Permit • '� CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY PERMIT #: MEC2008-00611
os 00611
TIGARD! 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/16/2008
'PARCEL: 2S 114AB -04300
SITE ADDRESS: 16410 SW 93RD AVE • ZONING: R -4.5
SUBDIVISION: KNEELAND ESTATES LOT: 030 JURISDICTION: TIG
PROJECT: OLSON
Project Description: Gas furnace replacement.
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: 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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
CRAIG & ILENE OLSON Description Date Amount
16410 SW 93RD
TIGARD, OR 97223 [MECH] Permit Fee 12/16/20C $72.50
[TAX] 12% State Surch 12/16/20C • $8.70
Phone: 503- 639 -2902 • Total $81.20
Contractor:
JACOBS HEATING & A/C
4474 SE MILWAUKIE
•
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 ordirect questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ,�f��,. G�!r' - ---'_ Permittee nature: Si C"'?/,� x
Signature:
Gam_
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: , P j - c $f f REQUIRED ON GREEN INSPECTION CARD.
Code I Inspection Description I PASS Date 1 By 1 Code I Inspection Description I PASS Date By I
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing _ 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain _ 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural _ 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
• 240 Exterior sheathing
245 Firewall
250 Roof nailing _ ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
. 260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
1 , 695 Misc. inspection:
` J( 699 Mechanical final
BUP - Fire Protection System Permit _ `
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
_ 999 _ Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer •
405 Excavation 345 Culvert/catch basin
410 Fill _ 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final •
210 Foundation walls
215 Footing drain .
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection ., 599 Final inspection
I: \ Building \ Forms \InspCard- AOP- Blank.doc 02/02/07
k Mechanic l Permit A lication
�j�� Received p perm Nn.: Ci of Tigard 'i r0./By: /, >ir i I
' , r' , Phor : 503.639.4171 Fax: 503, 131 5 SW Mall Blvd., Tigard, O 4'rr..;,„ Plan Review - -
, 0 �•rR 'r „.,�` G ay% Date /By: Orhu Permit
Ins ction Line: 503.639,4175 •�
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11:1 New constru' lion ddition/a her4,..il acetnent MOChartiGal perm fees* are based on the value of the ww'k
la performed- Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: 1r mechanical materials, equipment, labor, overhead, and profit.
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lob site address: }' ` C - 13 S W 67 -3 f ` RfY, (ZU� Air conditioning or heat pump
HQ �Q [ (requires site plan showing placement) , 14.00
City/State/ZIP: ' T ,� �, � Gj '� _ Furnace 100,000 BTU (ducts/vents) 14.00
J „lag Furnace 100,000+ BTU (ducts/ureis) 17,90
Suite/bldg./apt. n .: I Project name: Gas heat pump 14.00
•
Cross street/three ions to job site: Duct work 10.00
- - 1- fydronicr hot water system 1
Residential boiler (radiator or
• hydronic) 14.00
-- - -- Unit heaters (fuel -type, not electric),
' in -wall, in -duct, suspended, etc. 14.00_
Subdivision: Lot nv.: Flue /vent for any of above I 6.80
Other: 1 10.00
Tax map /parcel nr +: Other fuel appliances
I�.)r) f %iA, ISj °l C l I( > It�y , ,� , � , y t b7��l i j ! , � , r ' „ '� ,r IIi I rI, W ate r he ater 10.00 -.
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! I a • •.111 4 1 r dlltt� . ,+ 1 1l� , •. li , . a I G�ulk?ltti'i c 1 , ! lit. d' . P ! %1.1{ tl . „+1L ,, _
10.00
C fil
� as fireplace
t 'Pii � Lt,C_ C GL_,_} m I , C ' Flue vent for water heater or gas
1 fireplace 10.00
o
I - Log lishter (has) t 0.00 ..
1 Wood /pellet stove 10.00
Wood fireplace/insert 10.00
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'1:.!:• '*I ' y ttt iat P• Atl ; '1,, 1 '' ! I, °'n 'rY'u( :}y;ti`� . ,. t•r'�'ui l i,l � jt ; illl. ai ll .'.r• Chimnev /liner /tlue/vent 10.00
11 �rp� 4
!;‘,!;.!!,'!;: 6 � '! I ! i.'!� t ', I"` ', -) ,I� + .-3 r.. A1MR!1•'! .•- •'•- .:lI.t111:" 111( ' ; 10.00
� Other:
Nair' , 1... - GL'i l .giy 61 SD n Environmental exhaust and ventilation
Address: �J\ Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust _ 10.00
Single -duct exhaust (bathrooms.
Phone: (o.3 p 367 -1,0 a" Fax: ( ) toilet compartments, utility rooms) 6,10
: , 1 + I I 4 1 q�y ( �, I ; ! ,', t P 1 1 11j Attic /crawls ace falls 10 .00
c ru „ r.. td i", r !r s, , i IV' ;:"Irltli. , iiaii0,4 „',x I1t .i r, rt.. - - p
Business name' Dthul': I 10.00
Fuel piping
Contact name: $5.40 for first four: $1.00 for each additional
Address: W Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit healer __
Phone: ( ) . Fax: : ( ) Water heater
------ Fireplace
E-mail: Range
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Business name: J Heating & Air Conditioning Clothes dryer (gas)
- - Other:
Address: 4474 SE Milwaukee l ii,ll�1l�i .i' ; lr� ,ii
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City / State/ZIP: Pc rtland, OR 97202 _ Subtotal ) `f • °.
Minimum permit fee ($72.50) " S
Phone_ (503) 234.7331 ' Fax; (503) 008.9108 Plan review (25% of permit &e)
CCB lie.: 1441 t • State surcharge (12% of permit fee) --
TOTAL PERMIT FEE `-
rC:
Authorized 516114[ . �"' I. _ -- This permit appficutiva expires it a penrtit is lip. railmd withilr ISO
Y . , Y days after it has been tleCepted as Corupldte_
Print name r‹,.,-5 r 1 ,
we
A Date: / o f (� "'a 0 W Fee meihodology Set by Tri- County Building lndustr SCNttC Board
1, / Isuildins \Perrnits\NECiPeiinhA1p.dsr 01/19/07 440.4617T (I1/02/COM/WEn)
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