Permit C ITY OF T I GA D MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00439
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/19/2007
PARCEL: 25111 DB -11900
SITE ADDRESS: 15215 SW 94TH AVE ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.12 LOT: 646 JURISDICTION: TIG
PROJECT: JONES
Project Description: Install gas furnace and a/c units.
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:
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
JONES, RICHARD NEWTON JR Description Date Amount
15215 SW 94TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 7/19/200 $72.50
[TAX] 8% State Surcha 7/19/200i $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 B • ��/ / /�. � Permittee Signature: Soo %#/'rte
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.
. „..
Mechanical Permit Appla ._ ,, 1' It I c FOR ovrict: l'SE ONLY
City of Tigard S l'eneii No.! t....1 EC2/:)53--C101-39
l SW Ilan Blvd., Tigard, OR 97223 Plan Review
' m ' . Phone: 503.639.4171 Fax: 503.598.1960 Dute/Sy: Other Permit
inspection Lino: 503.639.4175 JUL 1 9 2001 Date Ready/8y: 6i sec Page 2 for
Internet: www.tigard-or.gov Netifes:I/Method: IIM SuPplemeatal Informatioa
--,
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? ' '41 EiNartEIRPNVISTAMITI""FTVENVIL141”1 '? I 744 1 41- - ,, „,A s iM,t 1 ,=,,t . '" ,4 7
..,. , - I, , Mechanical permit fees* arc based on the value of the work
0 New construction pg Addition/ ; teratioreplacemnt performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit,
:' ' .. 1 91111rFPXLVTArrep AMEigliFIN,A Value: $
'' :4674 ' i dirillg .., .`c.s,111 -) .' 1 el 0. l A ' ."? t 'At ° ' 3) 4 , 7, -.; --..,.•-•.,... -,,, . **, !. ,,,..... -.. ",,-.,,fu }',1
41; 4 " ' t I ' ' , '• 10 , -.C'' 7V, ,,, 4;11;4_ ' k '
pil 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist
0 Multi-family 0 Master builder 0 Other: Description 1 Qty, Ea. Total
,4 ,,4; : - Tokairpopragi llcating/cooling
I4,,,, , .,, , ■ ,1„1 . 4, -.!.1,,,.., 40; 4,4 ' ; " M..,
Air conditioning or heat pump
Job site uddress: i 5 i. .L. ,, , 44-, (requires site plan ahowiag placement) I 14.00 Al•r-'14
City/StaterZI?: '1 ev\rA / 0 611-2-2-.44 Furnace 100,000 BTU (duets/vats) I 14.00 ft/ - t..)c)
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: 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 (radiator or
hydro 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct. SUSpended. etc. 10.00
Flue/vent for any of above 10,00
Subdivision: Lot no,:
Other: 1(113°
Tax map/parcel no.: Other fuel appliances
-4=1, Ar, .,,,y4 trne.1 T..4a, it mu,- 4.f.f.y - 1 1 ; la% 17,;, N.' 7
trif"LEViMARVY Water heater : ' ' ' 10.00
c ,, .4. ,;■',e.' , ! .,.-', ■ Ai. ii + - , 'tassel . , , ( ' sit i . % ' ' , ' ' ii • ■ le ■ t A :4 ....-' ,
as fireplace 10,00
-
1 / AA $ 4 •I A-- ( U- .0p.e) Ad A.4 r Lk. , t- fA i( . Flue vent for water boater or as
fireplace 10.00
Lag lighter (gas) 10,00
Wood/pellet StOVe 10.00
' . Wood fireplace/insert 10,00 _
. 1, , , „. 0 I .,,,, mi , .t 4 izimmnamtir , ,. r I ,, Chimney/liner/fluthent 10.00
., r ' . 4. 57, MT:401A fil 14- it f • I, : i , ot „ , ,. ......
10.00
Name: / 441. ta. A Environmental exhaust and venfila ion _
Range hood/other kitchen
Address: . equipment 10.00
City/State/ZIP: Cl - othe$ dryer exhaust 10.00
Sinec-duct exhaust (bathrooms.
Phone: (SZ) tr246(4 - 2As I I Fax: ( ) toilet compartments, utility rooms) _ 6.80
,11 r , lig Iggamm.„6..:cill,i.ti.:,.m.1xi. ,,,
. 1 ,, t
'/ " .. , Attic/crawlspace fans 10,00
Crther: 10.00
Business name: Fuel nipitig
-
Contact name: $6,40 for first four; S1.01.1 for each additional
Furnace, etc.
Address: ..
Gus heat pump
City/State/Z1P: Wall/suspended/unit heater
Phone; ( ) Fax: ; ( ) - Water heater
Fireplace ,
E-mail: ft.agn e _
.il p 1 EiiitMfirMtlfli; 1 1 4....ix w, rvrov
,m ..,, e, i ; Barbecue
,, ‘ s :dinr-niMP+.' ' ' ... .' • ,' ' , • ul " .1ballt."■ ,261111I tLitiinaser I 5 4,1*, . , 4 I 4. ,} ■ _ , ,.,
Business mun_.
e: .
...- . lanrigirarrilaffilillffliM11111 ot
Cla dryer (gas)
Address, v
.. liFralinliMMANZIMMI kt,r,leragWErnr .4 7 1 . 1 7,11f, " ,,r4lii;"` 1, , I ,,i1;14iiii.g' 7
City/State/ZIP: ma t ' - i .11 A 6 t- i i i",9-Oc.-.), - Subtotal za,00
hrfinanum permit fee ($72.50) 1 _,..,-.,
Phone:/' ) v... -_-_e_52.3 / Fax. 95(.4f - 4. 00 Plan review (25% of permit fee)
CCB tic,: I State surchar (8% of permit fee) i'7, 00
/ TOTAL PERMIT FEE - 78,S0 .
•' 1 i / I - 1 +- This permit application expires if a permit is not obtained within lie
Authorized signature! , 1 A 6.6 A: 4 11.4L ( days atter it has been accepted as ceuviere-
Print name: (\a t clAik.,C utf:IthAr • Fee methodology set by Tri Buildieg Industry Service Board
t:\Buiiaing\Perms1MEC °"
, , Date: - '7 ) 1 g 0 .- ? , m
440-4617T (11/01/cOr4Ivia)
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H01.466
PRoN
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503 - 231
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: M 1EC2007.00439
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 71/912007
Phone: (503) 639 -4171 ' /��mp��j n��ilr'�.�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,�±i AIL.
INSPECTION WORKSHEET FOR DATE: 10/2/2007 TIME: 7:04AM PAGE: r.0
SITE ADDRESS: 15715 SW 94TH AVE CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO 12 LOT #: 646 TYPE OF USE:
PROJECT NAME: Jt,?NES
DESCRIPTION: Install gas furnace and a/c units.
OWNER: JONES, RICHARD NEW'T'ON JR, PHONE #:
CONTRACTOR: JAC,COBS HEATING + NC PHONE #: 503- 2347331
Inspection Request Scheduled For: Date: 10/21:007 Pour Time:
Code # Inspection Descriptio' Confirm # Contact # Message
699 Mechanical final V 058759 -01 503-234-7331 Y p.91-
Corrections /Comments/ Instructions:
A /AO ,
A
MR. -del re o'igr■Mrag 1 A 1
i (
X PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
// ``I FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: "' Date: Phone #: (503) 718-
)