -6285
Reg #: LIC 61947
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
/
Issued :y: 4. %f / L Permittee Sig a liil��J1i `
Call 503.639.4175 by 7:00 a.m. for inspections that , ine - day.
This permit card shall be kept in a conspicuous place on the job e until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Mt.f: t10 }3 00578
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/19/200»3
Phone: (503) 639 -4171 Vfilifl
Inspection Requests (24 Hrs.): (503) 639 -4175 -_ -_
INSPECTION WORKSHEET FOR DATE: 12/9/M08 TIME: 7:02AM PAGE: 26
SITE ADDRESS: 12454 SW EDGfWATER CT CLASS OF WORK:
SUBDIVISION: MII.LVIEW LOT #: ()02 TYPE OF USE:
PROJECT NAME: VARNUM
DESCRIPTION: I nsfaii gas furnace.
OWNER: VARNUM, STEVE PHONE #: 60 3. j77- 0o9•1
CONTRACTOR: COLUMBIA NW HEATING INC PHONE #: 503-543-3624
Inspection Request Scheduled For: Date: 12/9/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 078806-01 503 - 54:3 -3624 ¥ ‘
Corrections /Comments /Instructions: i l
e -
, li, ...?
I f , ice" „ wily
� !
1.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
1 FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4
L nspector: " Date: Phone #: (503) 718- ��
Mechanical Permit Application I C S C 1 i t 4144.4";14",a4.1::!. PY .;;infll
Pl: 0 d. I �r ` ftr,,V0,74 4 f 'w�l'£ •=1 Vti ,i q� '�' P. rraT 'ra' Y +'f �' � ,M ri.y a' y,
,� re lt " 01 = I I )' li�l z0 1 l r ; d .f.', r 5 '� ' .k..:. �;
J� '' 4S$4 ,'Su -t " � 4ATA::�'L 41 �!Mw._ .;i:.t e.V.rt . r. :. , :4 a $ 1� . a ,r . ?S Ai
l i,, V.' Cit of Ti NO V . • 2 ived /I a 4g Perm No.: N 1 �� (1.- (26 ?
r 11 6r1 e/B , t�
N„ ` ° 13125 SW Hall Blvd., Tigard, OR 97223 / 9 Plan Review
r 9 ;.* Phone: 503.639.4171 Fax: 503.598.1960 C' �> � � �, � , y . Other Permit:
•r I G A R D Inspection Line: 503.639 p p � ea. /g f rier - ® See Page 2 for
"cHr'�•) •w#r Internet: www.tigard- or.gov PLA' F -G/ GIN, tE - •, t _ ,, A ; � _ t : �/ Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
•
I=1 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*
21- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
El ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /dt/ 5L/ so) f Q6(,�A•7 ' Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: 'T2& a qz,v3 Furnace 100,000 BTU (ducts/vents) / 14.00 i ti.co
f Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: 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
• n c- GAS /' n S Arf � Flue DESCRIPTION OF WORK . . Water heater 10.00
� S7/ V F � Gas f 10.00
fi-J /-(.t'
vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
•
Wood fireplace/insert 10.00
7 4ROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: S7IZ a L//7J/fl Environmental exhaust and ventilation
Address: 9�+�'� � ��++ �Jn // a Range hood/other kitchen
/e) �Sy cJu' / J(�� �A7 equipment 10.00
City /State /ZIP: 7-26. U C 47a� 3 Clothes dryer exhaust 10.00
P � t
Single-duct (bathrooms,
Phone: ( � ) D 4 Fax: ( ) toilet t compartments, , utility ity rooms) 6.80
VI APPLICANT . ❑ PERSON Attic /crawlspace fans 10.00
Business name: 54 e AS J 7(-y Other: 10.00
L Fuel tin
PP g
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
• CONTRACTOR .. .. - Barbecue
Business name: C6(.0111674) NO) NefiT17J6 Clothes dryer (gas)
Other:
Address: a ACV 6a-07 • . _ • MECHANICAL PERMIT FEES*
City /State /ZIP: c sc i g r P�SC 9 Subtotal /1/.
Phone: U
( 5q3- 3() Fax: ( ) 54/ 6330 Minimum permit fee ($72.50) 7a.
Plan review (25% of permit fee)
CCB tic.: 61q to/ o//0 State surcharge (12% of permit fee) $ • 70
0 ( TOTAL PERMIT FEE 131.,X) 1 This permit application expires if a permit is not obtained within 180
Authorized signature:,
' days after it has been accepted as complete.
Print name: GeH7 1 1 1I I Date: / f l/ - * F ee methodology set by Tri-County Building Industry Service Board
1 \ Building \PermitalEC- PermitApp.doc 01 /19/07 440 -4617T (11 /07/COM/WEB)
ICON architecture /planning inc.
M e M9
;c . date: December 4, 2007
of i,rchitec[s
NCA.'R5
W/ ' rco.narohg c.' con:
to: City of Tigard
tel 503.534 0337
13125 SW Hall Blvd.
fax 503.534.0339 Tigard, OR 97223
info @iconarchitect.com cc: Jim Standring — Owner
Mike Baker — General Contractor
via: FAX (503) 684 -7297
FAX (503) 598 -9081
from: Dan L. Goodrich AIA
re: Oak Street gewnharmes- CjeA
Building #1
Tigard, OR
project #: 10009.04
This is to confirm that the architectural and structural requirements of the
project noted above has been constructed pursuant the plans and speciation's
as required by the construction documents and building permits noted above.
Regular on site observations were made and all comments and concerns
have been addressed. In addition; all welds were visually observed as being
satisfactory.
If you have any questions please feel free to contact me.
Thank you.
c'''="DANAEL
• if
0
Dan L. Goodrich AIA
Architect of Record
1 r
•