Permit 6 I
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00198
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/12/2006
PARCEL: 1 S135DD -00600
SITE ADDRESS: 11831 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: HOFFARBER TRACTS NO.2 LOT: 040 JURISDICTION: TIG
Project Description: Install exhaust fans & hood. Valuation $ 6302.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
• TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:'
Owner: FEES
YOUNG'S FUNERAL HOME INC Description Date Amount
11831 SW PACIFIC HWY
TIGARD, OR 97223 [MECH] Permit Fee 51121200E $166.70
[TAX] 8% State Surcha 5/12/200€ $13.34
Total $180.04
Phone:
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 OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: �� Permittee Signature: S p , A`
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business aa
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.
FROMr:JACOBS HEATING FAX NO. :503 813 9258 May. 12 2006 10:18AM P1
Mechanical Permit � i ii i cat FOR llh l 1C1 11 ti 1 ': O ,. , I . v
- ,� - Received i �/ Mechanic ` p�
_ Date /13rJ f� D6 Perm No, jCd �a e i 9/}
City of Ti and C Plannin Approval Building
y DatcBy: Permit No.:
13125 SW Hall Blvd. (, �,� Ov Plan Review Other •
Tigard, Oregon 97223 : Date/By: _ ,, Pcrmit No.: _
Phone: 503.639 -4171 Fax: 5 3-59k:190 Post-Review Land Ilse
F ) 3 ' f , k DaDate/By: Internet: www.ci.tigard.or.us r�� <
�`� _ ■ !� I M Contact Case No.:
1u ' .' See Page 2 for
24 -hour Inspection Request;13 .4175 ' - ' Na ,WJMethud: � S ® upplomental Information.
.,.,.•: :.:. ;,..•,.::1: g.T%Vi' :=i • lil
Ni New construction • Demolition Mechanical permit fees* are based on the total value of the work
A Addition/alteration/re • lacement IN Other: • Demolition performed. Indicate the value (rounded to the nearest dollar) of all
r . ; , : ; - rr ,, , 4rvf' . : .- mechanical materials, equipment, labor, overhead and profit.
I & 2 -Famil dwellin: % Comrncrcial/Industri.al Value: $ (p , LED See Page 2 for Fee Schedule
0 Accessory Building EN Multi - Family i : : • t' �I.a `FA:. •' iiiFi f;11`.'. ' =3' :..... .
Description 9. 11 Taal
❑ Master Builder .. Other: . .. . " .• Headug/Cooling
;31311! . , •a n• s +• , Y ' , 6 8'" j�.+ 156; . „,.'; :;>r; +• .: Furnace - add - air conditioning*» 14.00
Job site address: I '. 3 paci 4i ( •H w as heat pump 14.00
Suite #: Bld /Apt. #: Duct work _ 14.00
Project Name: \ca" -� aY1P.!f i�.l Hydronic hot water system 14.(l()
ob site: R boner
Cross street/Directions to
J (for radiator o hydronic system) - 14.00
Unit heaters (fuel, not electric)
in wall -duct suspended, etc.) 14.00
Flue/vent (for any of above) 1 0.00
Subdivision: •_—_ ,. I Lot #: _ , Rcpair units • 12.15 -
--� Other. Fu.. ct Apptlanccs
Tax map /parcel #: Water heater 10.00 '
•'S' t• y ..; .. ._ ( -
•';�`. «:'•'t- „..:.�.?,?-:�:5 'Citg Pt
. . ' ?V•..{�{ C.`• ''
.' ,'► :. _ �i:�: .. : .,N`/
.�.. s:... Gas fireplace 1 0.0(1
\ y s - l,1 ` ha1A ,z c-; Flue vent (water heater /gas fireplace) -- 10.00
Lou lighter (gas 10.00
l Jiff ;- \r-G_ -�. tfC�(`'>� Wood/Pellet stout - 10.00 •
Wood fireplace/insert _ 10.00
Chimney/liner /flue/vent 10.00
:'. � iai rr r M �r..�.45 ,n
.r� ” „�
�! &:: Other: 10.00 _
�a..�.;�.�:?aJ��ri ti�.r���i,�.�'�'�.�� � �.����1.�._;•;'yi,,�.l - ; ,..., ' riF... a-- ,
Name: (�Ljr1 LAYK�rCJl.1 ( \'� . • ' • • • • • '' Environmental Ex haust &V'en = . . •
Address: Range hood /other k itchen equipment LOA_
15 \ i,-i G 'v J... ,._ _._ - Clothes dryer exhaust 10.00
City/State/Zip: • \ r4l Dq q� r ) Single duct exhaust
Phone: (p3q - l a Fax: (bathrooms, toilet compartments,
Tr., r : T , r17 o ""•t ')' utility rooms 6.80
Name: Attic/crawl space fans 10.00
_
Address: - . - —.- •..... "" - . Other: —• - 1 0.00 �_
Pail rim
y /Stat % "($5.40 for first 4, $1.00 each additional)
Phone; A - � —Max: Furnace, etc. _ »` -
Gas heat pump r»
E-mail: Wall /suspended/unit heater * * _•
,.. '',!!;' ;;." . `. "•, ? s -*C.': /t. `r:' {'.. . s... .. Water heater ••
F ireplace ••
Business Name: � �� �Q�fi ,� i *»
Address: L SE mt ■ R _.
