Permit a C ITY O F T I GA R® MECHANICAL PERMIT '
`' • a ;• COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00536
TIGAIiD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/30/2008
- PARCEL: 25111 BC - 03300
SITE ADDRESS: 10375 SW VIEW TER ZONING: R - 3.5
SUBDIVISION: DOUGLAS HEIGHTS LOT: 008 JURISDICTION: TIG
PROJECT: , JOHNSON
Project Description: Gas furnace replacement.
' 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: DOMES. INCIN:
NAT 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
DOUGLAS & SUE JOHNSON Description Date Amount
10375 SW VIEW TERRACE
TIGARD, OR 97223 [MECH] Permit Fee 10/30/20( $72.50
[TAX] 12% State Surch 10/30/20C $8.70
• Total $81.20
Phone: 503- 639 -0737
•
Contractor:
JACOBS HEATING & NC
4474 SE MILWAUKIE
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: �L j ,A�, Permfffee Signature: ___...-J_-_-_ �.
Call ' =� .639.4175 by 7:00 a.m. for inspections that busines . ay.
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: c REQUIRED ON GREEN INSPECTION CARD.
1 Code I Inspection Description I PASS Date I By ✓ Code I Inspection Description 1 PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing - 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 • Foundation walls 130 Ceiling cover •
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation • 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
•
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls • 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line •
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper .
299 Final inspection 635 Smoke detector shutdown •
640 Exhaust hood
695 Misc. inspection:
• 699 Mechanical final •
BUP - Fire Protection System Permit •
905 Sprinkler underfloor /slab PLM - Plumbing Permit •
910 Sprinkler rough -in -
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
• 340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls •
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
1: \ Building \Forms \InspCard- AOP- Blank.doc 02/02/07 •
10/30/2008 08:42 5038139257 JACOBS HEATING PAGE 02/02
L.\..
i,
Mechanical Permit Application
I.,1c. (W1.10.: ' USE c) :�I.,
Rec ����
City of Tigard � �c t Dot s e eive e' /By: y: d iaiAL�1•; •
. 13125 SW Hall Blvd., Tigard, OR 97223 Review
�� +a Plan Rev
Phone: 303.639.4171 Fax: 503.598.1 Cj A Otlter PePermit; i. i .,,,.ii t j inspection Line: 503.639 4175
Interne): www,tigard .or.gov O �O Date Ready/sy: roar 65 Set Pep, for
OC C , NotinediMnhod• �} Supprementet hifermnrion
a ice \�.
TYPE OF WORK c� Q. so • COMMERCIAL FEE* SCHEDULE - USE CHECIU.Isr
❑ New construction wAddilion/alterationh"bp Mccltanicnl permit fees' are based on the value of the work
❑ Demolition ❑ Other. $t performed. Indicate the value (rounded to the nearest dollar) of oil
mechanical materials. equpment, labor, overhead and profit.
CATEGORY OF CONSTRUCTION Value: S
JE dwelling RESIDF.NTLILEQUTPMENr /SYSTEMS FEES*
I- and 2-family g ❑ Commercial /industrial ❑ Accessory building
❑ Multi-family ❑ Master builder ❑ Other: For special blfarrrra /Ion use c /�ecl //sr.
Description I Qty. 1 Ea. Total
JOB SrlE INFORMATION AND LOCATION _Deallna/cooltng
Job site address: /6.3 7s 5 y V t e W '7-E rret C Air conditioning or heat pump
p '~ (requires s;tepho showing placement) 14.00
City/State/71P: 71 - cv,re\ 1 R - aa._Y Furnace 100,000 BTU (duelsIvents) J 14.00 IS • ti
Suite/bldg./apt. no.: Project name: j b n S 0..(1 _ Furnace 100,000+ BTU tducts/ventsl 17.90
Gas healpump - L 14.00
CKISS street/directions to job she: Duct work -- 10,00
-
Hydronic hot wafer system _ 11.00
Residential boiler (radiator or
1)1±21_ ic 14.00
Unit heaters (lust -type, not elccule),
in - wall, in -dun. Suspended. etc, 14.00
Subdivision: I Lot no Fluc/vemt for any of above 6.60
- - Other; 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK , Water heater - 10.00
as
R r a (flex C - cos fireplace 10.00 ;
T ` f ) �fi Q ' � Flue vent for water healer of gas
4 10.00
Log lighter (gas) 10.00
— W stove 10.00
Wood firepleec/inserl 10.00
_
ROPERTY OWNER I El TENANT _ Chtmneyllmcd0udvcnl — 10.00
1 Other: 10.00
Name:
cal._ - S LLt 3 0 0i Environmental exhaust and ventilation
Address: Range hoed/other kitchen
equipment 10,00
City/State/ZIP: - Clothes dryer exhaust _ 1 0.00 •
Sin Ie.duet exhaust (bathroom.
