Permit CITY TIGARD MECHANICAL PERMIT
_ COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00055
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/4/2009
PARCEL: 2S114AD - 00800
SITE ADDRESS: 08967 SW WAVERLY DR ZONING: R -
SUBDIVISION: WAVERLY ESTATES LOT: 007 JURISDICTION: TIG
PROJECT: ERVIN
Project Description: (1) fuel piping for range.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
WILLIAM & VERONICA ERVIN Description Date Amount
8967 SW WAVERLY DR
TIGARD, OR 97224 [MECH] Permit Fee 2/4/2009 $72.50
[TAX] 12% State Surch 2/4/2009 $8 70
Phone: Total $81.20
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -9550
FAX 503 - 650 -1220
Reg #: LIC 120277
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: arAl Aft r ta b : J., Permittee Signature: �X Q A 0i 14 : W' 1
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.
,_ {� .
Mechanical Permit Applicatl CEWED 1.0R.()1 F is F, ,
City of Tigard Received ,---‘ Ai -O
DatelBy: �
Permit No.:
' �C( - _ ..4 1, I /L a
q 13125 SW Hall Blvd., Tigard OR 97223 PlanRevie -
IN
Phone, 503,639.4171 Fax 503.598. EB t LUIJ Other Permit:
D a t e/By:
T,i t A t: DD( Inspection Line: 503.639.4175 Date Ready/By. luris ia See Page 2 for
- Internet: www.tigard or.gov N otified/Method. Supplemental Information
CITY OF TIGARD Pa e
rt��l
' 1► 11 I
�° r.71 R "7" iJ '�^ t'S7� i''r, ti � * Ht . n• r r- n �a Pi iaf:ercuran! 'y:ac
} ,� -`4` ■ p• 4 �� nFas .0 7 r.2. Fa tx'irl � s' .lu n
�f' !`u�. :. 's� a ' R r 14 :ilaIt �AtA.Ii.35' t'! ti t'��f+.hls�i3rG b l i M' h T t ! r , l {.
❑ 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) o. ell
❑ Demolition ❑Other.
mechanical materials, equipment, labor, overhead, and profit.
��Lp�aFtItl �` 1 ea It �' , ',t i= '�"y"� , �-,, t Q �}#""`,;1 t11 `q �`a Value: $ i t
a7fl @t :�1�)NEMENH T L�.MTRZS q. lh7a"4t t t.akl . , �'3 L, PI 11 ."l'!. PiI I .'..:I '! PL'1 ' J A I .'F f' �.ICa f 1 el fix l S ' ICt771 (y q
1- and 2- family dwelling ❑Commercial /industrial El Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
* p 'W frulne a S +
,d.a u. ai- ro�r., :� Description I Qty. � Ea. l To
p ' I H'IIII 1 I 11,°•'f 1111. X4'1 •�
'. ° 1 u� 1x 1 . �I 7i''t �5' i w , aI "' It E. .1.7,t l:��i �g t` i.'• .
'E7G1iA y��.,- '' ';. '; I_k 'Jestin
rap., I aru •1ii . u. „ iiraii. 7 ' m e`�•1: b'i.,-'IS, ,i. i`.!.-� I,r -.'?i: rrFV �.
�I�""� c Lti1t7�V ��,� ` Air conditioning or heat pump
Job site address:
(requires sae plan showing plaoemem) 14.00
City/Stale /ZIP: � , � � i x . C c w 1 Z.Z.%-1/4 Furnace 100,000 BTU (duerwems) _ 14.00
Furnace 100,000+ BTU (ducaNents) 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 1 -
Other: 10.00
Tax map /parcel no.: Other fuel appliances
I {el 1 �: i 1r xu eul cy:,r P c � 3a f s1 1 ar C .,I; i ii t" :
1 h l liE ' iair IE c I 11 � iiiial i il?I, lishiinfl i.1!I n • A., .reitil . . y 1 1- 1 1
��W]. - V 1 d. d0A N.. i � r Water heater 1000 I
4 (
�+ Gas fire. lace 10.00
%try O`°�ICOK qtr? Cis g �� Flue vent for water heater or gas
fireplace 10.00
'ih t("c... 41- \toCtti it e Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
'u ersalg° tt�c'. il� �i.��,� c't!a' as Imo• I 6�1�i �tl la. 4 � Chimney /liner!(lue /vent 10.00
71ME �,*Y of rr��.momreaarnra ' EREIP � a rixl Other: 10.00
Name: `� %r -hy Environmental exhaust and ventilation
Address: �V� S�� <�Wh�l b�V-e. Range hood/other kitchen
equipment 10.00
City /State/ZIP:r,� ax: ( 2..1-A Clothes dryer exhaust 1000
