Permit CITY TIGARD MECHANICAL PERMIT
r COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00070
DATE ISSUED: 2/11/2008
, TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102BB -00833
SITE ADDRESS: 10050 SW JOHNSON ST ZONING: R -4.5
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT: 016 JURISDICTION: TIG
PROJECT: SMITH
Project Description: Replace gas furnace and add AC.
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: 1 DOMES. INCIN:
NAT 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
SMITH, STEPHEN A + CHRISTINE D Description Date Amount
10050 SW JOHNSON
TIGARD, OR 97223 [MECH] Permit Fee 2/11/200E $72.50
[TAX] 12% State Surch 2/11/200E $8.70
Total $81.20
Phone: 503- 639 -5633
Contractor:
JACOBS HEATING & A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -234 -7331
FAX 503- 808 -9108
Reg #: LIC 1441
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.
Issued By: jeid I Permittee Signature: e77 � . c 7yl.
Call 503.639.4175 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.
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d im° e 41 131 SW Hall Blvd., Tigard, OR 97' 3 a i i t I] �" t Out Parma N. _ �� - OL29
Phone: 503,639.4171 Fax 503.598,196 .1 Ann Review
. Inspection Line: 503.639.4175 r Date/By: ()they Pcnnit;
1 1i, K Il b g 200 3 Date Road i8
sue! Internet: www.li •ard•or. ov r i D J ' i I Ready /13y: 1w a' S Sc e Pagel 1urVT nor
NUdhnd/MetlbQd;
Supplemental lnarlOII
p 8 � r � p{; LLL mtntal
0 Now construction , A Ills }'an.� ••N, �dditrott/ 4 � au Nr� dt��a1� t
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a� I � �,+s,cw'�3� � t >� u'�`� „'� ;1�� G !'�� � vim' �'mf a �f� , i
�; Q f, aliment A `' il- c'' ` Mechanical penult tees• arc based an the value of the work
performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
i I ?:'� it�" ;,"+ut L ,a{° � ' alq ur�azya , 1 JP rt,w .
yt ������(� mechanical materials. e.w.m
I 1 '1. . 111 . 1 $.01111 i �k i1!))lia„ a,l:tl ,m$'1 Nurse }•It�uu "{. , Il giIiflE l;1 IEE�� ent. overhead, and •rofi
t
21 1- and 2-family dwelling I E l 1 �� , `l� 't + �V1 k,o hum
Y g ❑ Commercial/industrial 0 building t �lvh - � ,. „1.., ,. ,i ..a-a,:, m�:fi4f ( I t I a
❑ Multi - family ❑ Master builder ❑ Other: For special irl/orrnariorr use checklist
(It I..' g {�
Description
�E��rEllvlli ' IIiN� {��q�jf�t .e `'',�1i�4'lt +l �t�n v rtYt�f �T � L P t 4 r t E p Qty, CAL Total
d lU � rL,1tl I t!',•,,. ► t;.�r;( t ti,Ic� � � i ,: "t 7V i . �{ � s !' i j,, Heatin cooli ,
Job site address: 10050 SW Johnson St Air conditioning or heat pump
(requires site plan showing placement) l 14.00 14.00
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (duets/veins) 1 14.00 14.00
Suite/bldg. /apt- no.: Prtlject name gyp_ Furnace 100,000+ BTU (duns /vents) 17.90
Gas heat un . 14.00
Cross street/directions to job site:
Duet work
1 14.00 I4.00
Hydronic hot water system 14,00 III
Residential boiler (radiator or
h dronic 14.00
Unit heaters (fuel-type, not electric),
_ in -wall. in -duct, sus. •ed, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 1 10.00 10.00
Tax map /parcel no.: Other: 10.00
I I t { tc {I• 1011} E'I 4 aww�rwl l 7W+ utt v „ Other fuel appliances
d i 1 1 i II 0 ESE ' �. 1 ' �r�'l '9" ' ",'14;j �� ' 11 .1(� iE rY n i ' Water heater ., � .., .tL�, � uaw,,,turu �atttllti: >, ,�� .� . # ; 1 ���G1��1� l'1� n - "
. ,, ,- �r�nt� il, W h 10.00
Gas fireplace 10,00
Flue vent for water heater or gas
Replace gas furnace and install air conditioner. fireplace 10.00
Log lighter (gas) INN 10. 00
_______________
Wood/. Net stove al 10.00 is
����� ,t
1 e" Wood fireplace /'insert 10.00
1 lit�tr'1 E, ,i . = „ . n1, 01 i!li�E� 1 '1 a .i ",� l ' ,' iz l� Chimnc /liner /flue /vent 10.00
l i�i a���ir' I,, ., { l �i�ra�s I�.,�„ ii Other: 11111 IOAO Mill
Name: Mike & Christine Heiser
Environmental exhaust and ventilation
Address: Range hood/other kitchen
.-. equipment 10.00
City /Stute /Z1P: Clothes erexhuust
10. 00 MEN
Phone: (503 )639.5633 F ax: ( ) Single -duct exhaust (bathrooms,
. 1'
• , u , 1 „ ; toilet com•urtments, utility rooms) 6.80
iiil'r), f , Q, 611 91 ie ,;�, 1 1� ; if �"' 1 ; tt 7''� 1 ' �t?9 " /� IN
ac ,� ] �' I �1 t u (,�, a r..1� � �:i��� �, �?tJ Anic L.rawls • sac tans 10,00
Business name: Other: 10,00
Contact name - - Fuel piping
55.40 for feral' (our; 51.00 for each additional
Address: Furnace. etc.
City/State/ZIP: Gas heat putn�
Wall /sus. nded/unit heater
Phone: ( ) I Fax:: ( ) Water heater
E-mail: Fireplace 111= OM
r 'BM 1 ' s s I @.1( 1 vE {i ifjf i t irV� c lye {t�f twr`a'wg 1+i rnq Mill 1 �, le,, Ran _
'i
11 1 . E 3 , ifir�a, , w� 1i d U � i� hi, �E i� 1M Barbecue
_ MN
Business name: Jacobs Heating & Mr Conditioning Clothes dryer .as)
Address: 4474 SE Mihvltukie Other: �3�t�0 -y�y 9�p
I ;� ii'''d1u, i nnP LIiJ't,1, fl '5 51;N .• , I��.�{1 4 1..tl {'i;} ,',1
City/State /Z1P: Portland, OR 97202
Subtotal 52.00
Phone: (503) 234 -7331 I Fax: (503) 808.9108 Minimum permit fee ($72.50) 72.50
CCD lie,: 1441 Plan review (25% of permit foe)
State surcharge (12% of permit fee) 8.70
TOTAL PERMIT` FEE 81.20
Authorized signature; "Phis permit application expires it a permit is net obtained within 180
days after it has been accepted us complete.
Print name: Michelle LeClair 1 Date: 2/7/08 '-~ ° Fee methodology set by 'In County Building Industry Service Board
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