Phone: (50 3) 4 37 - C 3 Fax: ( ) loilct companmcnts, utility rooms) 6.20
❑ APPLICANT ❑ CONTACT PERSON Auic/crawlspacc fans _ I0,00
Business name: Other: 10,00
Fuel piping _
Contact name: S5,40 for first four; 51.00 fur each additiona
Address: Furnace, etc.
City /SGttc21P: Gas heat pump
Wall /suspended/ttnit heater
Phone: ( ) Fax: : ( ) Water heater
L•mail: - Fircpine
_ R ange
CONTRACTOR Barbecue
Business name: Jacobs Heating & Air Conditioning Clothes diver _
Address: 4474 SE Milwaukle Other
MECHANICAL PERMIT FEES*
City /State/Zl Portland. OR 97202 Subtotal •
Phone: (S03)234.7331 Fax: (803) 808.9105 Minimum permit fee (572.30) — 7 4 1,,
CC8lie. :1441 - _ Plan renew (25% of permit fee)
State surcharge (1276 afpermit fee) 7-0
TOTAL. partmniumFor I.ao
Authorized signature: r � � I �� ,,_, �' This permit application expires (e permit is nut obtained within 190
�� .ill dais after it has been accepted ae eninplete.
I Print name. — t^' • ; if • Dale: /0 30 t) fee methodolog xi by Tri -Caumy Buildinil industry Scree ROW
Iw.ddlne P.nnsI \vtic.pm,cL*pp doe tun 9+m
4 ' 6117 (I ImVCOMJWEp) (5 / /
CITY OF TIGARD et
BUILDING DIVISION PERMIT #: 7/..)0 0 , - o 5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 /�du °„ �' A
In Requests (24 Hrs.): (503) 639 -4175
•��
INSPECTION WORKSHEET FOR DATE: ( 24 /C6 TIME: PAGE:
SITE ADDRESS: �j (
I 3`7� � Y eco f �p--- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
. Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
t/, '.
I IF . if W V
C C
1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
� / l l 2 iCe)Inspector: 1/ D Phone #: (503) 718
C OF TIGARD
,
B ILDING DIVISION PERMIT #: MEC2008-00536
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/30/2008
Phone: (503) 639-4171 At
.14,11111„
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/6/2008 TIME: 7:00AIVI PAGE: 33
SITE ADDRESS: 10375 SW VIEW TER CLASS OF WORK: il
SUBDIVISION: DOUGLAS HEIGHTS LOT #: 008 TYPE OF USE:
PROJECT NAME: JOHNSON
DESCRIPTION: Gas furnace replacement.
OWNER: JOHNSON, DOUGLAS & SUE PHONE #: 503-639-0737
CONTRACTOR: JACOBS HEATING & NC PHONE #: 603-231-7331
Inspection Request Scheduled For: Date: 11/612008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6. Mechanical final 077735-01 503-2347331 y
Corrections/Comments/Instructions:
MING. . . 0 , ---- • -
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.-- :..., I... _, _ .,- , _ -,-. ..
-----
• 7 PASS 1] - "PA1 --- :r rIAL APPROVAL • 0 CANCEL El NO ACCESS
0 FAIL ri CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
..-
Inspector: Date: // Phone #: (503) 718-