Permit Ir d"
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00466
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/15/2008
PARCEL: 25111 AD -14300
SITE ADDRESS: 14933 SW 91ST AVE ZONING: R -4.5
SUBDIVISION: MALLARD LAKES LOT: 009 JURISDICTION: TIG
PROJECT: HARBURY
Project Description: Removing existing gas water heater and installing new venting.
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: 1
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
HENRY & SUSAN HARBURY Description Date Amount
SUSAN F
14933 SW 91ST AVE [MECH] Permit Fee 9/15/200E $72.50
TIGARD, OR 97224 [TAX] 12% State Surch 9/15/200E $8.70
Total $81.20
Phone: 503- 624 -6852
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. 230397
TIGARDRD, , OR 8 97281 REQUIRED ITEMS AND REPORTS
Contact #: PR1 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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 Permittee Signature:
0'!.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.
i
Mechanical Permit Application -., - • .- , . . t . • , ,- ....i : 1 , OR - Orizic:LusE O I Y:
''13125 SW Hall Blvd. f ,... .)
• Tigard OR 97223 .
, ,
P ,...c.:-..,,
Plan Review tr i -11: Y alp Permit No.:yri
..'-' . 6 ..,;'.. Phone: 503.639.4171 Fax: 503.598.19.■- ,V•••••e'.... Date/By: Other Permit:
ion ne:
' . Inspect Line: 503.639.4175
TIGARD 40,-1.,:c , .‘ .Date Ready/By: Ju • • lii See Page 2 for
iii
- Internet: www.tigard-or.gov 't: '1/4 ...., ' ‘vr\ :. • . .tified/Method:
7 Supplemental Information
c2
TYPE OF WORK. - . r* A -,:.11 ,' 4 COMMERCIAL,E. SCHEDULE '- USE CHECKLIST
frt MO
0 New construction 4_ Addition/alteration/rep Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: 5?A‘.. mechanical materials, equipment, labor, overhead, and profit.
• - . CATEGORY OF CONSTRUCTION .._._- ,....7z;,,:::::: Value: $
••%':,7't - RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
cgl. 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description Qty. Ea. Total
' - - - JOB SITE INFORMATION AND LOCATION .% '..-,...' Heating/cooling
Job site address: 1 Z il 3 -. ()) 1 I -51 k V e- Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: --ri 6)7_, I 7-2-2-11 Furnace 100,000 BTU (ducts/vents) 14.00
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 14.00
Hydronic hot water system 14.00
A )
. R-D , Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK heater I 10.00
..... .
Gas fireplace 10.00
1 )E7it IN; 1 ivt er_44 • i DE or 2.67.-0 44-1/.) 6 Flue vent for water heater or gas
E ‘ A) GAS to 11 lirm 1 )1714- A- fireplace ( 10.00 id.`:-,
Log lighter (gas) 10.00
piik) TAN v-L-ES S . C cri 6 Ve7 'r UN IT ' Wood/pellet stove 10.00
64-5
1 5 EX 1 .T7 A"( , Wood fireplace/insert 10.00
, .. Chimney/liner/flue/vent 10.00
g PROPERTY OWNER 0 TENANT . .:1.. -
Other: 10.00
Name: 5 (As A-v.) .1-i)002. a_ s.i Environmental exhaust and ventilation
Address: I 1 1 33 5 (Ai 1 1 .-f hv c. Range hood/other kitchen
equipment • 10.00
City/State/ZIP: - 7) 6, Ppe_o /- Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( 93) 6 azi - ( qc Fax: ( ) toilet compartments, utility rooms) 6.80
: - • ' - 0 APPLICANT 0 CONTACT PERSON ' ' Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name(, TA / b y $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: 5-b3 )62 q - 2 ,7 0 q Fax: : 93 )s• 6 D. -26 Water heater
Fireplace
E-mail:
Range
. .
. CONTRACTOR .
e .- Barbecue
.....
Business name: (1 i burr? bi CA / ,-' ecrp// Ae c9---elL, Clothes dryer (gas)
Address: q 13 0 X „23 o 3 9 ---) U 0 Other:
c's: :,:: -.:- -.'.,' :..! MECHANICAL PERMIT FEES*
City/State/ZIP: /77 6 i f /2, ,2..... q - -2-P1 Subtotal ja,. 0 0
Minimum permit fee ($72.50) -72,c0
Phone: (51r) 6 2- Li - - - 2 1 0 it Fax: (33 ) S'V? — 0 >76
, Plan review (25% of permit fee)
CCB lie.: 7k 3 s• ' State surcharge (12% of permit fee) i- - 7-0
TOTAL PERMIT FEE cirii •
St
Authorized signature:
This permit application expires if a permit is n iii ot obtained in 180
days after it has been accepted as complete.
Print name: Date: 7 _ (t..,2 p . Fee methodology set by Tri-County Building Industry Service Board
-1"
I \BuildingWermits WEC-PermitApp.doe 04/06/06 440-4617T (11/07JCOWWEB)
CITY OF TIGARD •
BUII-DING DIVISION
Alhi, PERMIT #: MEC20013-00466
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/160008
Phone: (503) 639-4171 a) . Ii'
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/9/20013 7:01AM 36
I
SITE ADDRESS: CLASS OF WORK:
14933 SW 91ST AVE
SUBDIVISION: LOT #: TYPE OF USE:
MALLARD LAKES 009
PROJECT NAME:
HARBURY
DESCRIPTION:
Removing existing gas water heater and installing new venting.
OWNER: PHONE #:
HARBURY, HENRY & SUSAN 603-624-6852
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 603-624-2704
Inspection Request Scheduled For: Date: 10/9/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 07&444-01 503-6242704 N
Corrections/Comments/Instructions:
41) "-- ,._ i• . (7-- . -1r . y '''' /
•
•
PASS
fl PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS
7 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
.../
Inspector:
.;/•" Date: fi — 0 Phone #: (503) 718- 2-4--•
_,. •