Permit \ _ ' `� CITY OF TIOARD'' MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00658
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/9/2007
PARCEL: 2S 111 AD - 16600
SITE ADDRESS: 09033 SW WESTLUND CT ZONING: R -4.5
SUBDIVISION: MALLARD LAKES LOT: 032 JURISDICTION: TIG
PROJECT: MEDINGER
Project Description: Replace gas furnace and AC
CLASS OF WORK: ALT 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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
MEDINGER, JOANNA EILEEN • Description Date Amount
9033 SW WESTLUND CT
TIGARD, OR 97224 [MECH] Permit Fee 11/8/2007 $72.50
[TAX] 8% State Surcha 11/8/2007 $5.80
Total $78.30
Phone: 503 -598 -3933
Contractor:
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -733 I
FAX 503- 808 -9108
Reg #: LIC 1441
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: er -1-1 c(-f-
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4
Mechanical Permit A t t lici,E0,; i 1'(1k 01.1.1('I: USI ONI \` •
City of Tigard ` ZQQ� eyed , r (, 8 cy
D , ; Permit r J,GLe)'7 DO . 5"g
13125 SW HaII Blvd., Tigard, OR 9722 Ov - Plan Review
II i Phone: 503.639.4171 Fax' 503.598.19 G T (�pD�By Other Permit:
. 1 l c : ,, i 0 ln'p` i tion Line: 503.639.4175 G e � O` 1 ` . q ' � " - 10 � Date Ready/By; h RI Sae Page 2 for
Internet: www.tigard- or.gov ® � 5 1116`�1V Notiiled/Mothod: cv u Supplemental Information
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CI New construction El Addition /alteration/replacement Mechanical permit fees" are based on the value work
performed. Indicate the value (rounded to the nearest dollar) o f all
In Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and�rofit.
1 ( i V{I + jk .� (,lr`{(�'r{,, •r ��q�r.$�rry',yYtyyy I ^ 1 ICI •,nu x w ��{JyJf'(w r.v,+w ninny ix ��um ur +n,y!Gy�J,�! i y,,ff� h }{�(i�1hy�I iJ'�'{`�(t�' Value. S
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lifll�lt � 'I1. 9' v nor. / . ' ,qy, :: i ,1' . �. �1°"1';l'il'lh LI ..
® 1 -and 2- family dwelling ID Commercial/industrial Accessory building `
f'ar special information use checklist.
❑ Multi - family [3 Master builder ❑ Other; Description Qty. I Ea. � Total
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41 sgrwla.l t4tiu w t t 9 K + r' , tuir, 11 b ' : 1 :
11 4 ` '. s1,,. 1 1 !( p ;��? y I a., Is ta 1 ;i li { ' I ( to ij �f: � ,1 r4 : ' ' Heating/cooling
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Job site address: 9033 SW Westland et Air conditioning or heat pump
(requhes site plan showier plaesmw() 1 14.00 14.00
City/State/ZIP: Tigard, OR 97224 Furnace 100.000 BTU (deetslventb) 1 14.00 14.00 -
Furnace 100,000+ S TU (duets/vents) 17.90
Suite/bldglapt. no,: I Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (nuliator or
hydronic) 14.00
Unit h (fuel -type, not electric),
in -wall. in- duct, suspended, etc 10.00
Subdivision: , Lot no.: Flue /vent for any of above 1 10.00 10.00
Other: I 10.00
11{{11 cTux l rnnp /pa no,: y� fi g � tr ( ( I� 1 f f t f11 t �, gp 9 3 Other fuel appliances
1fl�3li l��II��� � f ; fi + I� U��ff it �3i :t� tW. ,,, t l,v,nl ll8f31 1 1 ) 11_ �f� �{�f�!3�11 �I �U� flldC tls l3 �� { �SCi �cl Water heater 10 00
n.+ un tare , r
Replace gas furnace and air conditioner Gas fireplace t or _ 10.00
Re
P S Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
r Wood fireplace/insert 10.00
ii I ;';:,I :i I, n Ju •d a t �' J 1,' • I1'' 'r 14 ' 1 ',i 1 ( 1I �' @ . Yr 1�' :'t "' t r;,f jl lnl �i r , t� I
' , Ot Chimney/liner/flue/vent 10.00
', Illt : �1, I n iM =,,li1�, ,• Il,+r t , Other. _ 10.00
Name: JoAnne Medinger Envirouuaental exhaust and ventilatiun
Addttas: Range hood/other kitchen
equipment 10.00
City /State/ZIP: Clothes dryer exhaust 1000
503 598 3935 Fax: - Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 6.80
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Pllltlll '�r' U 84iif t 31 1P�illAilx�� il!ill C11191r� I H'�'1&idfl ikailWiti UM" Anic/crawlspace fans 10 00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 fur each additional
Address:
Furnace, etc.
Gas heat pump •
City /State/ZIP: Wall/suspended/unit heater
Phone. ( ) I Fax:: ( ) water heater
Fireplace
E -mail; Range
IF I •i:•' "'• vt'� 1 1 �� `�" (u �z _ 11 +�1 "W1� 1 W r''1M ;.. P r
I i { 'rye, „ 51 'lliti�it'vl i lli�(" fl' �' f f !r(i, x . ii } ) i 1 ,( s ,kith, ; 1 'Erie Barb
ill I ilt�w � �i,h x.,. 1 r tn1� r�,,.jl at:Jtarpciiu' 1 �������'�•�',�'�Ji�"i� , . I•,.i uJ4
Business name: Jacobs Heating & Air Conditioning Clothes dryer (gas)
Other.
Address: 4474 SE Milwaukee _
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City /State/ZIP: Portland, OR 97202 Subtotal 38.00
Phone: (503) 234.7331 Fax: (503) 808.9108 Minimum permit fee ($72.50) 72.50
Plan review (25% of permit fee) ; " -'
CCB lic.: 1441 State surcharge (8% of permit fee) 5 ^80
TOTAL PERMIT FEE 78.30
Authorized 5tgtta / , This permit application expires if a permit IS net obtained within 1tlU
/t days utter it has been accepted as complete.
-
Print name: Michelle LeClair Date: 11.7.07 • Fee methodolog // ysei by Tr,-- County Buildinglndusay Sei vice Board
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CITY OF TIGARD
BUILDING DIVISION w PERMIT #: MEC2007 -00558
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 111912007
Phone: (503) 639 -4171 (�
. �!'+
Inspection Requests (24 Hrs.): (503) 639 -4175 -A I..
INSPECTION WORKSHEET FOR DATE: 1/23/200 TIME: 7:00AM PAGE: 13
SITE ADDRESS: 09033 SVV WESTI.UND CT CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 032 TYPE OF USE:
PROJECT NAME: IMIEDINGER
DESCRIPTION: Replace gas furnace and At;
OWNER: MEDINGER, JOANNA F_II.E EN, PHONE #: 503 -598- 3033.
CONTRACTOR: JACOBS HEATING -a NC PHONE #: 50-234-7331
Inspection Request Scheduled For: Date: 112 :3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
693 Mechanical final 063746 -02 503-234-7331 N
Corrections /Comments /Instructions:
II' PA. t RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
El FAIL ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / Phone #: (503) 718- L /