Permit x' ,' O 9'
illg CITY OF �TIGARD MECHANICAL PERMIT
is
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00238
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/1/2007
PARCEL: 1 S133DA -07100
SITE ADDRESS: 12980 SW HAWK'S BEARD ST ZONING: R -7
SUBDIVISION: AMART SUMMERLAKE LOT: 093 JURISDICTION: TIG
PROJECT: KRUSE
Project Description: Install a/c unit.
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
KARL KRUSE Description Date Amount
12980 SW HAWKS BEARD
TIGARD, OR 97223 [MECH] Permit Fee 5/1/2007 $72.50
[TAX] 8% State Surcha 5/1/2007 $5.80
Total $78.30
Phone:
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. _ Permittee Signatu � .; . A 1
Call 503.639.4175 by 7:00 a.m. for inspections th - • usiness 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.
,.,_ edianical Permit Application r , . „, FOR OFFICE USE ONLY
f ifl 14- R E jew ei v ed City of Tigard ��= , f n y _ De/B 0 - i Permit No.:H . 7� 2 n 'I3125 SW Hall Bl vd., Ti g ard , OR 97n `�' y
C Other Permit:
11 Phone: 503.639.4171 Fax: 503.598.1960 Date /By:
T I G n R D Inspection Line: 503.639 Date Ready /By: la See Page 2 for
Internet: www.tigard- or.gov APR " t 7 2 007 Notified/Method: Supplemental Information
1 V iN
E o.:•: �aCOMMERCIAL:FEE „UI;E' 'USE. ;C
ti
I r i , .. f . 1 TW nt `y � i I ° M echanic a l p ermit fees ar e b ased on th v alue o f t h e .. w o r k
❑ New construction � R1'1'1411.1'7\1,
Add►tfon/atteration /re lacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
...... . ................
;:< : M:. : Value: $ •
... -.:: >. ; a . CATEGORY .OF CONSTRUCTION::.:::.:::.::: � ...
Lid t- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building " RESIDENTitAIs >EQUIPMEIVT :1 SYSTEMS FEES * - `'
N ,. /S..
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. _ Total
:.? JOB SITE .INFORMATIONAND (OCATIONx,�r „
Job site address: •' WI J � L{, k B eeur d U .6 - Air conditionin r heat pump
ues site p an showing placement) 1 14.00
City /State /ZIP: rykt,-Of O f� 9—Tea-a---3 Furnace 100,000 BTU (ducts/vents) 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
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances • .:.:..a : ,...,..: .:;;;; : : ' =WOR
Water heater 10.00
Gas fireplace 10.00
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
•
. =:u.... Chimney /liner /flue /vent 10.00
J'' ;;: ; . ° ,,,:�•.: :::�...:�:::'❑ TENANT ;' ;::' :;:.', . 10 00
.�... „:..::::� .:.::.:: �..�.... Other:
Name: e �/� t 4a( v _ i s.� Environmental exhaust and ventilation
Address: �-� ' I �l Range hood /other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) PP1C --5 3G Fax: ( ) toilet compartments, utility rooms) 6.80
'i :: ":. ` IN APPLIANT x' ` 4 ° : $ CONNTA �- 'P.ERSOi`i:: :' ` 1 c;cra�vlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: S5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
.; :::3... .:,. �..!:� ,.�..�, ; ,:CONTR;ACTUR'` ' Barbecue
....m _..... ....,rte.. �.: ; ..... � -.: ..:.. ......,. ... -. ,.�a � � .
)a r.bbts G J l a .� 1) Clothes dryer (gas)
Business name: S •
A
er
ddress: • 1 `r 1, I �V V- �AA.�. �:.. • . //,, * ,, . MEGH:AN1Cr1L•I intmTr EE$”' .;
City /State /Z[ ° . ...: , Subtotal
Per lit d D g e t a
Phone: ( ) ° 7 � 3 I / Fax: ( ) R S-- I O Minimum permit fee (mit fee)
I � � / Plan review (25% of permit ee)
CCB lic.: State surcharge (8% of permit fee) R
• • TOTAL PERMIT FEE 7n, O
Authorized signal t�ti --�� I • r , / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: •- /Mb - VA (JYL10 Date:4 I C, / 7 ' Fee methodology set by Tri- County Building Industry Service Board
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CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MEC2007 -00 38
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 51//2007
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 f °_ _..
INSPECTION WORKSHEET FOR DATE: 5/4/2007 TIME: 7;00AM PAGE: 31
SITE ADDRESS: 12980 SW IIA1NK'S BEARD ST CLASS OF WORK:
SUBDIVISION: MART SUMMERL.AKE LOT #: 093 TYPE OF USE:
PROJECT NAME: KRUSE
DESCRIPTION: Install a/c unit.
OWNER: KRUSE, KARL PHONE #:
CONTRACTOR: JACOBS HEATING + NC PHONE #: 503 -234 -7331
Inspection Request Scheduled For: Date: 5/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 047648 -01 503 -234 -7331 N
Corrections /Comments /Instructions:
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , Date:. mod- Phone #: (503) 718-