Permit ¢' �4
C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00317
1•••••• 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/8/2005
PARCEL: 25111 AB -08800
SITE ADDRESS: 09435 SW VIEW TERR ZONING: R -4.5
• SUBDIVISION: PENROSE TERRACE LOT: 033 JURISDICTION: TIG
Project Description: Replace furnace & add A/C.
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: 1 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
TAKEDO, CHIJO & JENNY Description Date Amount
9435 SW VIEW TERRACE
TIGARD, OR 97224 [TAX] 8% State Surcha 6/8/2005 $5.80
[MECH] Permit Fee 6/8/2005 $72.50
Total $78.30
Phone: 503- 670 -7035
Contractor:
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
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: Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business dal?.
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.
'tFROMtJa cob sHeat1ng FAX NO. • Jun. 08 2005 09:19AM P2
Mechanical Permit Applicatio r.iirr lir•Ffc r: frsr:l.,lvr.�
eit' of Tigard Per mitm,
Rece ived / �� n
.3125 SW Hall Blvd., Tiga 5 �. 27.3 Plan Rev low 0� `�^ T Os ��J� :/
Phone. 503 039 4171 Fax 503.598 1960 ; , , : .: r ,,,..'.. \ Date /y Other Permit:
2 00 5 y
Inspection Lim 503.0 +39,4175 ,'/ �� Dale h eady /By' Jam: RI See rage x for
: -
Tn acme www.ci,tlgard ,t.
.or,us Notified/Method: (( mation
CITY OF T!GAF D — �1 . I Supplemental infor
r :..' ,.-i•'- r• 91, 11r - `I +t , l�' l f y ;' +.'.viii j`,,..;., r ;'i A':i,i -��rr ...I 7 ''1' r,;� I , CC *ititc.4i.. 'k'''Sr>'lirfiliiif USE' CIiF t
El New construction 0 Addition /Alteration /replacement Mechanical prnnu fees air, hand on the value of the work
pet funned. Indicate the value (rounded u+ the ncatr_st dollar) of all
❑ Demolition ❑ C)ther, mechanical materials, equipment, labor, overhead, and profit __ _
l;y; :• '�+� � ;rrl' ,--- I • e ...,.,_, 1 ,. 1 '!" Value.
'r •t�s.'�' + "I'��� "•a. Qt'.I' ;, Y'll) • w,4�;` a •, tTmftaly ' :INi�' , ^ +:" „- ' , ; ,i ... •- - --- -.
- ' Rl✓tiIllI�N'1'rAL', EQUIPMENT / SYSTEMS FEES'
nil 2- family dwelling ❑ Commercial /indu4rrirll ❑ Accessoiy building _ -• • --• • - -' - - - -- -
I',nr sper't<rl in /i>rnlnrmn urr rhrckl,s
❑ Multi-family ❑ Mntilcr hulldcl r 1 tither ” - ' j - i
I)cseiToon I . l.n:_._.I._ broil
1 i, 4 . ':
'' 'ii.,yeliair Ott.,lrr>1WWttt�PA IOli;A.t4t) t'OCATIoI!f',, •''y„ fteaunweno _ —__-
Job site address- , e - �, /e - ...__— Air conditioning or hear pomp 1
_ rc Dima slto plait ehowm - placomcnq 1 14.00
City /State/ZIP: . ' - Plirnacc 100,0(8) BUJ (dtictl/ve„ Ll) , i __ 14.00 __ __ -
- - — Purnaee 100,0014. Li (ducts /vents) 17.90
Suitc/bldg. /apt. no - - -- Project name: Gas 0c s heat pump 14.O
--- --
Cross ttrcelfdirectiuns to job site: Duct work _ 14.00
Hydrnntr hot water system -- 14 00
-- - ..__...,...,., __- .._ -•_ -- -- -- -.._ _ .. ...... . __. Residential toiler (tadiawr or
hydronic) .- --- -- , 14.00
.- - - •-- - -- . . ...... - -- Unit heaters (thel•type, not electric.),
_ -- in -wall, in -duct, suspended, etc 10 00
tiuh, {ivisinn: lent tin r u vent or any o a use
- -.... - - .. -. - - - - -- - - - Other 1 0 00
- - - -- - - -- - - - ---
Tax map /parcel no.; _ °thee• fuel a _•- _ _
4 T ' K�:Q' . i/ ' r r « ,� ' I •• 1 " ifi ' I`. 1.: '"'
.1�I k 'r,f ,, t� o r � 'y; � 1'ti1 . .rW y, .
,., . �H "I log,. : '1 ).1 .1! I � �. ' — ..
Sto...). r a.a� , F 1 Y1 I .le n ( water heater 10.00
Gas fireplace - -.._ .. -- 10.00
--P. Floc vent for water heater or gas
__ — ]./1 % — Lag Ihtcrlgas� 10.00
- -- - - - - Wood/pellet stove - — 10,00
-
_ Wood fireplace/insert ._ - 10 00
Ni P 5jrt�y '+��"� i� .tiY.t,�j' ] I � q . I . •' p�"�77. "!'"'° !rr' 1 r.
