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Permit \7 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00561 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/13/2006 PARCEL: 2S103BA -00107 SITE ADDRESS: 11710 SW ANN ST ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS LOT: 007 JURISDICTION: TIG Project Description: Install furnace, ductwork, gas line for furnace and water heater. CLASS OF WORK: OTR 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: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CU) DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: GAS OUTLETS: 2 > 10000 cfm: Owner: FEES ROGER POTTHOFF Description Date Amount 11710 SWANN ST TIGARD, OR 97223 [MECH] Permit Fee 11/13/20C $72.50 [TAX] 8% State Surchaq 11/13/20C $5.80 Total $78.30 Phone: 503 - 524 -3754 Contractor: JACOBS HEATING + NC 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 OU NC by calling 503.246.6699 or 1.800.332.2344. • Issu d By: ' - 9 0.4/K,d Permittee Signature: _4/ 4 1/ r it flt r--- -�`- -- -� Call 503.6394175 by 7:00 a.m. for inspec ions that busin- (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 Permit Application 1 Mechanical : 1 (,lt t)1'hic l: t tii': t)l.l' City Tigard it ���� ® i�- Received `�- ' A PcmitNo <:H .� , • / Q© tY g � L� Received 131SW Hall BlvdTigard, OR 97231 ,u Other Permit: 503.639.4171 Fax: 503.598.1960 3 /A ;.,;fi I ,. i,, Date/rly: Inspection Line: 503.639.4175 NOV t 3 2006 1 Date Ready/By:. I° is: El See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: • / / 6 Supplemental information CITY OF TIGARD e sal r�i r nay 1 "!jl .f a.�+ 1 {,a ., s.L.i ( , fi 9 3,: £'� , C� "r:;( ,.- =L `t4 .i'a 7 •,= l C ,.: �.,•<:.-:4 ;F a.t:i:� N.: *: . , � . { F i :3alt:�.M uh 4t � { ;11 f t ;(. , ( ",:i •t�qd l;dE: � �' � f " .i�� a �iil'i, ` k�, I5f`'i's ° �.� r :l ^ G�< t � fli:' � .K l' =l`lli. ;ll . {.t l' t f? r n•su.. l; si ii , ;,aiiiirginl s .:» .I.. w. € , .'..1 d.. �t,,. r( },p i.:' Ff`t ;F}�p��{ } �{ �t � , <� p t.,:�# "'` � '" :, .oR�r . .,, ..�I�, -.� .. =.�t,i� l . ...� ,�. . €..� .�i��I<� >�,, =>.i��,.. �� � '�';. �fl1flEi- �7" ci�?= �1�1�( tr�illl�? 2itl�1�3R' iltflf: &2- .,; ��r:�,3t: � :F.,' : r. Yi? Y. •, x; ;£, k ., <. ,t.n =t: l .$ �ni' 1 .t�gfs!: »ttEr� �,._.� ru•.�rm. = . u! � . ,, I-. .,.. 4r 1.,., t'• 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. ,�j ;r:;:i:; . :; r "�'�- „� „E,:.i...�`:s:s, .,£:. ,. ;_, .,t< ",t':li i ..j:;1:1. {wf;sMr;rt.rr.,:a`,i'I :i�.Y�1; Value: $ l ,.'{s 4' •it.t -l.pn kl:itkllki = »ift:, ;,rh "�f. „ �si.:i:. �fl. =. <n !(. ^.r ; i �i� � �X} . s?. i�f: { ; CA:� „G,Q • '.[.r,1, �,1�: ..,,,„4„,,,,,,„ :,s;< :il.� I?`�,_ I,: i s �,rysr- =i;:. i �:t, .kv =5;'•t:;» ?r: k i * 3 :l:w.S=r.g <.lt;� f ?; t�ta't::� <?,lu�+! <u 1c�,t't�:l ?' ... ......... . : .