Permit CITY OF TIGARD
MECHANICAL PERMIT
I?1' DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00182
c � l � l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/20/2005
PARCEL: 2S 102AD -01203
SITE ADDRESS: 08800 SW COMMERCIAL ST ZONING: CBD
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: HVAC units (3) and heat pumps. Value: $51,810.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: S1 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
HUMPHRIES, RICHARD B AND Description Date Amount
THELMA MAGNO [MECH] Permit Fee 4/20/200E $794.00
PO BOX 230626 [TAX] 8% State Surchar€ 4/20/200E $123.44
TIGARD, OR 97223 [MECPLN] Plan Rev 4/20/200E $192.87
Phone: Total $1,110.31
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: z {' " Permittee Signature:_ _ . ,�
-
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.
Mechanical Perrr>l LlOn FOR OFFICE USE
Tigard [ Received /� p
City SW a l Blvd., Date /By: ..0 / Permit G 4, 06 __ / /
13125 SW Hall Blvd., Tigard, OR 972 ({ 0) Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 s - ` GA K U - Gdia ri+Io v eiili .,, Date /By: Other Permit:
Inspection Line: 503.639.4175 Ga./ � "` __ � "" Date Ready /By: See Page 2 for
Internet: www.ci.tigard.or.us BUIL DINGOI \I®' 89 " Notifie tur 74 Supplemental Information
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... . , ....:T -YP�', OFD ORK ,.. <, :: IAL<F' LE E �" HE �'ST I
, ,�. -- � , ..- ... -..,,, .. _ - _ .W „, �-- ,- : >,: >.., :_' i � ~,C9MlYIERC EE * CHEDII `U S C CICL.
„
Mechanical permit fees* are based on the value of the work
El New construction i, Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
,,
;.r=: c, ;; .:- ::.._. �,; c:,:sr��sg;:�e <�3�, . �, ,. Value: pp
.GATEGbRY ="OF CO U CT'ION' -- �'£# '� � � �—
`'` = RESIDEN 1
Q77' PMEPI %S YST MS��-Z�EES?0" ' = � •p �
El 1- and 2- family dwelling gl Commercial /industrial ❑ Accessory building ''
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JO ; INF O TION A ND'> LOCAT ION _
6- Heating/cooling
.a „•; H. .:�,n,: ^,a,us� _ :.. _ -- _ _.��,:::,. ,,~zoo ,<,. ,;, "'�i'` ,,,,�, � .,,�� >;
Job site address: o Air conditioning or heat pump
�� i r ,; . c . t r —c ( t X (requires site plan showing placement) 14.00
City/State /ZIP: —r, e ._ �-\ Fumace 100,000 BTU (ducts /vents) 14.00
C� � �a � ��{ Furnace 100,000+ BTU (ducts /vents) 17.90
Suite bldg. /apt. no.: Project name: Y 11 - '�Y v «� Gas heat pump 14.00
Cross street/directions to job site: 1-1 l 1 VP fl ) ( ' ` / Duct work 14.00
` 1 � -- ` 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: Lot no.:
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
i t e -s .; :.r- :. ;z, '�: ',,i:. fir, -,:•.' :a:''.
'a'. " Water heater 10.00
i
; ,:h �..�,. `.DES , .:12IP: =ION�'OF "4'V1' r at`;
/' Gas fireplace 10.00
- SJ�/a // _ ? fO 7;"; ��Q / 7 ,5 Flue vent for water heater or gas
fireplace 10.00
���,�,��
�e- T ��//7 .7�J ��+�i .1Ur ',Y'V :6- D`5-ed Log lighter (gas) 10.00
t / JrJ e �eLCT.S .1 /t) �f/iQfe — Wood/pellet stove 10.00
XrieS G ,,//t . /"G l4
Wood fireplace/insert 10.00
,z_, l >, ••, ,.' „ Chimney /liner /flue /vent 10.00
'f ' 3PIPERTY;OWNER , , a ,,,: aIE1VANT:- -
- F Othe
10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
-i `;,' r Attic/crawlspace fans 10.00
x ,�APPI:iCANT.^ > " -;;; %; 0 6 ❑,: CONTAGT��I'ERSQN' p
Other: 10.00
Business name:
��w C "� eI '(�' c__..x3 oL �ic-,... Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: -
Range
,- `r.,:',,.,� ' %a,: 3
;CO,NTRACTOI2 ����q '`
`�5L`: ke�SNH'• x , �_< ru°"E& � tszsk''9ni.0 Barbecue �
Business name: Clothes dryer (gas)
1 `� / Other:
Address : ?','",t' a ;,.,;<.
V�. ECHA ES *a ? °.' a
City/State /ZIP: -) 4_ ( c - - --.., Subtotal
Phone: ( ) Fax: (i,_-5,. Minimum permit fee ($72.50)
J — ..,...3,..9 ..,...3,..9 mil, _a Q Plan review (25% of permit fee)
CCB lie.: '4 / State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: _ --, c . j--y i 7 Date: Uri o l * Fee methodology set by Tri- County Building Industry Service Board
r
CITY OF TIGARD
I I BUILDING DIVISION
Ai, PERMIT #: MEG2005001B2
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/20/2005
/�i� Phone: (503) 639 -4171 iv,/pi upf, �i �R�
Inspection Requests (24 Hrs.): (503) 639 -4175 '__—
INSPECTION WORKSHEET FOR DATE: 7/21/2005 TIME: 7:09AM PAGE: 68
SITE ADDRESS: 08800 SW COMMERCIAL ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MAGNO HUMPHRIES
DESCRIPTION: HVAC units (3) and heat pumps. Value: $51,810.
OWNER: HUMPHRIES, RICHARD B AND, PHONE #:
CONTRACTOR: JACOBS HEATING 4. NC PHONE #: 503 -234 -7331
Inspection Request Scheduled For: Date: 7f21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
•
699 Mechanical final 011869-01 503 -463 -4500 N
Corrections /Comments/ Instructions:
/.1
• • trill
' II KA ■ 171411
1
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED ---- E'' Inspector: .�� Date: (hone #: (503) 718-