Permit ilk
C ITY OF TIGARD MECHANICAL PERMIT
4 lii DEV ELOPMENT SERVICES PERMIT #: MEC2006 -00279
6 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/20/2006 6
PARCEL: 2S110DD -12300
SITE ADDRESS: 10720 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.13 LOT: 693 JURISDICTION: TIG
Project Description: Hepa air cleaner.
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:
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: 1 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
RUTH SUNDBY Description Date Amount
10720 SW HIGHLAND CR
TIGARD, OR 97224 [MECH] Permit Fee 6/20/200€ $72.50
[TAX] 8% State Surcha 6/20/200€ $5.80
Total $78.30
Phone:
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 By:,- Permittee Signature: _ C? \()
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.
i
PROP t. acobsHeating FAX ND. : Jun. 19 2006 12:07PM P2
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Meth an>I�,�l Permit Anal>lcanon.. I t,u (►I I(1' 1,1 i 1.1
City of Tigard Date//By ► ; 0 6 r Pam No, V\6 6 , -dI) 9
13125 SW Hall Blvd., Tigard, OR 97223 ' I n I ' ■ r Plan Review
Phone; 503.639.4171 Fax: 503.598.1960 J I 1 — c/ L U U U ;r,.w +w r ''r 1 ' f I Date/By: other Penhi':
L
inspection Line: 503,639.4175 • ,. ' 'i . Data Rcarty/By: Asti,' El Soo Page 2 for
Internet: www,cl,tfgard,or,us ✓4TY OP i u Netified/Methed: - f -k r , Supplemental Inibrmatlon
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❑ New construction ►�i Addition/alteration/replacement Mechanical permit fees* tire bused on the value or the work
pertbrmed, indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and .
ks i � 1 ; i r rnlal,ner rumuY f'tn �x y to,{pmait9rai�:at ottriurf ' ,,. , ' •C '' it Value:
rI y�jl9JJffgg tlr I,d a ll't �(I I R ;}ki11I
9u hw il it r { ' $ "� y. . 1'4
#Aril .�tAI.1C ?I39 ' ' � >u 4,il x ihJd40 (anti Rs i , a: s .fa er ups aro11 a r. .. I. t.a , „ r . a ^' ' l N altu+ i il iaft l+{v t d¢il ;ertt utjj r, r {r'orc rr�ru7ltii 1 7 i' r . A
lI { 1 3 .. � ' 19 i ∎ I d' l lifts 7 1441 N ithl li tli 'N :1l 14i l . `1 J 1 k,n
►:� t- and 2- family dwelling 0 Commercial /industrial CI Accessory building �S t Y+ i usrlAa rlals'1111 l
islalrltlrurq :dsrrlydilrrlaFii {tnul,1 r, t3�i�l +bliu +t'hh11�iCEt ! {'9ti . ' G
El Multi-family ❑Master builder 0
For information use checklist,
Description I Qty, f
� t, :q�� � 8a. ] Total
p 'at t1 �{ , iM s �.,V, i U . . l l , , i (a ; l ,, ,, 1 ' i i 6 d t r u i
T p ill' ., , Ili ( I L r ' . i p I ii , 11 ' { 1 1 j i s ' ;1; ., r H eatln cooling
+� 1... I [ . .! , l a r.' to aniiiAl !+ r l,. � - u ,2whn1, 7,�hrrtrinlrr r11� ,h,t1 tau' rtant� i2�ta 1!1 � rw trli n A I 1. � —w
Job site address: 1 /'''�`''� 4: Air conditioning or heat pump
_ / / ► �i ` �� �' (requires site plan showing placement) 14.00
Cit / State/ZIP: �, Pumice 100,000 !STD (duats/venni) 14.00
y I I �' , ` '� Furnace 100,000+ BTU (ducts/yenta) 17,90
Suite/bldg. /apt. no.: W Prof ect name: Gas heat pump _ -" 14.00
Cross street/directions to job site; Duct work — 14,00_ _
"" "" " "'" —" Hydronio hot water system 14.00 ______
„_p Residential boiler (radiator or
hydrenic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc, 10.00
Subdivision: Lot no.: l luolvant far any of above 10.04 _
._...._—.— Other: 10.00 _ _ _
Tax map /parcel no.: Other fuel appliances
p
7