Chunky /liner /fluc/vent 1l) 00
•fN �'� iy'.ini i�ylef iT icil o'uli':� r �Iq;1 (`ktAI`i —__
P?' %°k r . , - „ ; , : Other: 100(1 .. Name r Environmental exhaust and ventilation
Address: r , - Range hood /other kitchen
`. ' C I - /Y �� -•_ • __•_ equipment 10 00
y ' I C c v1i D.,../...t. Clotho,' dryer exhaust 1(1.00
- -
Phone: ( ) '' ' O ••' '7 Pnx ( ) _..._... -• ° - - e parhncnts, ro
l ilily r mne) . -. . _._ 9 • 1. ' - q� 1- +fygjq* . / Trr'�-rRt 77..:Y - ^ -- -, -•+- toil(con - , 0.8 . -_ ...._
. ' � , l '
.,- ,'" . tr, y , - r• (�,'•CON'l•K.C1 • • '1l'FR Attic /cttiwlspace faits 10.00 -- • ,. -1:.... ....- ..L- .
()thtsr 10.00
Business nam . (; ' Q �7, y � --� p i i -- - Fuel pipi ng .....•_- ...... _.. ..
Contact name: • 0 $$.40 for first four; $1.00 for each additioltal __ --
r__
Address; q — f� ? M ' t A . 1 Q ✓ G as h ce, etc. ,
1 / Gas heat pump.
City/State/ZIP: -4 - [ l 06 en .,2 q Z Wall /a hwtar . _- ���
Phone: 5 . i Pax: _ _ -
3 , - -_.. = � ) �.., J - __.. , - Water heater .. Fireplace. .,.., _.,._.. - . ..___.•_
R mail
e� r,. ,lip. (( `' . r -L' t} �l T A � '`EI ° EriT 5 i ; : ll'I I r3f k,' + r '
! ,fr i ,i,,.l �� JG.lh.1 �i . .2 If� + ;, � jq 11.i.' -, .'r. Barbecue —_ .•,. -_.,. - -- ■
Business name: Clothes dryer (es)
- -_- -
- ,,.•_.m _ — Other r
Address; -- — - IVIii �Y;IF � r le i. i'tiltkil agli` '
City /State/ZIP: Subtotal -7) � i
Phone: ( L ....t I Fax: ( ) Minimum permit fee ($72.50) d r �
..,,- _... __.____ Plan review (25% of permit fcc)
CCB lie.: — Y State surcharge (8% of permit fec)
TOTAL PE FEE ��t
Authorized sigttetur 1 I (n This permit applientlon expires If a pet mit Ii not obtained within 1811
i _ - - day. after It bay been accepted as complete
Print name- • ACITEM I 1 I Matt:. • Fee ,nethndrdngy ( 7 , letlet � 7 hy '1 ri•C:nunty Building ladu.5try Servire tnnrd •
I \QUu 1ing+Per,nh.+M(IC- PermitApp+tur, 17x13 *in..1t "r (I t/0Y /COIN/Wpn) I �
'FROM •: JacobsHeating FAX NO. : Jun. 08 2005_09: 19AM P3
l CD G °L- ` C1
SITE PLAN P S
A
DIRECTION
I
HOUSE
A FRONT'
STREET y • L i e--A0 \ --e.r
Job Name " _ _ _ .._.
Address C ? I- 4 3 L ( `• (Ca (
c:o
Model if g `E--- o -- so
Make
JACOBS HEATING & AC
4474 SE Milwaukir Ave.
Portland, OR 07202
(503) 2:-34-733 1
(503) 813 -9257 fax
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2ppr�pp317
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: &8/2006
Phone: (503) 639 -4171 ai 1 , ' I
Inspection Requests (24 Hrs.): (503) 639 -4175 F.__—
INSPECTION WORKSHEET FOR DATE: 8/24/2005 TIME: 7 PAGE: 75
SITE ADDRESS: 09435 SW VIEW TERR CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 033 TYPE OF USE:
PROJECT NAME: TAKEDO
DESCRIPTION: Replace furnace & add NC.
OWNER: TAKEDO, CHIJO & JENNY, PHONE #: 503-670-7035
CONTRACTOR: JACOBS HEATING + A/C PHONE #: 603 -234 -7331
Inspection Request Scheduled For: • Date: 8/24/2005 Pour Time:
Code # Inspection Description onfirm # Contact # Message
695 Misc. inspection 1014041-01 503 - 936 -2632 N
Corrections /Comments /Instructions:
IN d. I Aleckc(r1;00t( 01,1 press
`-'‘If IA ac e_ ck A A.C. i .k ci i O.C.
C- '4 F O . / - E Le v; c e, ( l � ti Spec. I (CL
ET L > D (1( A cr _0( a vow -O03 .
i .,,,,....,......___________ __,..
Lr _________.
A Pre/.. ve . Gom pIei -
- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INS' CTION ❑ ADDITIONAL FEES ASSESSED
d
G
Inspector: 1 ` Date: a MI 9 5— Phone #: (503) 718 -