Permit A _ 1
,,, TIGARD MECHANICAL PERMIT •
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 00558
TI GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/26/2007
PARCEL: 25111 DD - 03400
SITE ADDRESS: 08915 SW HAMLET ST ZONING: R -4.5
SUBDIVISION: STRATFORD LOT: 024 JURISDICTION: TIG
PROJECT: KOBLEGARDE
Project Description: Replace furnace and AC
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: 1 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
KOBLEGARDE, B RUPERT Description Date Amount
510 MAYER BUILDING
1130 SW MORRISON ST [MECH] Permit Fee 9/26/20W $72.50
PORTLAND, OR 97205 [TAX] 8% State Surcha 9/26/2007 $5.80
Total $78.30
Phone: 503 -222 -3135
Contractor:
HEATING SPECIALIST INC, THE
9300 NE HALSEY
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 257 -7000
FAX na
Reg #: LIC 56628
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: Cilf9.4.1ac,e. .,,t/iS Permittee Signature: e) £ p c
all 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.
Frar=:.Jlie Heating Specialist 503 257 7702 09/25/2007 08:08 #931 P.001/002
Mechanical Permit Applicat 2 i b ()1 1 ]c r BSI cir\i'.1
Ci of Tigard Received v 56 P erm t N o b7-� a 5 S Tigard OR 97223 S E P 2 5 2007 1:.
Phone: 503.639.4171 Fax: 503.598.196x± V Date/By, Other Permit:
Inspection Line: 503.639.4175 �r+ p of TIGARD 5 1 r n a n: p Date Ready/By: JuJr See Page 2 for
Interact www.tigard ��'���GDivr��W N otified/Melhod; �/ Supplemental Information
xY { r r �"��s 3 >E P �'r ' -.4r - � " iii z cIfilaFiitt1 tFEE DL1LE x k `;
❑ New construction Addition/alteration/replacement Mechanical pennit fees* are based on the value of the work
perforated. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
iFfa rl - u ro � '#,,tri V,`CONST .V r� � n , ':� Y 41Ar i
II S FE)�S* a L t ;
• 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
Multi family ❑ �{ RESIDENTrALtQUIPMEI� S7TST E
Master builder 0 For special information use checklist.
Description 1 Qty. I Ea. I Total
'yx�`c? �'��'^,`�u3+.i i ^ ":� sz .r .�( +c z �� Fu r zv r..+ -T t � K : y
„I ' ,era �,...W ,' .'�-; ICO '� w , , R 04,4 ..,.� . LOC�t1'1?TQ.1� r, ; ; r ` 4-' _ Heating/cooling
Job site address: gq IS 1...\ am Air conditioning or heat pump
(requires site plan showing placement) 1 14.00 A a pp
City / State/ZIP: ! 1 0 Z. q' a 3y Furnace 100,000 BTU (ducts/vents) )) 14.00 1%4 017
1 ` Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: J Project name: 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. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
ir��' '" .'" r' "� 41eMa . ga w wK k i - : . x- : 4 -J �t fi" "� �',,',,,,,�r 4 a - �^ Water heater 10,00
,,, t�:: ;s5. ;, A Z. � ir. . .a t 't' 0 ,5 u � e ? r � .S4r,i0 ,,. _ 4:4 :11M r: ,-,.. � 7
Gas fireplace 10.00
C A4 0 I C,t.,C e., Fl) (' (1- &C e. Flue vent for water heater or gas
1r / r •� fireplace 10.00
�• Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
' . ms s -..,At , q„ i Chimney/liner /flue/vent 10.00
=L y ) ROPF1 TY -` 4 ." #0 _ S Other 10.00
Name: Il V n p _ (---4, K V 6U (1 a (' 0 - Environmental exhaust and ventilation
Address: �"" Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
2 Single -duct exhaust (bathrooms,
Phone: (h,) a a--� IJ \ -3 Fax. ( ) toilet compartments, utility rooms) 6.80
FTi :14 :'' 2 /P, � ®arA'P..reti TEOI _' , x? •Ql�i1'AGT ia,§"a r pr Attic/crawlspace fans 10.00
4n'�a ^ .. - 10.00
Other: _
Business name:
Fuel piping
Contact name: 55.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: WaWsuspended/unit heater
Phone: ( )
Fax: : ( ) Water heater
Fireplace
E -mail: Range
c ;..4 .,''"+ �7 ' -x ,r. 9ti.+ c "1.v - e iCi `YJ "7. -4e a . - 1 `
4 " '= 4`sw rga a�6 vs •s:r a rsa r sr isd Barbecue
Business name. 1 p _ (� C Clothes dryer (gas)
t ' -' 1 . (� JC,1 Other
Address: U ' 1 - �,i+ v s . -7°_2V G GAT P,ER1�tI d. z±, , 7et, `' ` ,
City /State/ZIP: Q�.� -i • A..) Og_ Q a Q. 0 Subtotal
c5 4 ") LOCO Fax: ( ) Minimum permit fee ($72.50) '?p
Phone:
S Plan review (25% of permit fee)
CCB lic.: S +w W ( ? 0 State surcharge (8% of permit fee) 5,5D
TOTAL PERMIT FEE 18 x 30
Authorized signature: This permit application expires if a permit is not obtained within 180
llli days after It Acs been accepted as complete.
Print name: i ,, n ' �, f ' I Date: 6 ? - 05 . - • Fee methodology set by Tri- County Building Industry Service Board
l:\ Building \Permiu\MEC- PermitApp.doc 04/06106 440- 4617T (11/02/COM/WEB)
) 1 \A (Or INk
,_Frorrtj TAre Heating Specialist 503 257 7702 09/25/2007 08:08 #931 P.002/002
Job Name 14 >; f e Job #
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Address q l cS 1) 14 a )1-Ad Date " 1 'or' -D7
City, State Zip — 11 a A O•. a 7 a aLl _
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CITY OF TIGARD i6ter/
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BUILDING DIVISION 1,,-- 4ii PERMIT #: 1EC2007-00558
•
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 912612007
Phone: (503) 639-4171 45014.00
Inspection Requests (24 Hrs.): (503) 639-4175 .416
INSPECTION WORKSHEET FOR DATE: 10/1112007 TIME: 7:01AM PAGE: 07
SITE ADDRESS: 06915 SW HAMLET ST CLASS OF WORK:
SUBDIVISION: STRATFORD LOT #: 024 TYPE OF USE:
PROJECT NAME: KOBLEGARDE
DESCRIPTION: Replace furnace and AC
OWNER: KOBLEGARDE, B RUPERT, PHONE #: 503-222-3135
CONTRACTOR: HEATING SPECIALIST INC, THE PHONE #: 503-257-7000
Inspection Request Scheduled For: Date: 1071112007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 057326-02 503-257-7000 Y
1 / 2 _tv r
P w t 680 (0 00
Corrections/Comments/Instructions: E 1/0 C
.414Ali
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rX PASS 1 I PARTIAL APPROVAL I I CANCEL NO ACCESS
fl FAIL n CAL FOR INSPECTION L ADDITIONAL FEES ASSESSED
,
( Inspector: Date: V (° 0 Phone #: (503) 718-
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