Permit rf
7 ®Y I `\' , � MECHANICAL PERMIT
i" COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00351
T[GA Dj 13125 SW Hall Blvd., Tigard, ard, OR 97223 503.639.4171 DATE ISSUED: 6/14/2007
�` "' �"' g PARCEL: 1 S125DB -07400
SITE ADDRESS: 07165 SW SHADY CT ZONING: R - 4.5
SUBDIVISION: SHADY DELL NO. 2 LOT: 047 JURISDICTION: TIG
PROJECT: SWEET
Project Description: Gas furnace and heat pump.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SWEET, MINOO S Description Date Amount
7165 SW SHADY CT
TIGARD, OR 97223 [MECH] Permit Fee 6/14/2007 $72.50
[TAX] 8% State Surcha 6/14/2007 $5.80
Total $78.30
Phone:
Contractor:
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -7331
FAX 503- 813 -9258
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:
A <<�� Permittee Signature: a, 6 e,
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.
Mechanical Per mit Applicatio FOR OFFICE USE ONLY
* City of Tigard R ECEVED Plan R Received Q PermitN ��J g DateByfe / • 3' -035
II V 13125 SW Hall Blvd., Tigard, OR 972 evi w
II ' Phone: 503.639.4171 Fax: 503.598.1960 Plan Re : Other Permit:
DateiBy
T I G A RD Inspection Line: 503.639.4175 JUN 1 4 2007 Date Ready/By: tcris: 0 See Page 2 for
Internet: www.tigard or.gov ^1TY OF TIGA ® Notified/Method: Supplemental Information
TYPE OF V P VRK I � I4I COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based 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, and profit.
_ CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
11- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
s W .. p () ` ^ l Air conditioning or heat pump
Job site address: 'V 1(/l�1 C �+- (requires site plan showing placement) 14.00 l�{
City /State /ZIP: 'T t C I 1a� Fumace 100,000 BTU ( ducts/vents) i 14.00 l�`f,DO
Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work , 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
/ r' I1 4C Q C p Flue vent for water heater or gas '
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
TENANT Chimney /liner /flue /vent 10.00
PROPERTY OWNER I ❑ Other: 10.00
Environmental exhaust and ventilation
Name: � l n � �� Q p ^ �p Range hood /other kitchen
Address: GO .yV 1 �i( (/` equipment 10.00
City /State /ZIP: l /�
0 Clothes dryer exhaust 10.00
Phon
Single -duct exhaust (bathrooms,
_�� ✓ jl Fes; ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business narne: Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Water heater
Phone: ( ) Fax: : ( ) Fireplace
E -mail: Range
• CONTRACTOR ,C Barbecue
(� Clothes dryer (gas)
Business name: Lc J5 H Q6 Other:
'' ° (
Address: , ; ° r " ' 3 f , i U V C { . . 2 - , A y . . MECHANICAL PERMIT FEES*
City/State/ZIP. rf I ( 12 7 " Subtotal
Y �i . �� r � � v Minimum pe rmit fee ($72.50) —1 �,5 �
Phone:) . J Y 7 33 i Fax: lF� 1, 0 CO Plan review (25% of permit fee)
CCB lic.: 1 )4._ / State surcharge (8% of permit fee) S.
TOTAL PERMIT FEE - 7`-.30
This permit application expires if a permit is not obtained within 180
Authorized signature: z/1 -I 10 ---- / days after it has been accepted as complete.
Print name: -� ,-- AA Date: (1 111 10 I * Fee methodology set by Tri- County Building Industry Service Board
t ' 1: i r L . ( 440 -4617T (11 /02/COM/WEB)
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