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Permit C ITY OF TIGARD MECHANICAL PERMIT PERMIT #: MEC2005-00584 l DEVELOPMENT SERVICES _. � 13125 S Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/19/2005 PARCEL: 2S103DC -05700 SITE ADDRESS: 13720 SW 115TH AVE ZONING: R -4.5 SUBDIVISION: VIEWMOUNT LOT: 045 JURISDICTION: TIG Project Description: Replace gas furnace and 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: GAS 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: 1 AIR HANDLING UNITS FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES DANA TAYLOR Description Date Amount 13720 SW 115TH AVE. [MECH] Permit Fee 9/19/200f. $72.50 TIGARD, OR 97223 [TAX] 8% State SurcharE 9/19/200f $5.80 Phone: 503 684 - 9205 Total $78.30 Contractor: JACOBS HEATING + A/C 4474 SE MILWAUKIE AVE REQUIRED ITEMS AND REPORTS PORTLAND, OR 97202 Phone: 503 234 - 7331 Reg #: LIC 1441 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 - 2344 Issued By: SU ,e_i , Permittee Signature: Ar i /_ /, _ A Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. FROM ZIT a cob SHeating FAX N0. . Sep. 16 2005 11:31AM P2 GOIt Ohh1C'F; l;til; ONLY 1Vtech Per mit Applica City of Tigard ECC`11`I E0 Received a nnte/ny: Permit No.: � 5'1:206 ��j i 1 1 �/� y� h '/ 1312$ SW Hall Blvd., Tigard, OR 972 Plan Rev ew / • othOr Pernik Phone: 503.639,4171 Fax: 503,598.19(10 * '° j Dstealy. SEP Datc Ready/By: r. ' 1611 see page 2 for Internet: ernet rnet :m Line: 503 ,639.417$ 1 2�U. { : www.ci.tigard.or.un Norified/MBtlladS .4 (_ Supplemental Information + r { h1 , ny''f '1" l)t•i t' ! l' {rdE !s { urrt };r •, Jy f uF cii r� S' ? ?I S4 rii # ,. rr q `,)rHc•s''r( /,� Irrrrb + ' , r t �.{ e,u ,, ; { i' , 4 F • i t i { / , f �f r � i a Sl r' tt r 4 4 r#v r) 7 rnl. a ria?, , y ' $ "'�P��`ilplilf,(' r�tt ; { i ` ( , l � {� f"$� i 1 , i t ,�,`• 1+,9 f z+: i,+ F � � ��' I }ry[1+ I � ++ 1lt • !t r, , �� ,� ?} {l, � {�}}f�'i�ltyr � (j!I • ii? � Iri � S'+tl C'1" f� � h ' �bl, ,r,l.f +ri�u,•1,WS2r i,},r r, . '1 y{ I I &i QQ,yy�{{�� 41 1{ /1sii l ' a 'r�}r. t Q ' -' ' 1 ''1 �} ' . ' r 1 eCli lj n ' • tt:i t 4 # s"' r base .t , li1_ {,`�i, {I, 44,hi }) ,,, .. + r•I.f�l,;�� a +ry•1��:?! ; }•• �� _ - nrlct:hanical permit fres° arc bused on the value of the work 0 New construction Addition /alteration /replacement performed- Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other- mechanical materials, equipment, labor, overhead and profit. r. � c y,14 ! sx I a a � SlSy ) 7 J 4�{ j ' �7 i,tar„ J !s + i Y-+utrr, { � , l S r3},r } t g W E • �r �n (l "• �ttg�yilt s, t � • V slue: $ , Ng 1 11 J' 1i }'+�� + ;t , l 77 ),: 11. . ,,,, !' }fj y ���S:1p 1 ' �Fy {:r ff1 i 1,1 ( 'f�. ^�47ti[fN�oi -`'I. t { ,rgrleii•ry .�rq ilp 4s�.S:7�7f`��(iuW;lftf�'l l�ItrJns�rff. ,Fri + ^ +fl�JPan; ;f , tN )I '! t!, �tHi;/ l l5t' �1 S�J fdr�l�� IIYG�1111 1!!1 S7Ytkt7r� /titvll(t'.' f4 Ylldllp' '.IV1ltKf;ll r{.ut�Stf�tlY�fn4R. 1, C, �J 1.) t, • . , < t f r } } \I` h'•}� .II.�d F H {i if' iJ. ld 1 . , :I �c �p 4 { �b f. .'.'i�rf' Accessory building �. , � t�" `r'�r lirsm`litlSlTIIS 1! .rli,«7r 3a, r r !.r, L fitii!,+sY t 1,� ;171!�14�r r�71!}��1� t� +iH� ® l- and 2- Family dwelling 0 Commercial /industrial ❑ y 8 ! or special information use checklist. _ 0 Multi- family 0 Master builder 0 Other: Description 1 Qty. 1 Lt, I Total 7 s - i I ^7 r ` 'Prot. id s Y rf f 1 { ,' J ,f'a rf Yf ys ■19trvrl rS ∎7'l r TWO '.r tN ., i € Heatin co nhIn i si• 1. i� # � s , { r ! } ,; l) (1 P l ' nq�Wyl' o ! i {' tt �fj 17.t7;r , ,,,s}SI�.'r � 1.. d� r rsst r. r ,'•IGisln�r:!,„01 : i„ t �ftAif t hi,,,., raN N 1i , � i ,,, •• r � , , !Jr S #�} ` Air conditioning heat pump Job site address: ' 1 �J , F� (squires she plan showing placement) 1 14,00 ;� -- Furnace 100,(100 BTU (d,ncts/vcnta) I 14,00 4 1. CJQ City / State/ZIP: -7-- C� ` � . � Furnace 100,0001 BTl1(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 - - - I•lydronic hot water system 14.00 • Residential boiler (radiator or hydronic) 14.00 — __ - -, , Unit. heaters (fool -type, not electric), in -wall, in -duct, suspended, etc. 10.00 • Fine /vent for any of above , Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances }+ ) 1 r � } �J JI n f i '� . ' J' 7 +' r , }:a-rul trn cr,r x+) e ms . r �r,rr a ",+ • {gpt r, s s , • 1, ! t,.. , heater e aer 10100 ...