Permit g t./
C ITY OF TIGARD MECHANICAL PERMIT
CIA DEVELOPMENT SERVICES PERMIT #: MEC2006 - 00429
61 I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/5/2006
PARCEL: 2 S 103 C B - 01700
SITE ADDRESS: 12300 SW JAMES ST ZONING: R
SUBDIVISION: WILLAMETTE LOT: 042 JURISDICTION: TIG
Project Description: Replace furnace & heat pump.
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:
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
JIM HURTT Description Date Amount
12300 SW JAMES ST
TIGARD, OR 97223 [MECH] Permit Fee 9/5/2006 $72.50
[TAX] 8% State Surcha 9/5/2006 $5.80
Total $78.30
Phone: 503- 320 -8111
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 Signature:
Call 503- 639 -4175 by 7:00 a.m. for inspections that business d
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.
•. FROM' e :JacobsHeating FAX NO. : Sep. 05 2006 10:34AM P1
Mechanical Permit , ' '' n‘ `
City of Tigard may: 9 O K vg '-, Pantdt Na !/ Q ‘
13125 SW Hall Blvd., Tigard, OR 97223 . C Plan Review
Phone: 503,639.4171 Fax: 503.5911.1960 t '' � 1 - Dete/By, OtberPamdt:
inspection Line: 303.639.4175 , a 1 f' Date ri ruA4 'l Si See Pap 2 for
Internet: www.ci.tigard,Or.ue Y i �� . Notified/Method: / / (3 I Sapplen ental Information
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❑ New construction ® Addition/alteration/replacement
permit fees* are based on the value of the work
perlbrmed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
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= I - and 2-family dwelling ❑ Commercial/industrial ❑Accessory building „,,,u,
For special Worrnation itre checklist.
❑ Multi - family ❑ Master builder ❑ Other: . )]eeoripticn I Qt f Bat 1 Total
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Job site address: /a L/� � U' .r r 'L Air conditioning or heat pump S Omaha eileyhn ehowina nleeemern) 1 14A0 I4-
Furnace 100,000 BTU (aors/ven11) _ 1 14.00
City/State/ZIP: �`. D — �(� - - Furnace 100 BTU/ducts/vertu) I 17.90 _ _
Suite/bldg, /apt no.: _ J Furnace Project name: Cm 1400
e heat pump
Cross etrcet/dircctione to job Bite: Thict 'mark 14.00
Hydranio hot water system 14.00
Residential boiler (radiator or
— hydronic) 14.00
11.._ Unit heaters (fuel -type, not electric).
' in-wall, in -duct, suspended, etc. 10.00
Subdivision; I Lot no.: Flue/vent for any of above 10.00
Other:
Tax map/parcel no.: t tar fuel appliances
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fl i i I P 111I111 1 ' 1 N ^II } t I ii If I 1!}} r }1 1 fF 1 i ' I aJ al ” i U4 1 3X { I I 1:Pr 1 { � yy 1 r I" Water boater
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111,. .1,14..I�I1t J..t1, ill 1�1,t l,. 1 21 1 , t, t, d�11,:; hl,: nr,.,i1.r,,mtill l;'ll+nllf. �, a.1r;.f fireplace 10,00
PI ...1 - L r / -• / - C(. 44- � - -- Flue vent for water heater or gee
fireplace _ 10.00
• • _ - Log lighter (gas) - 10.00
Wood/pellet stove 10,00
Wood fireplace/insert 10.00
}l;eilg °y,1n sc::p ttrlt!aA �rY� tFt ''rl 1 111 . n: i1,Ni.,,, ...r,1; r tzu• Chimney/liner /flue/vent 10.00
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Name: ,� .I - -- Etivlrottmeatal exhaust and vesetllatlotl
Address: Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
- i , ' -'' I Fax: Single-duct exhaust nt (ua lity'G e,
( ) toilet campartttmmts utility trams) 6.80
'li'1!G4l;il I'IVn Ni tli1P!� 11]I ,.9n11 1174 h 'L. '1 . tll'Pli C IjIQ k, P: i U - Y.P. ^C .1,.T • rpZt,1 10.00
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Business name: ' Other I 10.00
Fuel piping
Contact name; $5.40 for first four 1.00 for each additional
Address: Furnace, etc,
Oas heat '
City/State/ZIP: Wall /su '. ended/unit heater r
. ��
Phone: ( ) I Pax: : ( ) Water heater
Fireplace
E-mail: R
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Business name: Jacobs Heating and Mr Conditioning
dryer (sae)
Other.
Address: 4474 SE Mllwaukie Ave _ ... M I ,i f 1iiiji 11 In, i °`I,, I' II! l lal a,n net ! ,
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City /State/ZIP: Portland, OR 97202 Subtotal
Phone: (503) 234 -7331 1 permit Fax: (303) 609 -9108 Minimum peit Ella ($72.50) _ 7 • 511-
_.I Plan review (25% of permit flee)
CCB lie.: 1441 el State surcharge (5% of permit fie)
�a�
TOTAL PERMIT FEE ;J
Authorized Si v � w Title permit appllaetlea expires Ira peredt h not obtained within 180
days after It has been notepad es complete.
Print ram ■ 4 (No ■ E e A 1 .. - Date; 1-- I — Oct .. I • Fee methodology set by Di- County Building lndoetry Service Board
@MSulkkne9emdtdMQC•Pe,mdtAppdx 12101 _ ..4 1 • /.`/ 1 ” ' 40H617f(11A02lCOWW5D)
FROM0:JacobsHeating FAX NO. : Sep. 05 2006 10:25AM P3
SITE PLAN
2.s' <0>
DIRECTION
- 1 1
• 3 S HOUSE
P'120N r •
STREET - --
Job Name l 1'^ 1 U R -1- 1 —
Address / 3
' .. 0>2 97 Z 2 -.j
Model f< /'e 0 3 b
make
JACOBS HEATING 8z AC
4474 SE Mflwaukte Ave.
Portland, OR 97202
(503) 234 -7331 -
(503) 813 -9257 fax