Permit MECHANICAL
CITY OF T
PERMIT
n , � � i�� DEVELOPMENT SERVICES PERMIT
1O/`8 -0474
PARCEL: 2S1O2CB -02500
SITE ADDRESS...: 13090 SW PACIFIC HWY
SUBDIVISION • FREWINGS ORCHARD TRACTS ZONING: C —G
BLOCK • LOT •007 JURISDICTION: TIG
1
CLASS OF WORK.•:ALT FLOOR FURN : 0 EVAF COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:P3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP : 0 DOMES. INCIN: 0
:GAS 3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE••.: 50+ HP : 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 10OK BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 5
FURN > =10OK BTU: 0 > 10000 cfm: 0
Remarks: Alteration to gas lines.
Owner: FEES
FOODMAKERS, INC type amount by date recpt
9330 BALBOA AVE PRMT $ 25.00 DLH 10/28/98 98- 310338
SAN DIEGO CA SPCT $ 1.25 DLH 10/28/98 98- 310338
Phone #:
Contractor: &jay - -- --
26.25 TOTAL
Phone #:
Reg #..:
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 - 081-0010 through OAR 952-001 -0080. You Nay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue By: Permittee Signature: _
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By ..a
13125 SW HALL BLVD. Commercial and Residential Date Rec'd /o /2P/feP"
TIGARD, OR 97223 Date to P.E. —
(503) 639 -4171, x304 / /6- Date to DST —
Print or Type i.--. Permit # /'iEC9,,P -0977
guRle- 1.7 9 Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
7T-61.C. ( W it Table 1A Mechanical Code Qty Price Amt
Job Street Address (� P - Su �ett A) Permit Fee 10.00
Address j CJ g a '1 ci J k ( "" 1) Furnace to 100,000 BTU
including ducts & vents 6.00
Bldg# jty /State Zip 2) Furnace 100,000 BTU+ •
CR. including ducts & vents 7.50
e (or ame of business 3) Floor Fumace
Owner J (//1caf -I- 1i . including vent - 6.00
Mailing Addres 4) Suspended heater, wall heater -
9 :� / /� / e or floor mounted heater 6.00
ISQ l �'� 5) Vent not included in appliance permit
City /State Zip n Phone e• 3.00
�i e �( [� 1 . 1 6.5 CHECK ALL *Boiler Heat Air
Name (or na of business) �J 41 i�/� THAT APPLY: Comp
or
Pump Cond Qty Price Amt
6) <3HP;absorb unit to
Occupant Mailing Address 100K BTU 6.00
7) 3 -15 HP;absorb unit
City /State Zip - Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb
unit .5-1 mil BTU 15.00
Contractor t4.5. 9) 30 -50 HP; absorb
'`z0uWV tc'H- p IU33 ! 1 t unit 1 -1.75 mil BTU 22.50
Prior to permit . lli�s rvp . rv cA p 10) >50HP; absorb unit
issuance, a copy >1.75 mil BTU 37.50
of all licenses iC>State N. Zip ahq � 9 11) Air handling unit to 10,000 CFM
are required if �( hr r _ 4.50
expired in COT 9 f- co�st„ Board Lic.# 4 0 4 12) Air handling unit 10,000 CFM+
database ' �c 7.50
Architect Name y /p ,o� ,,- 13) Non - portable evaporate cooler 4.50
or Mailing Address 14) Vent fan connected to a single duct -
3.00
15) Ventilation system not included in
Engineer City/State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No 0 7.50
Residential 0 Commercial)( 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
4.50
kCtn +e 9 qs • l i- i1&5 20) Wood stove
fitt1 es 6s t %Y 1 pi $ Pr/ e"V 4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas" LPG 0 electric 0 - 22) Other units .
,, '' 4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each) _
/ .50
Signat f Owner/ ent Date .MA-.<r)
L
0 ' / 7/7r Minimum Permit Fee $25.00 SUBTOTAL rJ
5 /.SURCHARGE Wag I.
Contact Person Nam Phone PLAN REVIEW 25% OF SUBTOTAL
A Required for ALL commercial permits only /77 'fr I '13-76/7 TOTAL
'State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit O
I:\rnechperm.doc rev 07/20/98 c�
Page No. 1 CASE HISTORY FOR CASE NO.: MEC98 -0474
JACK -IN -THE BOX
13090 SW PACIFIC HWY
12/28/98
Action Description Req/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
•
MECC007 Application received / / / / 10/28/98 RECD DLH 10/28/98 DLH
MECC008 Permit created / / / / 10/28/98 DONE DLH 10/28/98 DLH
MECC090 (F) Issue permit / / / / 10/28/98 DONE DLH 10/28/98 DLH
MECC705 Gas Line Insp 10/28/98 / / 10/29/98 no pressure on gauge (5 #) FAIL RC 11/02/98 J *H
MECC705 Gas Line Insp / / / / 11/03/98 #340411 PART RB 11/03/98 RB
Seal gas line at exterior (Meter).
2# gas- regulators req'd at all
appliances. Pound -to- inches regulators
to be used and shall be made accessible.
Vent indoor regulators OR use vent
limiting devise, mounted horizontally
facing upward.
NOTE:
Inspection of gas line to be viewed at
later date. If this inspection was for
a 60# test /30- minutes, please re -test. •
{11# @ 1206 -1221}
MECC799 Final Inspection / / / / 12/10/98 PASS RB 12/10/98 RB
MECC800 Case Finaled / / / / 12/11/98 PASS RB 12/11/98 J *H