�„ � i , ,.!_. �� £,:; l.;r: ... a,�a:9. nti >j �� �.s`+r�`'s.,> .. ,� *rt T . t�:s::,t,, � ,.,t i•rh' �i {`t�. ® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ” " "'` ° ' " ' ''' `'' ' �`'{ °� "'''" s' f ``i "' For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total ii f t + ' }t i ; il r 1 1 .,. 1 .. 1 =i `ii7" i 3 _ , I , : gun g .;. it,�o s£'x i i `•i "'till' {, s !i : ra,l:r:. ,>if� :,le pr,1; i, "•3 ii . t.;i �ti e u• lhili f a ; ` u:. , : 1 '1� tl `- :r. :i• C - . ,11 . 1Zi; % e o- (t.4 :,',.::'. t,ll?yt ;�.,,t ?.lt� ,t;, , a;; rfr' �lz� • I 111V)�? , �A;�q�t , �lt�il�'1�T�C ; _`C'1<�� "s., 1V , d2, s .� ,:,. H eating/cooling i _ .,, x:r, .� ^:k -• -• o,. 4.,. » &, .rPtiz I "•at,a t:+i;:.113if....:ls Ee, Job site address: / / 7 lo d_Av Ah --t- , Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State/ZIP: ri 'Sek.{/C.L, —722—e3 Furnace 100,000 BTU (ducts /vents) ' 14.00 Furnace 100,0001 BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: Gas heat pump 14.00 Cross street/directions to job site: Duct work l 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 Subdivision: I Lot no.: Flue/vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances , t.. S;f::'�N>1;7:" ':1�;=a ='.1 l•$i =x'; 1'f : ,�,z w ,,,� y ,.. ,a,,�,,. ; rl <' f�t:',tit•`?:f:;l,i;'>a EVi:£! >' ilia. '- +s' p � 3glll :'��.£ Ali }}! .e. i,l. ,. i ' , n.x ` "..i,dyy`� �!'� ! �yW, i�,�� ! t�,,yrr� .1„ � <:� i.� � t ,.:.., Water heater 10.00 �> O ,t 1< iN , I T ; <14,, i( F53lit'. - <? :Ut1tS,C` tii.l:1.I,1';Y,Y KI�<.iE 113;e,,�, T'r�...-. �r!<<� %•.•r 1 . ,tii , f % !� `• 'tI?ulllti�dttiitia:81i1,7 tit .131:Ytil£rril,'t^1'sr:'v'i�",°; e£; 3 ,S:- .a: .. , . n4�ml.,- ., �,l�L,.,�i, •..p.: ,..�sf~It7�Ssa;: .7,,!e'rv� =iri£,i A I �1?,.,tu . Gas fireplace 10.00 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 • 3; 0,• .tm o>*, :? =aa r "s!i at;"� ;Pub a¢'iL,: isri<i nk•t'" "F °• -. ' ; , v <it� " IS:�1' ?illi[! 2 ;p i, ,;< Chimney /liner /flue/vent 10.00 ��``''ff '.I N , i r1��),_ e y �{{ �,�t . i y Ei Fi a 4, j ' 'I i:4; ' 'taf '�jpi � g '� u . �:, . a,. w. :., l� +fs i z ,.l, i I x .: .t l i;:�[a� ; " r 1 f 'i ; ; ' `.11. , .11.x. ..,„ -�. l,'. ,,,t,, A '�! 4 silt' i,l�t' „.., , €��?� 'y� ,:! : ! ,��;;s:.t,r, r ;3i.(.��,.. -rr.�. i.. <k, < ?N , > , .,. a .._ ..� , ,.�,; =<!ra �,;;,xt. , ��, <,., :, .. ,,.:. <, :, £Y<.., ,� ...:u� . Other: 10.00 Name: wh, � ±h, Environmental exhaust and ventilation Address: Range hood /other kitchen equipment 10.00 City /State/ZIP: Clothes dryer exhaust 10.00 ,( Single -duct exhaust (bathrooms, Phones �” J Fax: ( ) toilet compartments, utility rooms) 6.80 I mlr. :r,r i,. , a " r ' >v_ti: a4 ;i. ?i:'a ,...,, ' .::i ( 10.00 r •: :h„ 6 f1 + ,£. t , `;i;�r?,;r<`..