Permit 1111 a CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00546
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/6/2008
PARCEL: 1 S133DD -06000
SITE ADDRESS: 12627 SW WINTER LAKE DR ZONING: R-4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT: 099 JURISDICTION: TIG
PROJECT: PRICE
Project Description: Furnace replacement.
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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
' Owner: FEES
ANTHONY & LAURIE PRICE Description Date Amount
12627 SW WINTERLAKE DR
TIGARD, OR 97223 [MECH] Permit Fee 11/6/200E $72.50
[TAX] 12% State Surch 11/6/200E $8.70
Phone: 503 625 - 6900
Total $81.20
Contractor:
ROTH HEATING & COOLING
P.O. BOX REQUIRED ITEMS AND REPORTS
9
CANBY, OR R 9 7013
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
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.
�
By: ` �. , - Pe ttee Signature: .) ,7/
Issued B /G1t�
AilMillk
Call 5 175 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.
.., , v , NOV -06 -2008 THU 12 15 PM ROTH HEATI O FAX NO. 5032663478 P. 02
Mechanical Permit A lie , ��� Filly ()HACK Ilti!'. ()NIA' '
'
Ci of Tigard Received
III Date/By: M 13125 SW Hall Blvd.. Tigard, OR 97223 A v " "-C. (� 6 t v Y` fJj ' 1' _ _ ( ,
d Phone: 503.639.4171 Fax: 503.598.1960 1 \1 p�D Other Permit:
1 , i u 14 13 Inspection Line; 503,639,417 ' 'C1G ` 1 �,
Internet: www.tigurd- or,gov / ` _` � ppl rn ml Information
TYPE OF, r' • • . „ ' , • : • .. COMMERCIAL. FEE "..SCF1EDULE .= `
Mechanical permit foes' arc based on the value oleic work
❑ New construction Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials.
equipment, labor, overhead, and profit .
• • • • ... CATEGORY OF CONSTRUCTION : , • ' 1. ' -', • Value; $
� RE. SIDENTIALEQIIPMENT 1 SYSTEMS FEES''•. '.
c.P-� j '- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family 12 Master builder ❑ Other.
For special trljormarron use checklist.
Description I Qty. r I:a. I Total
JOB SITE INFORMATION 'AND LOCATION - ' _ Heating/cooling
Job site address: ( ? 6 �`7 s i (A) /„ AL - Air conditioning or heat pump • (names site plan showing placement) 14.00
City/State/L1P: (712- "� • Furnace 100,000 BTU (ducts/vents) / 14.00 1% '
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: tn' r J� Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot wiper system 14.00
Residential boiler (radiator or
hydron 14,00
' ` I ■ 1 Unit heaters (fuel -type, not electric).
— -��� ��� �* in -wall, in -duct, su , ded, etc. 14.00
Flue/vent for any of above 6 80
Subdivision: I v'A Ir I 1 Lot no.;
Other: 10,00 .veyw Tax map /parcel no.: ' � l �'"'� Other fuel appliances -
• DESCRIPTION. OF WORK ' .. . '. Water heater 10.00 -
Gas fireplace 10.00
Flue vent for water heater or gas
, Log l igh 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplacc/insen 10.00 • . • . :'- E
PROPRTY�OWNCR', .. ' - I . , . . ..Q TENANT,. '.. • • " ' • Chimney /liner / flue/vent 10.00
Other: 10.00
Name: ()us t Q Environmental exhaust and ventilation
Address: Range hood /other kitchen
equipment 10.00
City/State/LIP: Clothes dryer exhaust 10.00
( ' ('�
Single-duct
comp rt exhaust (bathrooms, utility Phone: rooms) ) � � Fax: ( ) toilet cotllparnitcnts, utility rooms) 6.80
' • ' APPLICANT: - . . • . • ' . • CI .CONTACT.: PERSON. Attic /crawlspace fans 10.00
Business name: Other. 10.00
Fuel piping
Contact nume: $5.40 for first four: $1.011 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/VP: Wall/suspended/unit heater
Phone: ( ) l Fare :: ( ) Water heater
Fireplace
E -mail: Range •
.. •. • • „ CONTRACTOR • • . : , .. , . . Barbecue
Business name : +601. {x Ck Clothes dryer (gas)
\ \'' Other
Address ) r j -- • . MECH NI4AU:•PERMIT.1FEES" - ' :
City /State/Z)P: a A jsokA d>____ck p - Subtotal
Minimum permit fee ($72.50) 7 2 S C)
Phone:) 2r10(p ( � Fax: ) ID. II) Plan review (25% of permit fee)
CCB lie.: g State surcharge (12% of perrrlit fee) 0
T TOTAL PERMIT FEE 8f, a0 ,
Authorized signature: This permit application expires if a permit is not obtained within IMO
IL days after it has been accepted us complete
Print name: r I/' . - .) I Date: J I 1 (0 • Foo methodology set by Tri- County Building Industry Service Board
I' Vleddlna Wcriniuu \MEC- PcauaAppdoe 01/10117 "l esa attJC M(W211)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 00546
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/6/2008
Phone: (503) 639 -4171 �o i
Inspection Requests (24 Hrs.): (503) 639 -4175 -IL
INSPECTION WORKSHEET FOR DATE: 11/18/2008 TIME: 7:01AM PAGE: 23
SITE ADDRESS: 12627 SW WINTER LAKE DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT #: 099 TYPE OF USE:
PROJECT NAME: PRICE
e DESCRIPTION: Furnace replacement.
OWNER: PRICE, ANTHONY & LAURIE PHONE #: 603. ------ 625.69(s_.)
CONTRACTOR: R011-I HEATING & COOLING PHONE #: g0"3 249
Inspection Request Scheduled For: Date: 11/18/2008 Pour Time:
" Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 078180 -01 503-266-1249 Y
Corrections /Comments/ Instructions:
E P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A Date: l/ —/8 —a 9. Phone #: (503) 718 - Z