Permit 17pi CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00612
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2008
PARCEL: 2S103BC -02900
SITE ADDRESS: 12180 SW ALBERTA ST ZONING: R -4.5
SUBDIVISION: CANOGA PARK LOT: 003 JURISDICTION: TIG
PROJECT: WILLSTATTER
Project Description: Replace 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
STEVE WILLSTATTER Description Date Amount
12180 SWALBERTA
TIGARD, OR 97223 [MECH] Permit Fee 12/19/20C $72.50
[TAX] 12% State Surchai 12/19/20C $8.70
Phone: 503 - 590 -4948
Total $81.20
Contractor:
ABLE HEATING & COOLING INC
12420 SWSUMMERCREST DR
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 443 -2058
FAX 503- 620 -3980
Reg #: LIC 108535
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.
Issu By: / `� L 4 Permittee Si. ature: �, / rs' h'.------t.
Call 503.639.4175 by 7:00 a.m. for inspections that • siness 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 t time of each inspection.
Mechanical Permit Application FOR OFFICE ESE o l
f *0•*.s' ® Receive
City of Tigard IJaielBy . ► Permit No..
• 13125 SW W Hall Blvd., Tigard, OR 97 ,, • o. _� C2 6�..�
r Plan Review
s '. m ' Phone: 503.639.4171 Fax: 503.59 ((X + L ' aate Other Permit:
T I G A R D Inspection Line: 503.639.4175 (` ‘ • •
• i:'� , • . El Page 2 for
Internet: www.tigard -or.gov � t\* t `y,, Supplemental information
TYPE OF WORK i f� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
v Mechanical permit fees' are based on the value of the work
❑ New construction NI .. ; nt performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
[24.- and 2- family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
g ❑ Commerciallindustrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Q Air conditioning or heat pump
Job site address:
2 I i,1.c �1 { ' .ir'-r l k - CJ\ S k- ' (requires site plan showing placement) 14.00
City/State /ZIP: 1, r t' Furnace 100,000 BTU (ducts/vents) 14.00
! l' Furnace 100,000+ BTU (dncts/vents) 1 17.90 I
Suite/bldg. /apt. no.: Project name: -we
• i L 1.5'1 Ll 1_ t' if Gas heat pump 14.00
•
Cross street/directions to job site: Duct work : 10.00 i
Hydronic hot water system I 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric), i
in -wall• in -duct. suspended, etc. 1 14.00
Subdivision: Lot no.: i Flue/vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/�" � 1 i Gas fireplace 10_00
V et S Fl" ✓ {.0 i l tn° v15.- -C (JCt, \- >r Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
PROPERTY OWNER ❑ TENANT Chimneyllinerlflue(vent • 10.00
t Other: 10.00
Name: sT {LJ W , I r es4 e . { t✓ Environmental exhaust and ventilation
Address: G Range hood/other kitchen
�1 C' 6 L✓ tl c4- equipment 10.00
City/State/ZIP: T+ qJ ty/ 0 -•,� 1 Clothes dryer exhaust 10.00
-7 Single -duct exhaust (bathrooms.
Phone: (SL73) 5q c Li � Lt (6 q Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON • Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $I.00 for each additional
Address: Furnace, etc.
Gas heat pump .
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater l
Fireplace
E -mail: Range i
CONTRACTOR Barbecue .i
Business name: ii 1 Clothes dryer (gas)
h`'C 1� u'G�t � . co :d �y L-L Other:
Address: i li.a c w s,, vy, ,,,, r" or e \_. e.. MECHANICAL PERMIT FEES*
City /State/ZIP: 1 (/+.,!` Lj'n ) '7 - Subtotal
1 '` J M i nimum permit fee ($72.50) 7?
Phone: ( C t. < c Fax: ( )
54 f � J •� G Plan review (25% of permit fee) C b
CCB lie.: ` ' 4 - + • 2 - - • State surcharge (12% of permit fee) . c! _ _
�- TOTAL PERMIT FEE e / / C 3` .Z°
r' This permit application expires if a permit is not obtain within 180
Authorized signature: '/ days after it has been accepted as complete.
"`
Print name: f�«y / / Lief/72e Date: ,L // ( 76 8 * Fee methodology set by Tri- County Building Industry Service Board
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dingermit Ws IEC•Pennitwpp.dcc 01/19/07 44046 17T ( 11/0Z/COM/WEa)
Z'd V0166L9809 ONI1000 CNV ONI1d2H 3l9V d018O 80 91. oea
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008-00612
13125 SW Hall Blvd., Tigard, OR 97223 ■i DATE ISSUED: 12/1912008
' Appr k
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/31/24 8 TIME: 7 PAGE: 28
SITE ADDRESS: 12180 SW ALBERTA ST CLASS OF WORK:
SUBDIVISION: CANOGA PARK LOT #: (03 TYPE OF USE:
PROJECT NAME: WILLSTATTER
DESCRIPTION: Replace gas furnace.
OWNER: W1LLSTATIER, STEVE PHONE #: 503-590-4948
CONTRACTOR: ABLE HEATING & COOLING INC PHONE #: 503-443.2058
Inspection Request Scheduled For: Date: 12/31/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 079276-01 503-443.2058
Corrections /Comments/ Instructions:
et-C.> LS7')
F.
PASS FA jARTIAL APPROVAL Ei CANCEL 0 NO ACCESS
• FAIL A CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
—1■1011P
Inspector: Date: /2. :C/46 Phone #: (503) 718- al-4'
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: //EC aUDB - 00(a ! a REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description I PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool •
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 E Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood •
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07
CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00612
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/19/2008
PARCEL: 2S103BC -02900
SITE ADDRESS: 12180 SW ALBERTA ST ZONING: R -4.5
SUBDIVISION: CANOGA PARK LOT: 003 JURISDICTION: TIG
PROJECT: WILLSTATTER
Project Description: Replace 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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: 1 <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
STEVE WILLSTATTER Description Date Amount
12180 SW ALBERTA
TIGARD, OR 97223 [MECH] Permit Fee 12/19/20C $72.50
[TAX] 12% State Surchai 12/19/20C $8.70
•
Phone: 503 -590 -4948 Total $81.20
Contractor:
ABLE HEATING & COOLING INC
12420 SW SUMMERCREST DR
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 443 -2058
FAX 503- 620 -3980
Reg #: LIC 108535
Ch
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Speciafty 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
‘ 143
Issu_d By: 1/ 1 L L , / Perm ittee Si ature: �'
Call 503.639.4175 by 7:00 a.m. for inspections that a siness 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 t time of each inspection.