Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00213
T f GA R n 13125 SW Halt Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/23/2013
Parcel: 2S103DB06400
Jurisdiction: Tigard
Site address: 11340 SW AMBIANCE PL
Project: Leslie Subdivision: GENESIS NO.2 Lot: 22
Project Description: (1) gas furnace installation
Contractor: WOLFER'S, INC Owner: LESLIE, THOMAS A & MARY L REV LI
290 YOUNG ST 11340 SW AMBIANCE PL
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE: 503 - 981 -4511 PHONE: 503 - 684 -3231
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/23/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/23/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/23/2013 $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: Permittee Signature: og 4j c4-7
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 /19/2013/FRI 09:17 AM )OLFEAS HEATING FAX No, 5039810801 P, 001
•
Mecbanical Permit APpli 4 ji E � FOl;C)h ICE l.ISt.ONLY
L Recei
li City of Tigard D at e ay: rf 3 / 3 sr Permit No._ 466, (90 3 - 3 1 3
4 13125 SW Hall Blvd., Tigard, OR 97223 •
R Phone: 503:718.2439 Fax: 503.590' IEEij Other Permit:
Inspection Line: 503.639.4175
2 2 2 013
(' 1 c.; A lt. n Date Ready/By: L Juet: 0 See page 2 for
Internet: www.tigard•or.gov CITYOFTIGARD Noti6ed/Method r �(� SupplementalInfarotatieu •
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Mec permit fees" are bas on the value often work
❑ New construction f Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
.0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
�— � era r �tdtra . , r i !! {c ��� -fir+ �a �� ��,( � sr ,- - ,.T7 .' Value: $
L f a '�'Sd, ., � r, yr i "'7 ',`t1 a a G eJ , 1 O T I meet','> i ,ila Svh'i`3�. 1 • l r r 'Fi i .11 i ' 1 rr , ,^I� s a •^
al,... 1.tni - i,re ..r ,..,..�.. ..� � . In .. 4 ' * "d a %. � iA .. ,s..,"' .t'' i 4t AV., `,,n, �'':;
dwelling' Commercial /industrial h� t,. s e �, ,
1- and:2 -famil
2 g ❑ ,❑ Accessory building For special JpJarmalton use checklist
.❑ Multi- family . '❑ Master builder .❑ Other: Description i Qty. I Ba. ( Total
q4 + ?.t .°4Sa!tiki., " , -511 h.'• * 7 A' r g "' i t 1)_ ♦'; ft »414 ,f,' L ro1Y lit4 wl>:i:4' ;' r conditioning i1Og1 -- -
'�'" " Air " • 46,75
Job site address HI G.j b W 4 vww b; - ,` Pi Furnace 100,000 BTU (duots/vents) I 46.75 +6) -7
City /State/ZIP: ~' d • 1 7 Puinace 100 +)3TU (dnots/vents) 54.91
Heat pump 61.06
Suite/bldg. /apt.'no.: project name; Mc r . I 443 11' e Ductwork 23.32
Cross street/directions to job site: Hydronic hot water system 2332
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric).
in -wall. in -duct, suspended, etc. 46:75
Flue /vent for any of above 23.32
•
Subdivision: Lot no.: Other: 2332
Other fuel appliances;
Tax map/parcel no.: Water heater 23.32
tl q y , j "'maiyy liy i it i S � v �' F ;T ;7 . F1771 7- 7 7 1 Gas fiE
� o! 14F� , C i i tiiR�',,,Ai� �3 W ?� , r�lt,�' cPlaceinscrt 3339
Flue vent for water heater or ges
fireplace 23.32
Log lighter (gas) - 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent _ 2332
O. i» i ati i ML+ v'S '�ti Y $ ' -0w7 +� +, .+ "Y"nh I ,«,� N I tl `"- """' .. Other:
u g' ; i 1 : i ltl giNir . is to ..� ;:;,, r� r::!;'': 'k1,; ,' :•' L s F ,,,g ' "' I a 1 r ,, 23 32
h t i�l' „ vc fir;,: a,i,. :. ,:.
Envlronmentel exhaust and ventilatign:
Name: j 1 t 1 - Range hood /other kitchen
i equipment 33,39 •
Address: 1 i • w H,1, no - P L Clothes dryer exhaust 3339
City /State/7.TP: 1 ad O , Single -duct exhaust (bathrooms,
f - toilet compartments, utility rooms) 2332
Phone: ( . ) t g-'. —3 Z3 Fax: ( ) Attic/crawlspace fans 23.32 _
x I kf;a .t telV�T .1" „ a i 23.32
i . 7 4 i,' n d r iffR : i -, ;ti2 a n ar r F a. 0`\ ,, ,, Othe
y,.,at, r�:.. »k rb rt`mrorr ,, 1 ,1 .A� �'� , t,M'S � � .p: r Mx,xnmq �. �
Fuel piping;
Business name: w a 1 . 4 ,r, $14.15 for first four; $4.03 for each additional
Contact name: _ tr4 Furnace, etc. .
Address: a ♦ S 4_ Gas heat pump
Wall /suspended/unit beater
City / State/ZIP: 1,... • • . , r G 7 , Water heater
Phone: ( $03 ' . -. S.'.1 Fax: : ($p1�) 9 fc — o g-' Fireplace -
Range
E r , 1 t - - • Barbecue - W
1 r t rt r L'C44 ! n�M ,4 n F ° '.1 r ` z;r .f :
..' u�.. II�. �.., �«+ S« ��:, t::,,., a:.a;.. +�,�';i�'LM1 + »��.,.�:�'� 7 J+,'�l�s�a; �t�:.,. ls�:^{; L, u��TX.: ''Mk":��n;✓mmt'"wl�i. n,.'ilat1`Ai "1*;:,l; Clothes dryer (gas)
Busi seas nerae: L,�
Other: gl' II
t t ,
Address: "IU L ,a 44.41,111 glIAL Ia s`Ja .,.,_
n Subtotal.
EMErailagnti. . J f..A. Q (_ C 701 Minimum permit fee ($90.00) 9 0.40
• Plan re view (25% of pemrit fee)
Phone: ( US) , / — L'/ ,. Fax: ( $(2 ) —
U State surcharge (12% of permit fee) 10.to
'CCB lie.: 1 ct ( i, TOTAL PRIVJIT FEE 100 .
This permit application expires if a permit is not obtained within 180
7:::, days after it has been accepted as complete.
Authorized signature: 'Ii.A. _ • Fee methodology sot by Tri -County Building Industry Service Beard
I Print name: I11r, U vC',5 Date: 17 /6r / -
mn,dIAinnlv..mk *UAVC 7rnnIt Ann nemn Anr aan4orrr el in7mnamov"-Fi
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
11340 SW AMBIANCE PL, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
04/29/2013 00:00
MEC2013-00213
PASS - No C of O
Violation Summary:
Inspector Contractor