Permit q CITY OF TIGARD MECHANICAL PERMIT
Ph
Is COMMUNITY DEVELOPMENT Permit #: MEC2013 00090
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013
T, f C, AR L� g Parcel: 1 S 134DC08300
Jurisdiction: Tigard
Site address: 11620 SW GALLO AVE
Project: Kiehlbauch Subdivision: GALLO'S VINEYARD Lot: 14
Project Description: (1) gas furnace replacement
Contractor: ROBBEN & SONS HEATING INC Owner: KIEHLBAUCH, JAMES MICHAEL &
2214 SE 8TH AVE VALLI DAWN
PORTLAND, OR 97214 11620 SW GALLO AVE
TIGARD, OR 97223
PHONE: 503 - 233 -5841 PHONE: 503 - 746 -5872
FAX: 503 - 238 -8849
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/12/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/12/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/12/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire . if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: 111.1 , j/) efit Permittee Signature: of ' j 4- ) 0 k
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. ,
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A 1 c EI
City of vED ,.lilt „,,, t( t; t tit.; oN,.1
ty Tigard �'�• Reamed
13 i2S SW Hall Blvd., Tigard, OR AO 1 1 2 013 »may: /C?' / 3 sr Permit No.;'I
M " Phone: 503.639.4171 Fax: 503198.1960 Phu Review it.
Inspection Line 503.639.4175 3 ' 1
1 1 , ; , I Date/By OlturPermit:
Internet: www.6gard�r.gov BUILDING TIGARD Date Ready /BY: York ION Notirad/Method: / Sup0 Sao plemental p le page l for
:. . i: ‘. T rev 1 � Supplemental l Information n
: Y�'. �g; wQfu� .(:;!6RN5.7';..',;:,.:�:;�. t,: • 1
D Newconsttvcti • ..O. ,. 14 ; :,:.4: .. 4 ":v�k�� 4.t:' +�:jg , t k '�) . .. �•� 1
on .r dition/altetation/repfacement Mechanical permit fees* a cre based b ed, Indicate the value (rounded to the nearest dollar) of all
value of work
Cj
Demolition
Other;
performed.
;':! mechanical materials c u;
s:. ;;TE'GORYYo' U � �; .',. meet labor overhead and .ro$t.
- and 2-family ; .. CA k* ..:..Fr�r,: gy.;'. . g;,
- family '��ati<y . ...
dwelling ❑ Commercial/industrial ,'1"•. ,' '
El Multi- family ❑ Accessory building �� *�� ' �`�.�.,. ,' .. r : : ��� n?�l� 'i`�;SYS�n7,S;�>I��s� . .'
0 builder 0 Other: F or sped° Information tae Q ONCOS
:;•:I;: tOB STlTF t Description reEll
';:
'4 ??Y • : A ,i4t :' r?A',t�' • ix yr.' . Qty. 13a.
..r�� � �`'�+ ` ,•'.� ' .r..� Heath]: cdolln:
��� t I �,( `� Air conditioning
Job site address:
City/State/ZIP: • ' 44.4„ _A1 , 4 • Wm site tan show'. • .laeemen 46.75 1 Furnace 100,000 BTU duola/vente IIII
Suite/bldgJapt. no.: Project name: Furnace 100 000+ BTU dams/vents
Cross street/directions to job site: . MU
Duct work 23 23.32 32
H drone hot water - tern . 23.32 IME
Residential boiler (radiator or
h dronic 2132 IIII
Unit heaters (fuel -type, not electric),
Subdivision:
in-wall in-duct su: ended etc. 46.75 MI
�
Lot no.: Pine/vent for an of above �
Tax map/p�dl no.: �~ Other: ��
i': { : y.ra; ' ; ,�� y � E,,' :'.� , Other fuel a . , fiances
.._f... � : ,o',� ..,r .
Gas fue,lace 23.32 lin
J •t-1 Flue vent for w
elter heater or gas 33.39
fire lace 23.32
Lo: li • ter • _ MIME
Wood/. ellct sto ,o MIME
'. '•e..' Wood fir dace/insert ��
• ' !,likli= .: , ;.g °. 4r., I'm "::1;:' • . "tip. R , , Ch' /liner/flue/vent ��
u: ' f <<, s �e t Itnne t
ti Other; 23.32
1 Environmental exhaust and ventilation
Address: I‘ (Q 51),_) • to Range hood/odter kitchen
City/State/ZIP: r ui anent r��
Clothes er exhaust INIEZIIIMI
Phone:
16.. 7 b Single -duct exhaust (bathrooms,
? .... ,.',r ro pla[i Ahri?' % ^ ? ��' z,° < -,,,, r z rr toiletcomtartments utili
`... '' x., f <: a "� �73°J rooms 1111112111111 ^ llr � .,:'�,.- k4.r,a, x;�Q 4 ��:�, , .rtws� 2 •'
\tb.i t"
Contact name: i = ;+ >t Other: j.i....��
Business name:
II III
Address _ C---'7 r+/ 4--d
$14.15 for first four- 54.03 for each additional
City/State/ZIP: r �� ry
Gas heat um
Phone•,' 7111 ,- t la . '1 "{ 2„1 y WalUsus nded/unit ��
AAA__ • ,;�,
'i,i ' :, . . y'ryi; :?a% .5>; �`o: ">usx` n .;...,,p., ........a,.....
w N ,iIY7 �
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L if 0 'r Clothes d r
Address: ��
S g � ' 1 � Other,
City /State/ZI1}: :!i!i,i�;F; p MM. I (1, r.s, . s ' s .il4i. Mt�"t; :P
Phonc�7S) ICyL*��J�.�y(: /�Q ':' ,:;,%; *.
- S F: yJ �� Subtotal MEM
CCB tic.: i4 �) — ! 7J Minimum permit foe ($90,00) E MU Plan review (25% of . ermit fee) NM
State surcharge (12% ofpemr;t fee)
Authorized signature: r TOTAL PERMIT FEE O •
b a
T d4 permit Print mama, . , L � application expires Ina permit ill not attained within 180
T t�'� cloys after it rte.,..,__. --
r:'B"i,diniaer,lialE,l . d1yp.da60 LZ '0 N� gate .�,0.uI ui }eaH suoS u aggo xbyTriald ti in . E106 . 1[ '9a
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11620 SW GALLO AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
02/27/2013 00:00
MEC2013-00090
PASS - No C of O
351035 minor label
Violation Summary:
Inspector Contractor