Permit CITY OF TIGARD
•
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00408
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/13/2010
fi l t h 17! 9 Parcel: 2S102BD01701
Jurisdiction: Tigard
Site address: 12830 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Davidson's Restaurant
Project Description: Replace 4 ton gas pack with same.
Owner: FEES
DAVIDSON, WILLIAM G & DIXIE L Description Date Amount
12830 SW PACIFIC HWY
TIGARD, OR 97223 Permit Fee 08/13/2010 $194.93
Plan Review 08/13/2010 $48.73
PHONE: 503 -639 -5111 12% State Surcharge - Mechanical 08/13/2010 $23.39
Contractor:
JACOBS HEATING & AIR CONDITIONING
4474 SE MILWAUKIE
PORTLAND, OR 97202
PHONE: 503 - 234 -7331
FAX: 503 -808 -9108
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: A -2 Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $267.05
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /AA V' Permittee Signature: SEL Aq _TGA - 4 I/
Call 503.639.4175 by 7:00 a.m. for an inspection 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 ApnlicatIOn - - *. . ; ., 1 ( 1. w:I.. om.
City of Tigard Recoval
D iMINOMM Pamil ND , te, .10 -00 "Og
N,....._ 13125 SW Hall Blvd,, Tigard, OR 9 Han Reos , i--,
l Phone: 503.639A171 Fate 503.59M 1 3 2010
Digver igyAwramaut. ILI 04 crP'"'
inspection Line: 503.639.4175 , ,.. Date • f y: ill Ed Set Page 2 for
ham= onywrigard . ; . Natifird/Methott Sootucgratal Information
',... . . " ":'.. ' ,e4 . 'i'; :. ' ". 1:., f'. AlaWiSfiri*C.: "ci ;,;.4 tREGizelipsr
Mee/tomcat permit &Wm based on the value of the work
CI New construction _ISLAdditIonfidtorationkeplacement
performed. Lr&ditc the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials. e. '111, , tabor overhead. and -Tofu.
'Value: $ 4 , • • .02
'. . . ' .-..:::: .', .•--..• . ---. Wit .s.i . , -.. • IP I ti ):;" , V.A.1 .......;:',IL .;,-. - ... :. :;:". . . . . .„. -
- .1 . 4
CI I- and 2-family dwelling tg-Cornmercialfuldustrial 0 AccoSSOry building
For special informartars use checklist.
0 Multi-family 0 Mailer builder 0 Other Description - 1 Qty. I EL 1 Total
iling§161:VT1 7 \z i,j f ir ::::':!:: ''::: ■., Heating/cooling - _
Air conditioning
EC= , .. - 12Mr1l... - - a (maim Sliti DWI shay/log*1=mm) 46.75
City/State/ZIP: - 1 - ' 1 el/AA j 0 . d Furnace 100.000 BTU tieseurverits) 46.75
Furnace 100,000+ BTU (clactsive414) 54.91
Suitribldgfapt. no.: 1 Project name:
Heat mime 61.06
Cross street/direCtions tojob site: Duct work 23.32
ilydronic hot wan' syslcm 23.32
Residential boiler (radiator or
bydrooic) 23.32
— Unit (fuel-type not electric),
in-wall in-duct. sus , ended. ere, 46.75
Flue/vent for any of above 23.32
Subdivision: Let ao.:
Othcr 23.32
Trot niapiparcel no.: . Other Awl aPPIIBP eel
. -.':!. ,:: ..... ;:;'.',. " ".:. , ; '. ' 6(4_ .. ..s , ..,...e):;' 1 7 , i 7 ::: :`.., ." 1 - :ni ...;':.:-::., ? lister healer 2332
LL
• C, Gas fireplace
Flue vent for water heater or ga5 3339 .
L.. .CL F - .lace 23.32
Log lighter (pe) 23.32
Wood(pelletstove 33.34
Wood Ilreplacefinscrt 7332_
. .; 4 ' " lgeti CISKStil*: . ,•;:,;:: '',.:: : ::."4:::r;..a, :: 1 . 7 ; ..,:: ,. ;, 1 .1 . ; . ' ,,.,: ;'.:• . 1i.:_, o Chinuteyninedfludvent 23,3i
23.32 I
Name: Oa- ' ■ 40 411, • C44..AAA,C,.. , Environmentat exhaust and vendlation
•
_
Address: 1,,..c-‘"(::::) c,.. t.,3 c ' Itange baud/other kitchen
"Ne a:Mime:at , 33.39
City/SlaterZIP: - r . ,, e;,..A c- g._ . Clothes drzr exhaust 3339
--- Single-duct aclunat (bolinnoms.
141044 -0 5 1 4 7 1 -St 1 t Fax ( ) toilet compartrnents, utility room5) _.. 23,32
1 .- - :•,?: ''. 4..,..',... 7 rj%' :: ::1:0 :;,•-..:.: 3,4 . 71, - CP; 4 7,. 1111 0 II 7 -;: tr. , .1,.,. TiF Atticicroulsouee flute 23 32
Other: 23.32
Business =MC!
FucI pipinit
Contact name:
51445 for flrat lour; S4.03 for each additional
Address: Furnace, etc. L
Gas heat pump
City/Siam/ZIP: —
— Wal Ifisuspendodhotit herder
Phone: ( ) Fax:: ( ) Water heater
E-mail: Fireplace -
Ranee "
P. 'T; - r ; .-L::•• .4:::•!'":1:ri, .17,1') . • ;':'. , ' . 7. ..u. -.z.,fr ; - :- ; .• - 4 - -: ' t .
"
Business name: Jacobs Heating & Alr Conditioning Clothes dryer (ens)
. _
Cohcr:
Ark1rcSs: 4474 SE Milwoulde Ave
'..‘ --.:-. '
City/StaterLIP: Portland, OR 97202
Subtotal
Phone (503)234-73J1 FaX: (503) =m Jilin, os ___14 i______u, omit ro ($90.00 -
CCB U.; 1441 I f e-L-0701E, Plan review (25% ofpantir fcc)
State surcharge (12% ofpermit fcc)
_____ TOTALPERMIT FEE U 7 05"^
Authorized signature: K. 4---,5*- . e•i-,V•ar--, Tall parosit agollestion miens if i wogs It not shalom! w1515 IBB
daya sifter II has term aectgied as complete.
Print name: k‘N.t1 4 1.... li - _ Date: , f,_> /0 a p methodology set* TA-County Building Industry Bunion; Board
I I.BuiltiogWamlutMgC.PcrugiAppclac mew ., 4.634617T (1 trestanowato
IT/Z13 30Vc1 ONIIV3H SHO3V LSZEZT8609 12E:60 KOZ/ET/80