Permit CITY TIGARD MECHANICAL PERMIT
I DEVELOPMENT SERVICES PERMIT #: MEC1999 -00573
:Al-
- - �' J 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4 DATE ISSUED: 12/29/1999
PARCEL: 2S103CA -00700
SITE ADDRESS: 13265 SW HOWARD DR
SUBDIVISION: WOODCREST ZONING: R -4.5
BLOCK: LOT: 014 JURISDICTION: URB
CLASS OF WORK: ALT 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:
LPG 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: 1
Remarks: Furnace, gas piping and exterior A/C unit. NC unit must not encroach within 5' of side or rear yard setbacks.
Owner: FEES
ROSE, DAVID & CHRISTIE Type By Date Amount Receipt
13265 SW HOWARD DR PRM4 BON 12/29/19c $50.00 99- 320741
TIGARD, OR 97223 5PC2 BON 12/29/19 $4.00 99- 320741
Total $54.00
Phone: 503 - 579 -0851
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 234 -7331 Heating Unt Insp
Reg #: LIC 1441 Final Inspection
ORIGINAL
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 obt 'n copies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: 1, ji Permittee Signature: k a , - d
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next siness day
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By gots3 '
13125 SIN I-i BLVD. Commercial and Residential Date Recd )Z -`1°I
TIGARD, OR 97223 RECEIVED Date to P.E.
(503) 639 -4171, x304 Date to DST
1 &le applications will not be accepted Called
Name of Development/F (1111,JNI ILG LI" '� Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address - Suite# A) Permit Fee * A'r`�I 16.00
1) Furnace to 100,000 BTU
Address i�o i-Et7oc��
Bldg# City /State Zip including ducts &vents see footnote 1,2 1 9.65 ` r ��
�
2) Furnace 100,000 BTU+
'T, cl ,r c OR 91 a23 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
/ c
Owner 3 � - 1 v ,L. (�V)r=iSr1- IW-� including vent see footnote 1,2 9.65 4) Suspended heater, wall heater
Mailing Address
� 9 _5(-3 ���� A or floor mounted heater see footnote 1,2 9.65
5) Vent not included in appliance permit 4.75
City/State Zip Phone Check all that apply: *Boiler Heat Air
I gAnO c )C 91 a3 57} -O`ssl For items 6 -10, see or Pump Cond Qty Price Amt
Name or name of business) footnotes 1.,2 Comp
6) <3HP;absorb unit to
100K BTU 1- Ii 9.65 G l
Occupant Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
Contractor Name 9) 30 -50 HP; absorb
/ unit 1 -1.75 mil BTU 36.00
-�c&c-�1 " `-- -A `✓1 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy ` / H S2_.- (f t L t..AA-Pc 11 Air handling unit to 10,000 CFM
of all licenses City/Sttate(� Zip Phone 7.00
are required if P+ i. 0 C- 9 - 0.0?.. .57x1 'O51 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const ; Colt. Board Lic.# Exp. Date 11.75
database � 13) Non - portable evaporate cooler
Architect Name 7
14) Vent fan connected to a single duct
or Mailing Address 4.75
15) Ventilation system not included in
appliance permit 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
7.00
Describe work to be done: 17) Domestic incinerators
12.00
New 0 Repair 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type incinerator
ResidentialX Commercial 0 48.25
19) Repair units
Additionai information or descripti of work: • 8.40
,,1-l.-- /;' .- v im c. 1� 20) Wood stove /gas FP /other units /clothe dryer /etc.
v `� 7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas talcs. See footnote 1 I 3.75 , 13
Type of fuel: oil 0 natural gas LPG 0 electric O 22) More than 4 -per outlet (eat .75
Minimum Permit Fee $50.00 SUBTOTAL '' ,'sop;,.
I hereby acknowledge that I have read this application, that the information `r5''/" SURCHARGE .. : sK BL OC
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL ' t
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only 0
TOTAL
Signature of Owner /Agent Date I I. . a'
( „ n MC � .L � le is } lq� Other Inspections and Fees:
�iCX� 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name 0 Phone hours) $50.00 per hour
Q..lcA Yltsz.. (.( L NIlA✓ . 331 2. Inspections for which no fee is specifically indicated (minimum
charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge- one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. *State Contractor Boiler Certification required
* *Residential A/C requires site plan showing placement of unit
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CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
/ BUP
Date Requested ` / AM PM 1 BLD
Location / 3 2 - (0 ®S J1e Suite / 999 -S 3
Contact Person Ph 10,1 / � � 9 — /
Contractor Ph SWR
BUILDING Tageickaaiar Peri L /;G' ( - GOO zo
Retaining Wall p%,. — 3 '; y'f (w) <6-7 ¶ j — �J F5 ELR
Footing
Foundation ® ` T „0, .^'� � _ , _ - FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab
Post & Beam (( / � SIT
Ext Sheath /Shear /Q,G{ w_v_JtJ LJ L 8yyt ,u -tai`✓
Int Sheath /Shear
Framing (— j ,e/1
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PADS PART FAIL
(fILLIMBING1
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
;'rains
P • _ FAIL
Post & Beam
Rough In
Gas Line
Smoke Dampers
T FAIL
E CTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
•
„Y PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D ate 7 ... r " l
Other y d Inspector l r Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.