BBQ **
Sly/State/Zip: �c:.a c rc 0 \ - 1,7:1c>"4. , dryer (gas) -�' ** y
—
Phone: c,- - a -1 11 Fax: F--0,- 535 Other~ ••
CCB Lic. #: \ UIUr, Total: 4
Authorized 1 Mechanical Permit Fees*
Signature: Date: S 1C•' 0(U Subtotal: $ _
11r Minimum Permit Fee $72.50 $ ,7tf
`1 �•C \ 1 _ _ Plan Review Fee (25% of Permit Fee) $ - t 2 ,/
— �' State Surcharge (8% of Permit Fee) S /.3.
(Please print name) - TOTAL PERMIT FEE $ I,
Notice: This permit application expires if a permit Is not obtained within "Fee methodology act by Trl- County Building Industry Service Board. al O
180 days after it has been accepted as complete. "Site plan required for exterior A/C units.
is \bets \Permit Forms\MecPermitApp.doc 01/03
Nby ngt5 .- u - nerO. E S)B1
CITY OF T1GARD
BUILDING DIVISION PERMIT #: MEC2006 -00198
13125 SW Hall Blvd., Tigard, OR 97223 / DATE ISSUED: 5112/2006
Phone: (503) 639 -4171 / �eam� 41
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I L�
INSPECTION WORKSHEET FOR DATE: 7/28/2006 TIME: 7:01AM PAGE: 53
SITE ADDRESS: 11831 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: HOFFARBER TRACTS NO.2 LOT #: 040 TYPE OF USE:
PROJECT NAME: YOUNG'S FUNERAL HOME
DESCRIPTION: Install exhaust fans & hood. Valuation $ 6302.
OWNER: YOUNG'S FUNERAL HOME INC, PHONE #:
CONTRACTOR: JACOBS HEATING + NC PHONE #: 503 -234 -7331
Inspection Request Scheduled For: Date: 7/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 033963 -01 503 - 718.2423 N
Corrections /Comments /Instructions:
i
''\/1/
01 — ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
V A . Inspector: Dater 20 C. Phone #: (503) 718- lil7
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MEC2006-00198
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/12/2006
Phone: (503) 639 -4171 - 1
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/27/2006 TIME: 7:03AM PAGE: 103
SITE ADDRESS: 11831 SW PACIFIC HWY CLASS OF WORK:
SUBDIVISION: HOFFARE3ER TRACTS NO.2 LOT #: 040 TYPE OF USE:
PROJECT NAME: YOUNG'S FUNERAL HOME
DESCRIPTION: Install exhaust fans & hood. Valuation $ 6302.
OWNER: YOUNG'S FUNERAL HOME INC, PHONE #:
CONTRACTOR: JACOBS HEATING + NC PHONE #: 503 -234 -7331
Inspection Request Scheduled For: Date: 7/27/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 033797 -01 503 -234 -7331 N
Corrections /Comments /Instructions:
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-