Permit a CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00531
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/28/2008
PARCEL: 1 S 134CC -03800
SITE ADDRESS: 12414 SW WINTER LAKE DR ZONING: R-4.5
SUBDIVISION: CAPSTONE LOT: 005 JURISDICTION: TIG
PROJECT: ZAPP
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
MATT ZAPP Description Date Amount
12414 SW WINTER LAKE DR
TIGARD, OR 97223 [MECH] Permit Fee 10/28/20C $72.50
[TAX] 12% State Surch 10/28/20C $8.70
Total $81.20
Phone: 503 - 524 -0410
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.
Iss ed By: (2/1/4 CX Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that • • siness 1 .
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 Application t; � FOR OFF1(. E l'SE ONLY
.Y
City of Tigard ii� C,l�� ` — n a tit) fl' 08 'X Permit No .Hee ._ GL
13125 SW Hall Blvd., Tigard, OR 97223 l� ^Rcvicw
' 1 C • Phone. 503.639 4171 Fax: 503.598.1960 n(4 �k/Oy Other Permit:
T I G A R D
Inspection Line: 503.639.417 OC \ t to Ready/By: tuns: RI See Page 2 tar
Internet www.tigard-or goy 0 ��� ! ptificd/Method: ‹ Sapplementat Information
al 1) TYPE OF WORK n tul1SP \ V COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
V Mechanical permit fats• are based on the value of die wort.
❑ New construction ❑ Addition /alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition El Other: mechanical materials, equipment, labor. overhead, and profit 1
CATEGORY OF CONSTRUCTION Value. S
] -and 2-family dwelling RESIDENTIAL EQUIPMENT I SYSTEMS FEES-
❑ y g ❑ Commercial /industrial ❑ Accessory building
For special information um checklist
❑ Multi - family 0 Master builder ❑ Other: Description Qty I Ea. Total
JOB SITE INFORMATIO AND LOCATION �� Healing/cooling
G 1L Air conditioning or heat pump
Job site address: /1"// �� 7 �� / (tequizes site plan shnwnnp placement) 14.00
City /State/ZIP: ! Furnace 100,000 BTU (ductalvents) / 14.00
Furnace 100,000+ BTU (ducts'vcnts) 17 90
Suite/bldg./apt. no.: Project name: 14 0
Gas heat pump
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 Fluehcnt for any of above 10.00
Other. 10.00
Tax map/parcel no : Other fuel appliances
DESCRIPTLON OF WORK Water heater _ 10.00
Gas fireplace 10.00
/7. ---.17 ILI G- �,. , ,4..,3 a Flue vent for water heater or gas •
I 4i�� fireplace 11) Ot)
Log lighter (gas) 1000
Wood/pellet stove 10 00
Wood frreplace/inien . 1000
V PROPERTY OWNER I ❑ TENANT Oter: Chimney/liner/flue/vent 10.00
Other: 10.30
Name: / g 2 ivy> Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10 00
City /State/ZIP. Clothes dryer exhaust 10.00
Single - duct exhaust (bathrooms.
Phonn3) Sv'/ O // h Fax: ( ) . toilet compartments, utility rooms) 6.80
[l �� ❑ APPLICANT oil/ ll ❑ CONTACT PERSON Atticicra wlspaoe fans , 10.00
Other. 10.00
Business name. Fuel piping
Contact naunef , '7) it 1 b Y S5.40 for first four, 51.00 for each additional i
Address: Furnace, etc. _
• Gas heat pump
City/StaterZ[P: Wall/suspended/unit heater
Phone: j3 )6 21 - 7D Li Fax:: 93 ) 3 a O D "26 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: (?,,,Ci /1,1-M 'b/0.. f-4,- / i e.tr oh .51-0c, Clothes dryer (gas)
Other. i
Address: go p o X .23 0 3 9 -7 MECHANICAL PERMIT FEES* -
City /State/ZIP: U j 7 eta j 2 9-7.z-i---/ Subtotal
Minimum permit fee ($72.50)
Phone: (511) to 2- q - 7. 7V $1 Fax: 33 ),S9? D�-70 Plan review (25 %ofpermit fee)
CCB tic.: 9 74 j S / r State surcharge (12% of permit fee)
TOTAL PERMIT FEE
signature:
This permit application expires if a permit is not obtained within 180
Authorized si
�' . 4 / J am
days after it has been accepted as complete.
0� Print name: M / Date: / (i Ig ,/f • Fee methodology set by Tn-County Building Industry Service Board •
era .,a.s...'v....,;r.wrFr.D.rn;,Ann Are 044/6106 / 44a 4 (JI Tr(t'OLCO\tnvts) •
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CITY. OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00531
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/28/2008
Phone: (503) 639 -4171 Atk
Inspection Requests (24 Hrs.): (503) 639 -4175 _ - 1.L
J
INSPECTION WORKSHEET FOR DATE: 11/20/2008 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 12414 SW WINTER LAKE DR CLASS OF WORK:
SUBDIVISION: CAPSTONE LOT #: 005 TYPE OF USE:
PROJECT NAME: ZAPP
DESCRIPTION: Replace gas furnace.
OWNER: ZAPP, MATT PHONE #: 603. 524 -0410
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624 -2704
Inspection Request Scheduled For: Date: 11/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G99 Mechanical final 07827501 503.624 -0410 Y
Corrections /Comments /Instructions: // / r'
0 �GC,JZiO , d . -,Lo Z 145 At S /8 Z 27c n/ed a L tir
.tine /4-cg3
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL U CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
A Z 5
Inspector: / / Date: /1- 20 - G ii5 Phone #: (503) 718-