` s °1':1`'11„ ". Atti / craw l space fans 1 l,Yi Iat 1a �. ,r . ; l; i '; , 1, ,Nf ,if..,,el :ii 1;7 ": 7;1i f la11‘c ; 1 : 1 ( 1 ?rr:LJiM G/lili 1;1. V.:,,, ,,,ilk ? r, {zi, �.utr` nF at , == .,p,a,.,.��r.:k „,,t,aat,i.; ,;[.,�, ..,.!£.,, ,.ra .._,:,�- _.,:- .,.,.k. _, ..L I.,.,, Other: 10.00 Business name: Fuel piping Contact name: • $5.40 for first four; $1.00 for each additional Furnace, etc. I Address: Gas heat pump City/State /ZIP: Wall /suspended /unit heater Phone: ( ) Fax: : ( ) Water heater [- Fireplace E -mail: Range q" ai N i i { ” ' r 1 i : i :, �ra y 'Sp N .. _ , k sS x 39 ii ° . :, 1 ,.~ '; 'c•„ _ ` u! il ;?�}li�i; � , v,'t � ukc l�} i;iii','� : Cr' " ::1, .y.,. : p f , l1 k i_ - S ii �a. it ai 0 li { ( p ill ..a 1 #it3 t( � ;.o�.r :. „ sl,. 11; 1` ;I Barbecue 11,iCIlil .9 9" Lit lgal et:.tsLt-t, :.•',.; «,;„16 :;,-,:t. 7 -.,... d':: Yi4, tt ::F;t.z fi: :T.:414:1;f,4•4i.",.;. I ;:7n: .. :,4; �i ic: Ae, Business name: Jacobs Heating and Air Conditioning Clothes dryer (gas) Other: Address: 4474 SE Milwaukie Ave i }!in' 11, I £ w' '.; '-; tr 1 s i i r` ,' 1 ;4 i s YE{F u ES f l: i t } 4 r � A r£,�+Sti #.# %IiaSfiu c:uar .i,p .-... .s.=sx .o.. „F�s.. �.,,ii(Lar,;n,. `h��.l7.,t'tq:�. City/State /ZIP: Portland, OR 97202 Subtotal p� Phone: (503) 234 -7331 Fax: (503) 808 -9108 Minimum permit fee ($72.50) 72..,:"Z.) Plan review (25% of permit fee) CCB lic.: 1441 State surcharge (8% of permit fee) l� RO TOTAL PERMIT FEE �°JJO Authorized si atufe , , • '- f This permit application expires if a permit is not obtained within 180 ■ i days after it has been accepted as complete. Print name 4 - ...-.1, _ �� // - I Date: I (°- 7 C/ • Fee methodology set by Tri- ( L C Building Industry Service Board i:\ Building \Permits \MEC- PemrilApp.doc 12/03 t}[ jlj �q-- �� laur , -4617T (I 1 /02/COM/WEB) YA '( 7t l CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2006-00551 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/13/2006 Phone: (503) 639 -4171 / I a Inspection Requests (24 Hrs.): (503) 639 - 4175 "(tilt INSPECTION WORKSHEET FOR DATE: 11/20/2006 TIME: 7 :01AM PAGE: 32 SITE ADDRESS: 11710 SW ANN ST CLASS OF WORK: SUBDIVISION: LERON HEIGHTS LOT #: 007 TYPE OF USE: PROJECT NAME: POTTHOFF DESCRIPTION: Install furnace, ductwork, gas line for furnace and water heater. • OWNER: POTTHOFF, ROGER PHONE #: 503 -524 -3754 CONTRACTOR: JACOBS HEATING + NC PHONE #: 503.234 -7331 Inspection Request Scheduled For: Date: 11/20/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 040027 -01 503-234-7331 N Corrections /Comments /Instructions: ASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: //- o d Phone #: (503) 718-