Single-duct exhaust (bathrooms,
Pj
Phone: ! C-g7, - �3 ) toilet compartments, utility rooms) 6.80
��� !ti P ate Tis, E • ±i a• 11 l) a1- T
th i' e tM. E 1 1 atrn ''e�' 'c ' f. + Attidcrawlspace fans IO 00
' lfi�2dil'JMiraii.>��ltu�urS75�� , • llr Ei!r' q , � ai9!�a;e�i. w. ..w "I a, . , �?I_')
Business name: I e � Q� • a L�
Other: i m LO 00 , I
piping
Contact name: 55.40 for first fouri$1.00 for each additional
����... t ?_. -,. Z t_ Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: ( \ # t t .,`c,,,� t. C\ c Wall /sus t ended /unit heater
Phone: EISS) l C\t:' ob Fax:: • . F t� - Water heater
Fire lace Ili
E -mail: Range ✓
I l S ,e}�� �!qlp - w ir 3i��: e9 I I s t ! , I R� i Barbecue
.IME Kh IMPtt _ li o ' .:lii I r I w f , P. i s i
Business name:. - \_\_c_ Clothes dryer (gas) ll
Other
Address: (' `•k s- _ y ,� E; s }} �'I„ e rr "
\ l.Z ' ` Z.\Z x'1 -• u,... . is = : b" 1f'_i 1a� _ _: I",I w � -1a y,∎
„ I , � awl�r.>r i •.,�r.,. .3^'.mu•.��,_ ..r �� s_��
City /State/ZIP: C.Cy �',P ok—t(, \S Subtotal
Minimum permit fee ($72 50) Pop '
Phone: t '� l iiF - D - 4:‘SS0 l Fax: 'y t.ti. Nap Plan review (25% of permit fee)
CCB lie.: \'Zcyz --1 State surcharge (I2 %ofpermit fee) Qy :1L,
TOTAL PERMIT FEE $1 .Z, '�
Authorized Si attire' .41.--_ This permit application expires if a permit a not obtained within 110
days after it has been accepted as oompiete-
Print name: 'Ni\ I Date: a.■1...CF‘ I • Fee methodology set by Tri- County Building Industry Service Bowl
I. 1Bw;dr11gVermas\NEC -PemttA 19/07 440-4617T (11 /021COM/WEB)
T'd 0221- OS9 -EDS Wd.O :2T 6002 b0 cla
CITY OF TIGARD 0
BUILDING DIVISION PERMIT #: MEC2009 00056
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/4/2009
Phone: (503) 639 -4171 !a ailWW.p llaI
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/25/2009 TIME: 7 :0OAM PAGE: 12
& e t 4e•t ¶Za
SITE A 00967 SW WAVERLY DR CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 007 TYPE OF USE:
PROJECT NAME: ERVIN
DESCRIPTION: (1) fuel piping for range.
OWNER: ERVIN, WILLIAM & VERONICA PHONE #:
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503 - 650-9550
Inspection Request Scheduled For: Date: 2/25/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas'line 080827 -01 503 -620 -6983 N
Corrections /Comments /Instructions:
--1-7 7' O / S M fJ
Ko . � T�� FA-i L -t�-L� .
•
1
❑ P P' ' IAL APPROVAL ❑ CANCEL ❑ NO ACCESS
t 'LL FOR INSPECTION ❑ ADDITIONAL: FEES ASSESSED 21-7
' Inspector:. t '` Date Phone #: (503) 718 - 2-fl/
*CITY OF TIGARD
BUILDING DIVISION 4 . PERMIT'#: MEC2009-00065
. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2J4/2009
Phone; (503) 639-4171 hortiotiV
Inspection Requests (24 Hrs.): (503) 639-4175 AIRILY:
INSPECTION WORKSHEET FOR DATE: 2/26/20 • 4 TIME: •7:03AM PAGE: 6
SITE ADDRESS: 00967 SW WAVERLY DR CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 007 TYPE OF USE:
PROJECT NAME: ERVII‘i
DESCRIPTION: (1) fuel piping for range.
OWNER: ERVIN, WILLIAM & VERONICA PHONE #:
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503-650-9550
Inspection Request Scheduled For: Date: 2126/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 000870-01 503-620-6983
CorreUions/C9mments/ Instructions:
/C-- /
•
•
•
t PAS • PARTIAL APPROVAL n CANCEL E NO ACCESS
0 FAIL r , CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
z_ 7Z/5
Inspector: . Date: 4 ' / Phone #: (503) 718- 2CV