Permit Z Paoli eettnessirneepoi-00920(14,106D)Te
CITY OF T I G A R D 1 1 O a4 MECHANICAL PERMIT
A,_ , I' DEVELOPMENT SERVICES �Sa PERMIT #: M 26/02 -00364
` ° "j 13125 SW Hal Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/26/02
PARCEL: 2S 116AD -29900
SITE ADDRESS: 16880 SW 126TH AVE
SUBDIVISION: KING CITY NO. 10 ZONING:
BLOCK: 13 LOT: OOA JURISDICTION: KIN
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B 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: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace NC.
Owner: FEES
KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt
15245 SW 116TH PRMT BB 8/26/02 $72.50 KING CITY
KING CITY, OR 97223 5PCT BB 8/26/02 $5.80 KING CITY
Total $78.30
Phone:
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 503 - 234 -7331 Cooling Unt Insp
Reg #: LIC 1441 Final Inspection
EXPIRED
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -9189.
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Issue By: ,. _, . ,_,4 4 _, i Permittee Signature: 61 (:<_,0
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day