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Permit CITY TIGARD 5' MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00107 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/15/2007 PARCEL: 2S 103BB -02000 SITE ADDRESS: 12285 SW 124TH AVE ZONING: R -4.5 SUBDIVISION: BROOKWAY LOT: 020 JURISDICTION: TIG PROJECT: GILL Project Description: Replace furnace. 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: DOMES. INCIN: 3 - 15 HP: COMML. INPUT: BTU ' 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES PETER GILL Description Date Amount 12285 SW 124TH AVE TIGARD, OR 97223 [MECH] Permit Fee 2/15/2007 $72.50 [TAX] 8% State Surcha 2/15/2007 $5.80 Total $78.30 Phone: • 503 -590 -3135 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: ✓e4 Permittee Signature: c , i\ „ 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. + Meclianical Permit ApplicaRECEIVED FOR OFFICE USE ONLY City of Tigard DPlan ate/By Review ./ y t,J Permit No. ` .e 1..,... 0 .60 4 . 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.196 c0 1 C DateBy: 2UU1 Other Permit: TI G ARD Inspection Line: 503.639 Date Ready/By: mcis: 0 See Page 2 for Internet: www.tigard or.gov G f TY OFTIG�RD Notified/Method: Supplemental Information BUILDING DIVISION ,. ... ._., ..,.r ... .. yya..> a :.> .; ...... .. ,, 3;' M "'A:i• �,a:' +9s`� +=. ::EBw' +• �: :"�.:� >n.. .r",. - ., -•.. 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Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. swa ;h•. � Value: $ 5N TIZ� aI of > °, � �7: ,'fir "•'`x;:° _. - -. ,. <. »,. � ,..,.x , ... -. , ,. ,.. .:xixr�.W . ........ ..:... ..........^r' ., ,.. e ..,- , . i:, -a ;` R SiD, ,11 I , *b.,...0.0 . NT j S,I .1.#: �S:FEES_SOt� ;'-" - land 2- family dwelling ❑ Commercial /industrial ❑ Accessory building �' ' "'`� "° " "`�° "�" For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. Total ::: >.. :.., ;,Aar 1 ,t. OCA _:: `� , `;�� i,:; :.::_. ;_`� - -� .JO, ,.�5 E A)\?Il °�? ,.,� �ONy� _ ,_ ^,: Heating/cooling Job site f site address: 1 o o 3I Y 'i_ h ■ Air conditioning or heat pump _ (requires p uires site Ian showing placement) 14.00 City /State /ZIP: ( a 5 Furnace 100,000 BTU (ducts /vents) I 14.00 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 hydronic) 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: 10.00 Tax map /parcel no.: Other fuel appliances =3 . t;x :? f= ..;�,. -*; -v-'- Water heater 10.00 4 . 4 „, Yw - lDESCR F z d a is , ...:: r4 Kl. ,,,- .t.,, % ,r „:; N,,,, . .._ ,, , z.u� ; �w,,,,. - , 10.00 Gas fireplace `jA iI lam Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Y �.�, - Chimney/liner/flue/vent ,?.��,'. ��•t:” -.fir° av�.�.,. a mow`+ a:: -. tj ' ; .. : : sue ' z� °�,< ,„fie u ;'y.X, sxl H per,°:g :;_` ''” ,❑,5170, N ,, i y - .�,rw.�„ ��;;.�,' � :>uI�QP��,•,T� .... �' E. ... , ., �' t. -.- =��i3, �_' -,�F,, �, ,u.. =�_ 4 <.';;:":�...._�,...�< Other: 10.00 Name: ne_(_Q N.[ I Environmental exhaust and ventilation .l l �t Range hood /other kitchen Address: equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 . Single -duct exhaust (bathrooms, Phone: ( ) '59 © 3, ( J) Fax: ( ) toilet compartments, utility rooms) 6.80 -. %,,"nT.".-s•.F�>'.,-, _,:M;= <•; <'r.P'', 10.00 »�fl, ate. �;;'��. ,:�� <,.:>�,; >;, r.£�. - x. �, '.. Attic /crawlspace fans f ` .„ "' ,� 'r;a; ";=> �_;'. ONTAG )TtgSO . : ;; 4•,, f`.r ° =�� ���: �._ < .. Other: 1000 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Furnace, etc. Address: Gas heat pump City /State /Z1P: WalUsuspended/unit heater Water heater Fax: Phone: ( ) ( ) Fireplace E -mail: Range A, m.,. qa�= x „�, ,3;�. -; e �:_." w�.E;y4. ;.. ., � • :'�, '�,' r• - � ' �= � Bar becue _. <,�;, ..;� . a� ,•:, . . : t dryer ”" "` Clothes d er (gas) Business name: i , ` 1 1111 f , 6-1e, Other Address: ,, ' , • ° r 9` 5 7.' � 1 ,, 4! d J Aye: . ; -... -: i ,,, M C TA1V.- _ . ,' ' IT,1? ' 5.4 ;'y ''; a'e;.. , Cit /State /ZIP: cpT f t f- l r1 Li R i 1' 01 Subtotal 2 .— Minimum permit fee ($72.50) "7* 'f) Phone: 7 3) ± "7 ) .. ) 1 Fax: l ( f 3t / — 9 co Plan review (25% of permit fee) CCB lie.: ! r.--1 , State surcharge (8% of permit fee) 5,. 30 TOTAL PERMIT FEE 7 f 7 �,_ / t � iC� This permit application expires if a permit is not obtained within ISO Authorized signature: �+ l days after it has been accepted as complete. Print name: +/-1/1 "1-- j c�L h Date: c 1 07 * Fee methodology set by Tri County Building Industry Service Board � I � ' /�([' 1:\ Building \Permits\MEC- PermitApp.doc 04/06/06 I 4404617T (I1/02/COM/WEB) ! V 5 CITY OF TIGARD 1 BUILDING DIVISION PERMIT #: MEC2007 -00107 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/15/2007 Phone: (503) 639 -4171 /onzyau14o�EI1I Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 3/14/2007 TIME: 7:00AM PAGE: 47 SITE ADDRESS: 12285 SW 124TH AVE CLASS OF WORK: SUBDIVISION: BROOKWAY LOT #: 020 TYPE OF USE: PROJECT NAME: GILL DESCRIPTION: Replace furnace. OWNER: GILL, PETER PHONE #: 503 -590 -3135 CONTRACTOR: JACOBS HEATING 4. NC PHONE #: 503- 234-7331 Inspection Request Scheduled For: Date: 3/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message AP 899 Mechanical final 044802 -01 503.234 -7331 Y t , Corrections /Comments /Instructions: 31 I • , AP I _ - - PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAJ _� CA FOR INSPECTION n ADD T IONAL FEES ASSESSED 1 q Inspector: ' f Date: 6 Phone #: (503) 718- ak2k_