1 i (1 . f rg..1 ilt, i 1 r. it , ii�ii,� i �l � � w os 4 rt ssIur to titian ,t ^ t1{ i¢ut i zt� . I ,t `" , t' Water heater 10.00
:lii�4141 li i ll11i i11 #144 -. ;1IY:Ef 1111lilu 8iRi4ii lisit��sti,l01 r 4 , 11 99 {I t.E I < , , 1 5G 11 1
1 f: t ; : ,
� Gas fireplace 10,40
\
�,N' ('\� f'�k1 Lye" Flue vent for water heater or gas
fireplace 10,00
-• Lod lighter (gas) 10,00 _
� Wood /pellet stove . 10.00
Wood fireplace /insert 10,00
1 y 1 1 1 n i r mr n1 ¢,rr za i1 k 'w r , tml Chimn Inner /fluelvent 10.00
' li4 41� 1 1 f 1 ' l l{ I, a 4N'I � " �,' A �` li ' t � s l i , t i�.� t�ri r I . it : Other; .,.�o,
d „ rstrzt , t iii Irlsis { l<ltl D i, r !w a sa
Name: I l , ' 1 : r Environmental exhaust and ventilation �-,
Address: Range hood /other kitchen
/ + t , " equipment 10.00 - ..,.._,
City /State/ZIP: Clothes dryer exhaust 10.00 • „_
Single - duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
E i 1 '15 1 JJ i``II{ 1 {s't r 1 li °E a situ i!a�wi +' 1� r �, 1 +,' s ti kal r rA il } de i st ` ' n i riA � u t tr a 4. i f, Att {c/e a ace fans 10.00
S f,t i i 1 171 t ,.
llllpSI ili .. afg th its {I m li t i 41' ,' 1 ��¢ ff fil An E f as Sa tyr ot 7 li m kv I t1 i '� � _�
,r w,oiu u u n, • in sr ABM t c iln w
Other: 1 10.00
Business name:
_.� 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 W „
Phone; ( ) _ _ Fax; ; ( ) Water heater
--• - ----, • _Fireplace
E -mail: Range
►l r,t ' t l 'l l {, S ' i! l�1 ' rG d I ,K, . sr,d } tt n i �,u , t ,a,�, a r inti� , >ai. B r ” t i i ! 1 3 iX it l ;� In ..._.
i1,� 4(14:4 1 „, ;4111;x,4, ►i ��44r l - tk titi, A fa 1�1,1A � l ,r 41ov , , f �lA 4 rVA' ;11 3 a Barb u� -- - --
Business name; Jacobi; Heating and Air Conditioning Clo thes dryer (gas} _
Other:
Address: 4474 SE M ilwaukle Ave f' p r118111" � n± "< ar';( ir i r 'm runSr�:1;•M a I WrM0.'�MI'd s l, , 1. �
.- ..-.,_ , ' �,., R1 ill iii i it 1 t , t s r i d it If 1 1 111 ^�, I ` , A . 111� , I1
I i r n 1'' �9Yld'e1 F a4 11 iS � i u
City /State/ZIP; Portland, OR 97202 __ Subtotal
Phone: (503) 234 - 7331 I Fax: (503) 80n-910a ^^ ^^• Minimum permit fee ($72.50)
,.. ,. -•- -- ,•.— Plan review (25%ofPermitfee)
CCA lie.: 1441 State surcharge (8% of permit foe)
- TOTAL PERMIT FEE
Authorized signature' Thh per emulation expires if a permit le not obtained within 180
drays after it has been accepted as complete.
Print namt _a.• a *P • r Date: e Fee methodology set by Tri- County Building Industry Service Board
Is8ulteina0errui ,svOC- rertnilAppeee 12,03 401 r 44e46 (7T(11ro2/COM /W8n)
CITY OF ;TI-GARD ',
BUILDING DIVISION PERMIT #: MEC2006-00279
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2006
Phone: (503) 639- 4171ia ��� @I' t
Inspection Requests (24 Hrs.): (503) 639 -4175 j I "AIL.
INSPECTION WORKSHEET FOR DATE: 9/26/2006 TIME: 7 :06AM • PAGE: 44
SITE ADDRESS: 10720 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.13 LOT #: 693 TYPE OF USE:
PROJECT NAME: SUNDBY .
. DESCRIPTION: Hepa air cleaner. ,
OWNER: SUNDBY, RUTH PHONE #:
CONTRACTOR: JACOBS HEATING + NC PHONE #: 503 -234-7331
Inspection Request Scheduled For: Date: 9/2812006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 037130 -01 603-624 -7012 N
Cor /Comments /Instructions: /'
l 6 . 1 ii .' f'-/7 ...,� ✓i'i f fi ∎ ;.. (..� .- C C n` l
1
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL Il NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: p Date: 9-2G -‘,&.... Phone #: (503) 718- 24.54-1