Permit CITY OF TIGARD MECHANICAL PERMIT
. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00209
T 1 G A R- Cn 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/29/2009
Parcel: 2S 101 AD01400
Jurisdiction: Tigard
Site address: 1 SW 68TH.AVE _
Subdivision: WEST PORTLAND HEIGHTS Lot: 33
Project: Oregon Ki Society
Project Description: Install new mini -spit heat pump.
Owner: FEES
OREGON KI SOCIETY Description Date Amount
PO BOX 2143
LAKE OSWEGO, OR 97035 Permit Fee 05/29/2009 $166.70
Plan Review 05/29/2009 $41.68
PHONE: 12% State Surcharge 05/29/2009 $20.00
Contractor:
JACOBS HEATING + AIR CONDITIONING
1421 SE HOLGATE
PORTLAND, OR 97202
PHONE: 503 -234 -7331
FAX:
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -3 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 1
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $228.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Imo,
Issued By: 4 f\ Q C /t J� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
05/11/2009 15:57 5038089108 JACOBS HEATING PAGE 01/06
• Mechanic • 1 Permit Aunlication RECEIVE if roll OFFICE USE ONLY
, 0
Received e--
Ci of Tigard paws N—, • , 2 .410. Perrnit No„ ii 4.. 4_40A. , • a 4zo?
. I R. 131 5 SW Hall Blvd , Tigard. OR 97223
; 11... Ph. , e: 503.639.4171 Fax: 503.598.1960 MAY 1 1 2009
ate/G • her Pennit:
- rico RD
Map- .Cin Line: 503.639.4175
nate Ready • y: e 08.0 ,-, ., NA,: a See Page 2 ft) r
Into let, www.tigard-or.gov
CITY OF TIGARD Notified/Method:3, —1 Supplemental Information
i IVISIO
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12 New constru tion vt ddition/alteration/replacement Mechanical permit fees* are based on the value of thc work
performed. Indicate the value (rounded to the nearest dollar) of all
1=1 Demolition 1:1 Other
mechanical materials, equipment, labor, overhead, and profit
''':;140;:7gl:i,V), '.' ,' 1. ...,,,,,. , , ,,....,,,..,.. ., ,,,., . Val , , .■ 9
.0 , ..,N.,,,,-„ , • ,• ,;i,. ,.,•,„.„.•,, -
Li 1- and 2 ly dwelling . 1grt'ornmercial/industrial 0 Acccssory building
For special taformation use checklist.
0 Multi • ID Master builder 0 Other:
Description 1 Qty. Ea. Total
e• ': ',MO* rfSi 7: .` L ' th '•;" lIgli . ff"d n
Job site address: 6,1 S) (0? 9 gb,) Air conditioning or heat purnp
(requires site plan sbowingplaccment) • 14.00
CitylStatelZIP: t 9..r.A_ 0 • '' 7 a Furnace 100,000 I3TU (duutsivent) ... 14 ,00
Furnace 100,0001 BTU (ducts/vents) 17.90
Suite/bldg./apt. n. Project name: 0 i oei t Gas heat pump 14.00
Cross street/dir 'nns lo job site:
Duct Work 10,00
Hydronic hot water system 1400
Residential boiler (radiator or
hydront9 14.00
•
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 14,00
—
Flue/vent torany of above _ 6.80
Subdivision: Lot no.:
Other ..
10.00
Tax map/parcel •.:
• Other fuel appliances
;'•";.c1•51;':gle' vny ifh i] mm. •217,Irra ,, N.s-. Water hcatcr 10.00
MEER & k■k e-tA.) Illn pti-\- fa-4 Pl.t.Prip Gas fireplace
Flue vent for water heater or gag 10.00
fireplace 10.00
Log lighter (gasl_ 10.00
_ World/pellet ctove _ 10.00
- Wood fireplacefinscrt 10.00
'' r' 51 4 1 aMli t IA '■ ar.7bli5INIP • lit■i,' ,41 J;;Illhi" IRA: ,,...,:, Chiimmney/liner/flue/vent ' i 10,00
1 10.00
I!:2l e 0 ' Osn k 1 0 C % R, Environmental exhaust and ventilation
Range hood/other kitchen
Address:
...equipment 10,uu
City/Statc/ZIP:
Clothes dryer exhaust 10.00
— Single-duct exhaust (bathrooms,
Phone: ( SO2) ) ()(p - 7 , I 1 Fax: ( )
toilet compniunents, utility rooms) 6.80
,::,;1 ,' r ■sii1j:V i,iii '; lgi grINO' ' ' Attligg1i1;!'l Atticknawlspace fans 10.00
Other: 10.00
Business name; —
• —
Fuel piping
Contact name:
S5.40 for first four; 31.00 for each addftioaaj
_
_
Address: Furnace. etc.
Gas heat pump
City/StatefEIP:
Wall/SuSpcnded/unit heater
Phone: ( ) I Pax: ( ) Water heater
Fireplace
E-mail:
Range
r A : 'AN 1 FFgEPRit'' .. '' :.''1.01:''..%414.W640 Barbecue
Business name: J: cobs Heating & Mr Conditioning Clothes drycr (gas)
Addreaa: 4474 S I) Milwnnkie
I ril 7" 4"te i *:...ROSig#: 4 5900::;,„..:.. " ..7- , ; ,..:.11 1, :• : ,, :. ::::.
City/State/ZIP: P. rtland, OR 97202 Subtotal
Phone: (503) 2.34. 331 ... Fax: (503) 808.9108 Minimum pennit.tee (S72.50)
_
Plan review (25% of permit fee)
CCB lic.: 1441 ' — -16 ,
stat. surcharge (12% of pennit fee) .
. .
Illgrr TOTAL PERMIT FEE
This permit application expires if A permit is not obtained within ISO
Authorize d sign , elleviifi r Plij■
Jays after it has been accepted as complete.
Print name: _ LINC. . .igiffLuirg Date: S — it -07 • Fce methodology set by Tr-County Building Industry Service Board
lAlkildingTermits \ MEC. ermitAppdoe 01/19/07 440-4617T (11/02/CONVWED)