Permit •
CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 - 00494 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/2/2008
PARCEL: 2S104CA - 05600
SITE ADDRESS: 13673 SW WESTRIDGE TER ZONING: R -7
SUBDIVISION: HILLSHIRE LOT: 056 JURISDICTION: TIG
PROJECT: DEBAUW
Project Description: Replacing 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:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WILLIAM & VIRGINIA DEBAUW Description Date Amount
PO BOX 19730 STE 61
PORTLAND, OR 97280 [MECH] Permit Fee 10121200€ $72.50
[TAX] 12% State Surch 10/2/200€ $8.70
Total $81.20
Phone: 503 -590 -7529
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. 230397
TIGARDRD, , OR 8 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI '503 624 - 2704
FAX 503 -598 -0270
Reg #: LIC 76359
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ----_0•110 Permittee Signature— L_
• Call 503.• ��5 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
e N. A.
p t r `wcv' .-r , 1 ik t 9u P217 b lY'M inT i , 1' t�, ii i iV` I'l 7 i '(1'$ /t 1 it
Mechanical Permit Application A _l , r � ' ' 4 ; '' j VIIl 0 IVO 1 , 1 IC L l l 1L O\l i „'� 1l iFi -14 tit ti' f, 0
fi
va. • M'rl ` R ece ved
t l rt City of Tigard vv.its euautN, ,: j I t * 11 ° 13125 SW Hall Blvd., Ti g ar Plan Review
d, OR 97223 Date/6t A _ I I //f � __ q
:a a 4 , 4; Phone. 503.639.4171 Fax. 503 598.1960 ;,, Date/By. Other Permit:
'� "'' Inspection Line: 503.639.4175
iT'tIG'1RDa 10�) Date Ready/By. Jura' I El See Page 2 for
■r tit +r Internet: www tigard or.gov t`otrfiocumetbei ,�` , 1 Supplemeasal tnrorru
TYPE OF WORK n
'‘C/ C ONLMERCIAL FEE" SCHEDULE - USECHECKLIS1
v Mechanical permit fees* are based un the value ul the wo, l
❑ New construction �ddition,
❑ Demolition ❑ Other: B
performed. ludicale the value (rounded to the nearest dollar) of all
mechanical materials, equipment,_labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
�-,� RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
[ j 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
❑ Multi-family ❑ Master builder ❑Other. For special information use checklist.
Description Qty. Ea. I 'I'otal
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address / /y ( /' y 1 Air conditioning or heat pump
r*� p (p -/ 3 +J t e .� (� / �..5 �J'�C tl J - ,Q, l --- t {6�E- , (roquires site plan showing piaccmen:) la 09
City /State /ZIP: -7-7-,47,. t 1t � C. / F702.2 .5 Furnace 100,000 BTU (ductsivents) f 14. /Kv
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
Residential boiler (radiator or
hvdronic) VI 00 I
Unit heaters (fuel -type, not electric), l
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
DESCRIPTION OF WORK Water heater 10 00
Gas fireplace 10 00
....7 .,,, a') 7 7...r - , r L. i:tI - -Clt4L Cier_ Flue vent for water heater or gas
/ G,pz„. fireplace , 10 00 I
Log lighter (gas) 10 00 _ I
Wood/pellet stove 10 00
Wood fireplace/insert 10 00 I
Chimney/liner/flue/vent 10.00
[PROPERTY OWNER ❑ TENANT
Other: 10.00
Name: G .” u - • a 1 ,, .,r Environmental exhaust and ventilation
Address. Range hood/other kitchen
equipment 10.30
City /State/ZIP: Clothes dryer exhaust 10.30
Single -duct exhaust (bathrooms,
Phone: ) , -' ., �� y Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10 00
Other: 1000
Business name:
Fuel piping _ Contact name. r -7) R i b y $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Pbone: cb3 )62 9 - 7 z ./ Fax:: 93 )S 9 - D ) 76 Water heater
Fireplace
E -mail
Range
CONTRACTOR Barbecue
•
Business name. «O/ ) b/ (,�,, / /,ib T y r i o t, / y , 6 (.., Clothes dryer (gas)
Other:
Address: g ,' p X .2 3 D 3 9 -7 MECHANICAL PERMIT FEES*
I City / State/ZIP: - /I v 4, r 2 (77z--/ Subtotal I
( -) (02- q - . -2V i t Fax, ( ) -,- 0,- Minimum permit fee ($72 50) 7) .'SV
Phone:
�� 70 Plan review (25% of permit fee) 1
CCB lic.: 7 b 3 5 9 ' Stale surcharge (12% of permit fee) 7o
TOTAL PERMIT FEE R( ) )
Authorized signature: ��224, ,e ,�i , This permit application expires if a permit is oat obtained within 180
�` dabs after t[ has been accepted as wmplrte.
Print name: /44./ 4(i, Date: 70 _ a ...6-,,y1 • Fee methodology set by Tn- County Building Industry Service Board
I auildinq'Permus4MEC -Pemc Aps doe o 440-1617T (11 /02/COM/WEa)
Z'd OLZO 869 ONLLV3H vistmnioo d91:10 90 ZO 100
CITY ,,OF TIGAR D
BUILDING DIVISION PERMIT #: MEC 2008 00494
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1012/70013
Phone: (503) 639 -4171 i�lc
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/1O/2008 TIME: 7:OOAM • PAGE: 52
SITE ADDRESS:
13673 SW WESTRID 3E TER CLASS OF WORK:
SUBDIVISION: wtll_I.SHIRL LOT #: O5G TYPE OF USE:
PROJECT NAME:
DEBAUW
DESCRIPTION: Replacing gas furnace.
OWNER: DEBAUW, WILLIAM & VIRGINIA PHONE #: 503 - 690-7529
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 603 - 6242704
Inspection Request Scheduled For: Date: 10/1(V2000 Pour Time:
•
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 076507 -01 503 -624- 2704 Y
Corrections/Comments/Instructions:.
Giz e /.- - L ,_ L — �0 Gl.ci %' ! -
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspecto Date:/e-/e- Phone #: (503) 718 - c