Permit CITY TIGARD MECHANICAL PERMIT
gal DEVELOPMENT SERVICES PERMIT #: MEC1999 - 00425
`�'i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/12/1999
PARCEL: 1S125CD-07900
SITE ADDRESS: 09909 SW LANDAU PL
SUBDIVISION: TIGARD WOODS ZONING: R - 4.5
BLOCK: LOT: 005 JURISDICTION: TIG
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:
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: AIR HANDLING. UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Add new air conditioner to existing SFD. A/C units cannot be placed within the required setback areas.
Owner: FEES
JIM NICOLA • Type By Date Amount Receipt
9909 SW LANDAU PLACE PRMT KJP 10/12/19.c $50.00 99- 318992
TIGARD, OR 97223 5PCT KJP 10/12/19, $4.00 99- 318992
Total $54.00
Phone: 503 - 452 - 5560
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Cooling Unt Insp
Phone: 503 - 234 -7331 Final Inspection
Reg #: LIC 1441
ORIGINAL
4,.
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 c ies of these rules or direct questions to OUNC by calling (503)246 - 9189.
Issue By: Permittee Signature: "711-a.A.eW — . a r - a
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
•
t Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. RECEIVED _
and Residentia Date Recd A /g /fq
TIGARD, OR 97223 - Date to P.E.
('503) 639 -4171, x304 OCT 0 8 1999 , 1 Date to DST
Print or Type Permit # th ee /cm-0
•
InSOMPItitiletikOfIreffible applications will not be accepted Called
Name of Development/Project Description -
Table 1A Mechanical Code Qty Price Amt
Job Street Address ^� Suite# A) Permit Fee ; '- ' 16.00
Address "Il�JL1 I�C.IndaU pi 1) Furnace to 100,000 BTU
/
Bldg# City/State Zip including ducts & vents see footnote 1,2 9.65
2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace --
Owner ( \ n ! LOI including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater
C � ^ Cott, /� I or floor mounted heater see footnote 1,2 9.65
'� l " 6.1 I LD ! 1CX C 5) Vent not included in appliance permit 4.75
C tats Zip p Phone Check all that apply: *Boiler Heat Air
a Q � "fSD- SSIce 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 t 9.65 1 • lOS
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
T ; +- G •.7( 1 unit 1-1.75 mil BTU 36.00
[°�- � 10) >50H 0HP; absorb unit
Prior to permit Mailing Address e >1.75 mil BTU • 60.15
issuance, a copy '"l - I M -- ` 6 l 11 Air handling unit to 10,000 CFM
of all licenses tat ,(� zip Phone 7.00
are required if -- G 1 . , -)- 3) 12) Air handling unit 10,000 CFM+
expired in COT Oregon Cor'sL � ( ont. Board Lic.# Exp. Date 11.75
''`t "�
database I il- 0 t)° ,() 13) Non - portable evaporate cooler
Architect Name 0 i 7.00 _
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 29k- R pair 0 Replace with like kind: Yes 0 No 0 18) Commercial or industrial type incinerator .
Residential k Commercial 0 48.25 '
19) Repair units
Additional information or description of work: 8.40
20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric O 22) More than 4 -per outlet (eac .75
Minimum Permit Fee $50.00 SUBTOTAL a° - 10 , OD
I hereby acknowledge that I have read this application, that the information + 13.% SURCHARGE ;„ ` : =- Li DO
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL .
the owner, that plans submitted are in compliance with Oregon State laws. Required for ALL commercial permits only a'
TOTAL
Signature of Owner /Agent Date k,N - Al
^n C trV1 Lt ✓�' I J I q Other Inspections and Fees: c4 63
1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name o Phone hours) $50.00 per hour
n
i /� „ () 6 n'I� t MCrn(Ar 'T I Y ` cD 3 _�33) 2. charg Inspections e -half hour for which ) $50.00 hour no p er
fee is specifically indicated (minimum
in /142
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 /e)/2-- l2 AM PM BLD
Location T,'!) !O ? /S t4 cite MEC /”
Contact Person Ph 1 S — LS - 5 - 6,0 PLM
Contractor / Ph SWR
• BU ILDING:"`' *.. ,, :F,3gf Po Tenant/ser ELC 1 9 7 ' 9 a�.p 31/
Retaining Wall ELR
Footing eic-C-CeSS.1
Foundation FPS
Ftg Drain SGN
Slab
Crawl Drain In,I/eCtl Note q ` } .
� � ` � / SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc: _
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
P T FAIL
CHANIC
eam
Rough In ec
Gas Line
Smoke Dampers 9-72
' ART FAIL
ECTRIC
Sew ce
Rough In
UG /Slab pr C/
Low Voltage
Fire larm •
PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA �.
Approach /Sidewalk Date / /
Other / Inspector / Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.