— I d� p�• 1 i��4 l i. Nil t � ,l l I NGp, ' e,y a ;4 d, , r !' i4 i I TTi 1 I p ii u , I Y A I R I yO ,,. igfp .. ji1 .. li!{ 4: ::!ril,Gr��ri3sE „it. :;!;) ; . ; : : :.I t t, ,, ,t1M•ines rt s t,, tlaii, a ,d Y:,. P., -t 1,. ., a ; Gan fireplace 10.00 /3 6t �� -1.-,... 1"1(��Q _ F 1u c vent for water heater or gas 10.00 `� ✓ 1 fireplace Lag lighter (h'as) 10.0(} Wood /pellet stove 10.00 Wood fireplace/insert 10.00 iy`'r I ry pS} !, G " t t r,. {si Pvs , tltl }� ri tr i t �r � ; �t 't{ w� { t r1) #n q , �, nr r ,(", t,, r t , `p ,* �{ t ! f r Chimney /liner /flue/vent _10.00 p }} y�t )'/�, t f f, 1 r1 a Ili f` ' ":' ' ;P I ' n�i,;h'��� � f'eiS� fffi{ I Io,00 P 1� �itn�,l.�iJsnrs'�vdl 1,ill,Luldrr rrr rtttF,li;t r , , 1r. I d ,tti ra 1, , + F Other: _.- Nam,: � ((` t2\ Environmental exhaust and ventilation ,� ,� ��� Range hood/other kitchen , Address: i ' � -1.c) ts i Imo A-----Q-- ui meat 10.00 City /State /ZiP: ' .--vraZ_. C"7- �:�-...... Clothes dryer exhaust 10.00 -, �� Single -duct exhaust (bathrooms, Phone: (a 2C GI Fax: ( ) toilet compartments, utility rooms) 0.80 - ,i !I {f ifr`}T > +' I'l lr,..a r�ltf +p: , +f s. ?.a t l y, of(p , ��} pp�js { •+ , 7 . ,{ l• �+ } ur"j�} ''i' ilr Antpt� g�digrppl �yS�.(,�l +sllu l"p, An {�{ �a.)r i � ` t:/CraWlspacC fans _ 10.00 M1' il, llL�111�U( �tfNlr+{ �ii�����{ 1�lillli�G7nl: rt' hSBYb�hB #r�Vtt =d�34i.�111���.,iil i t �r81(Atl}yl @Vr�lf� +,�+i137�rr,'rJV,Cf1�y SE: Atti Other: 10.00 Business name: _ Fuel piping - Contact name: $5.40 for first four; $1.00 for each additional Address: _ Furnace, etc. i —_. - - - S. .,. Gas heat pump Ci ty / State/Zll': Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater . .. - — - .r, Fireplace r -mail: Range f 1 ! r �{ ; + q m ., f 1 ; {rr ;, xI it Y lR�l #, '1 ;,:/ :, {'j a ' 'M � 1 1�,; ..l 3 ran ; i�Mi / 1 1: , . ,. : L, .►�iVf i l ' m . ; l i t 1,: ; ".�� ' a , �n . irf r3Us {i ,1 (wi� ,)1 ,s ,l.rr !s t ��,tals,u2 5 3 1. 113 u + Business name: Jacobs Heating and Air Conditioning Clothes dryer (gas) - ..., - • -- Other: Address: 4474 SE Mllwaukie Ave s) f ? 11l�ltf ll� 1 `�f'FJ'siY 1 C u ' V »tP�s ,rns�, } n v 1 1 x,g r �s r,}uiLl stl�`,, 1� syE �. l r - 1 + 1;+b�ft +IHar,R {fii3L; Y'i' !i't,ir� r 14�f,i 9,l,$)19i,1u9 Sre sit }r 4s:m ;>33idfni,iirktr ttjllt:F+3Pr' l :. i; 1. ,Ill r City/State/ZIP: Portland, OR 97202 Subtotal .. "' Minimum permit fee ($72.50) ,� Phone: ($03) 234 -7331 Fax (503) 110 rmit 8 - 9108 - � .. ., Plan review (25% of pe fee) CCB lie.: 1441 State surcharge (8% of permit fcc) J , `_� TOTAL PERMIT FEE. - 1% 30 �t—V t.C� „ � v c This permit application expires If a permit is nol obtained withh, 1110 Authorized signature; ure: C �� days niter it ass been accepted as complete. - Print name:SlanwvriNfer, 1 Date: G? —I '! * ]Foe methodology set by Tri Cotnny Building Industry ServiC hoard MitilIAIne1 Permits \MSC- 1'cnntlApp.duc 12/03 440 -4617T (11/02 /CUM /WW1) FROM ;JacobsHeating FAX NO. : Sep. 16 2005 11:32AM P3 • SITE PLAN DIRECTION � � 1 HOUSE 4 "-` " FRONT 2S STREET - Job Name 0 0 v Address \ 3 a. 5 w — 4'"[ �` : • a.4 r- - Model # •3 � Is t © 3 Make JACOBS HEATING & AC 4474 SE Milwatukie Ave. Portland, OR 97202 (503) 234 -7331 (503) 813 -9257 fax