Permit q CITY OF TIGARD MECHANICAL PERMIT
1, _
s COMMUNITY DEVELOPMENT Permit #: MEC2013 -00217
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/24/2013
T l �' '� �� 9 Parcel: 2S112CD05800
Jurisdiction: Tigard
Site address: 7930 CHURCHILL WAY
Project: Cappuccio Subdivision: BOND PARK NO.2 Lot: 38
Project Description: (1) gas furnace installation
Contractor: NORTHWEST HVAC SERVICE INC Owner: CAPPUCCIO, LOUIS A
14004 NE 82ND AVE 27931 VIA ESTANCIA
VANCOUVER, WA 98662 SAN JUAN CAPISTRANO, CA 92072
PHONE: 360- 576 -9679 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/24/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/24/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/24/2013 $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 Notif ion Cen • Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0 90. You may obtain a copy of the rules
or direct estions to OUNC . c. ' g 50 987 or 1.800.332.2344. ' I\
Issued / i � _i Permittee Signature: v \;--
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.
Apr 22 2013 8:31 HP Fax page 2
Mechanical Permit Applicati ;�E+ D I olz oFru t S[ oN1,1
- City of Tigard Received — 7
a l l3 c Permit No.: .4.v o
il iii
3- er
13125 SW !Blvd., Tigard, OR 97223 2 213 a� DauBy. 4 l a a 1
Phone: 5 .718.2439 Fax: 503.598.I960 P1attReview OthwPcmit:
t 1 GA 1: I , ltaspection 'ne: 503.639.4175 Date/By: Ready/By
Date
Internet: .tigard -or gov CI�' OF TIGAR p Noll fiedMetho J "' See Page
ent 1 2 for
BUILDINGDNISION Notified/Method ��� Supplemental Information sn lem
y b `r j tC K : w ut 7 C a a lout
IIGt" .c.1 flirt A1k. :. Al t� d; �p {{ ;-' y.r a ' 'Ii= -'; + A ...�. 11 o! + a1' ii j ,xt f �`
F°".',. `.t@`:.. : :. .n_ ...,,a '' C•sin:v�nc 9lC:F ,.t.YxtO ' ..
Mechanical permit foes* are batted on the value of the work
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, andprofit.
1 :Anti :4,ih P' ' 3. ¢,re( Frb E r s�zcrr�- i f Value S
("' s ♦. �` ra j ,t"t ..• 9 �,: a e .. r++n tx m-c'1 •=?� "e• efiiP'T9 .. Lf t
a'2'r E: 7u.n i t< �°lalse a - �� 4'YO'l i I � s t '. r i
i1 1 - and 2- family dw ling ❑ Commercial/industrial ❑ Accesso building y .�„ a .i�.t"o.�a m are
ry g For ;Redd !p jorrntrNo are tlrteAdltl
• ulti ❑ Master builder ❑ Other: Description I Qty i I Total
I, II € l � r 4 - r ch i ,p;w nst��] J t i u ,;° . -�,, , Huth
Iir 44. 0 , )',) _6'1 air • ' ',No Y - er,i4! #,i.c � ` i.. 7 Q. , � i 'x ' ' .: n '
�> >�:da�.,m..- ev�,t:c_r Air conditioning 46.75
Job site address: — 793 j O ,' u , ) � i . l Furnace 100,0001371J (duns/vents) / 46.75 I
City /State/ZIP: 641I j . L _ t 2 Furnace 100,000+ BTC: (ductslvents) 54.91
Suite /bldg. /apt. no.: 1 I Project name: Heat pump 61.06
r �1 - C C — Duct work 23.32
Cross strt t; directions job site: _Ilydranic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric), ' d
in -wall, in du, suspended, etc. 46.75
Flue/vent for any of above 23.32
Other:
Subdivision: Lot no.: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
N • . ,o N , 'r'" , "tCt►«i:. ' 1 ° t6 = � r r' j ' 1 Gas fireplace /insert 33.39
J '' Flue vent for water heater or gas
�a _ AL J •1 e 0 li , ALA , _ f fireplace 23.32
° Log lighter (gas) 2332
p Wood/pellet stove 33.39
V I C) I...- PI I Wood fireplace/insert 23.32
a
Chimney/liner /flue/vent 2332
t � � r, � r 1 :...' � 1a a � � i 't� , ,, +," � . l i w i ;a Other: 23.32
i�i�:u+ g I ', 4 l " rk 4 1 . ,H,. ,t 4: , , ` ; ,t i, + 4 . Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/7.1P: Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( )
r�- h S L AttirJcrawlsp 23.32
.- darn i • +t = t��, Other: 2332
&sines name: w HI C`_ C Fuel piping:
[> S14.15 for Rat four; S4.03 for each additional Contact name: �� v ��� _Furnace, etc.
Address: Gas heat pump
- Wall/suspended/unit heater
City /State/ZIP: i Water heater
Phone: 366 Q — 623 C) I Fax: (3)) 5 _ ! � X / Fireplace
L Range
E-mail:
., ur „ �, � Barbecue
f r t<s' ' � ., l� ' _ a r ._ , "'PI n F ' rs /; 117' I Clothes dryer (gas)
1)
Bwiness name: � � L Other:
(� Air Q� n4 / /2,7-c___
n t'?13 ewr neeax f. [
/ y Nr v ee , w ' , ai ' .,,, t� � ! , w ,.... V w .
Address' 1
Subtotal
City /State/ZIP: i �+^ �,,,t a ` • 1.4/4- qt 'z Minimum permit fee (590.00) a�
Phone: 3 )) • a ' F � b) /3- .` Plan review (25% of permit fee) r
State surcharge (12% of permit fee) lam+ ff 0
CCB lie.: nrallaTt ' 1 TOTAL PERMIT FEE 7 ra�a�, f s
���_ This permit appiicanee expires if a permit is net obtaiaed within 180
days after it hes bees accepted as complete.
Authorized sign I/ • Fee methodology set by Tri- Coanly Building Industry Service Board
I Print name: S ' L.Q j Z
Date: y ^/ / +P c) 11f /06 1 /�
l:lauildi°a1PQwitaUIEC_Peim 040113, doc 440-46177 (1 t/o2.CCWWEB)
■
Apr 22 2013 8:31 HP Fax page 1
NW HVAC, INC.
Heating * Cooling * Ventilation
14004 NE 82 Ave. Vancouver, WA 98662 -1061
Office: (360) 576 -9679 Fax: (360) 576 -1588
NWHVAC.NET
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TO:
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ATTENTI ���.. t' i. , ,
DATE: i /-'. • r I %lC PAX: jU 3 Sp tIr - / yl
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PAGES: (Including cover)
I rr
* Comments
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
7930 CHURCHILL WAY, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
04/25/2013 00:00
MEC2013-00217
PASS - No C of O
Violation Summary:
Inspector Contractor