Permit Iv' u CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -10001
TIGARD DATE ISSUED: 6/4/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S11106 -00500
SITE ADDRESS: 14805 SW 103RD AVE ZONING: R - 3.5
SUBDIVISION: DEL MONTE SUBDIVISION LOT: 004 JURISDICTION: TIG
PROJECT: MUNHALL
Project Description: Replace gas furnace and install a /c.
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
WALT MUNHALL Description Date Amount
14805 SW 103RD AVE
TIGARD, OR 97223 [MECH] Permit Fee 6/4/2008 $72.50
[TAX] 12% State Surchai 6/4/2008 $8.70
Phone: 503- 620 -6830
Total $81.20
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 : 0 0/
EC I I P Si ' ��
�i�_L�� --.�/ �`i /I% / yam.
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.
tit
RECEIVE
Mech anical Per mit A Iication , � �' ' ` i SE. w��'x' .z... ��'0 -- 1, .,
pl>I te nt u1 -i ;1(1 u �t��t)NI )� � � ���� �; h,.
' City of Tigard JUN 0 3 2008 R I : i l i . ��ii V 6,/ A
' 13125 SW Hat alvd.. Tigard. OR 9722] �'�Y' "` �r, Qb J� Ferrell Nq., /1&' 4W D Ave/
, Phone: 501639.4171 Fax: 503.598.14 Platt kcviow
f InspeeIi0n Lire: 503,639,4l 75 I1 OF TI GARD Daz ka Oilier Permit'
I I ` > t' ` B UILDING DIVISIO ' i'a itdarlWit se r a 2 lace
Internet: wavaa'.tigordwr.gpa Nolifi &upplamenrol Ntioa
_ TYPE OF WORK COMMERCIAL 1PEE• SCHEDULE - USE CHECICUSr
❑ Now construction Addition/alteration/replacement Mechanical permit Pees' nrr G>ued on the value orate work
❑ Demolition 0 Other: performed. Indicate the value (rounded to the neatest dollar / 01' all
mechanical materials, equipment, labor_ overhead. and profit.
' CATEGORY OF CONSTRUCTION Value: $
® 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessoy building
RESIDENTIAL EQUIPMENT/ SYSTEMS FEES"
p Multi- family ❑ Master builder [] Other: For ctc /itgjoraeaua►r use checklur,
Dcseriptio E a , Total
JOB SITE INFORMATION AND LOCATION 1leutlnp,/coatiog
Job site address: 14805 SW 103rd Air conditioning or heat pump - -
-
acquires site plan thaw inn placement) I 14.00 14.00
City /Stote/ZIP: Tigard, OH 97224 Furnace 100.000 BTU (daerc+vaaut V I 14,00 14,00
Furnace 100.000+ BTU (duetdnbcul 17.90
Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross strLetldirections in job site: Duct work 10.00
l ydronie hot water system 14.00
-- husideraial boiler (radiator at
hydronic) 14.00
-- Unit heaters (fuel -type, not electric).
in'.wall, in -duct. suspended, etc. 14.00
Subdivision: Lot no,: Flac/vent for any Of above 1, 6.80 6,80
- Other: 10.00
Tax mop/parcel no.: Other tel appliances
DESCRIPTION OF' WORK water heater 10,00
- Gas fireplace 10.00
_., Flue vent for water heater or gas
Replace as furnace uad install air conditioner. f' 1 ° � 10,0.4 I
tog ligh (teas) _ 1000
Wood /pellet store 10.00
Wood fireplace/insert 10.00
l'' PROPERTY OWNER I ❑ TENANT Chininey/liner /tluelveat _ 10.00
- Other 10,00
Name: Walter 1lunhall Enslrooloental eshaast and venllfutiae
Address: Range hood/other kitchen
equipment _ 10,00
City /ShattlZ]P: Clothes dryer exhaust 10. 00
Phone: (5031620.6830 _ - Fax: ( ) Slingie•dust exhaust (bathrooms. .
toilet eompnrtrnyrus, utility looms) 6.80
CJ T
APPLICANT 0 . CON ACT PERSON Attidcrawlspace fans _10.00
Business name: Other: 10.00
Furl piping
Contact name: _ S5.40 far fire four:SIAO forrach odditiaant _
Address; Furnace. etc.
Gas twat m
City /State/ZIP:
Wall/suspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
E -moil: .
Run c
CONTRACTOR Barbecue
Business name: Jacobs Boating & Air Conditioning Clothes tierce (gall _ —
- - - Other.
_Address: 4474 SE hli(wrtukitr
MECHANICAL PERMIT FEES*
City/State/ZIP: Portland. OR 97202 Subtotal _ 30.80
Phone: (503) 234.7331 I Fax: (503) 808.9108 Minimum permit fix ($72.50) 72.50
- Platt Mims (25% of permit fee)
CCs tic.: 1411 State surcharge (12% of permit fee) 8.74
/ TOTAL PERMIT FEE 81.54
Authorized signature; { Thh pariah aerate -mien expires if a penult Is not obtained within too
day* u{ lerIt been accepte +d>al complata,
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BUILDING
PERkA|T kHEC2008'1OOD1
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| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 614/2008
Phone: (503) 639-4171
Inspection Requests (24Hm�:(5O3)63A'4175 ~�h�� ^��..
INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: }:OOAAA PAGE: 21
SITE ADDRESS: 14805 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: DEL |VI{)N'[E5NBD|N0(>yV LOT #: 004 TYPE OF USE:
PROJECT NAME: MUNHALL
DESCRIPTION: Replace gas furnace and install a/c.
OWNER: MUNHALL, WALT PHONE #: 603-6286830
CONTRACTOR: JACOBS HEATING & NC PHONE #: 503-2347331
Inspection Request Scheduled For: . Date: 7/10y2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
093 Mechanical final 072437-02 603-234-7331 Y
•
Corrections/Comments/Instructions:
gi) i• - .. • - ~ '1 ` 7 --_,crg ~ ^ '
,
'
ASS |l PARTIAL APPROVAL n CANCEL 0 NO ACCESS
n FAIL 111 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
•/A
Inspector: / / • Date: 7 -- , ( 6 .- ~»ra Phone #: (503) 718-
SITE PLAN
0 2.c)
DIRECT] ON
HOUSE FRONT
STREET L73
Job No/zit U A -(z ni A4//
Address ja
t , - C9- . 4' 7 2 )-
Model 4
Make
JACOBS HEATING & AC
4474 SE Milwaukee Ave.
Portland, OR 97202
(503) 284 -7331
(503) 813 -9257 fax
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