Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2009 -00286
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/16/2009
Parcel: 2S102BD03000
Jurisdiction: Tigard
Site address: 13025 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Truck Terminal Inc.
Project Description: Replace 5 ton heat pump.
Owner: FEES
TRUCK TERMINALS INC Description Date Amount
15965 NW TULLAMORRIE WAY 12% State Surcharge - Mechanical 06/16/2009 $8.70
PORTLAND, OR 97229 Permit Fee 06/16/2009 $179.30
PHONE: 12% State Surcharge - Mechanical 06/16/2009 $12.82
Contractor:
JACOBS HEATING & AIR CONDITIONING
4474 SE MILWAUKIE
PORTLAND, OR 97202
PHONE: 503 -234 -7331
FAX: 503- 808 -9108
Type of Use:
Class of Work: Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: 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 $200.82
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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. o n
Issued By ��' L� Q U .\ n Permittee Signature: CJ V
Call 503.639.4175 by 7:00 a.m. for an Inspection that business day. p
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.
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Mechanical Permit Applicali3t c F n FOR OrrICE USE ONLY
Cit of Tigard F 1\ I ,Re.ei
..._
. • 131 25 SW Hail siva., Tigard. OR
I t.
: . oh $03,639,4111 Fax: 503.59S.1960
II
011cr Prim&
TIGARD
Pion Review
Inspection Line: 503.09 JUN 1 1 Z009 p,,045.:.
•
Dalc Rertilvaly: • tun, 0 See Page 1 tor •
(miner wn.w.ti Storific&Niethrd: III q supplement311rtformalion
CITY c7 110
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T37k. 104:404Pf;;;. .. - • - :':.; ....-,...! i....„..___picogftcw FEE
,..
New construction .. .
1 . . - . lt• echanical• pinta II
b Ilasedtinme,lbe work
0 ON dditionfalterationirep lacement
perfumed. Indicate the value (rounded lo dlt. nearest dollar) of all
0 Demolition 13 Other: roechaniO1 =serials. equipment, labor. overh and fh
CATEGORY OF CONSTRUCTION :; :': :- • .: : --:. • -:•...,:-; .. Value: S - 7 • • .. ,....!
., ..:.:,. EO,HHICIEScif,1 SYMMS FE1:S.* I
0'1 :mil 2 dwelling ArCornmercittliindustrial 0 Accessory building
For Tema ill formoon use thecklisl. _I
0 Multi.finnily 0 N■laster builder 0 Other:
DeseriptiOn Qty. 1 nt. T.111 ;
. , . ..
JOB s .. • •••• .-., . ... Healing/cooling _
[Lob site address: ; I .a.5' SiA) 04 ', s a
Air conditioning or hem pump
cquires sac alan Aeuiria abeernAtaii . 14.00 '
City/Statcalr:
T . . 0 Fs, 9 7 eza-3 Furgace 10.0.000 BTU Muote'very0 14.00 j
1 i ----, F urnace 100;000+ 'BTU PluoVvenn) 17.90
Su itc/hldr,./ap t, no.: j Project name: / int, K... " Via k ..3'13,C. ..Gae.hcat pump. • 1400
_
------
Cross. AMCIAIITCCliOttS to job site Duet xvork 10P0 _
— --
• 1-lvdmii le hot water system 14,00
Resident ial•boile r (radiator Of
...■....--_-............
becironiel 14.00
Unit heaters (fuel•typc, not electric). •
rn-Wall,M suspended. etc.. ' .14.00
Rua/vent for arty al above .... I .
Subdi vision: Lot no.:
Other: , I 10.00
_,
'fax maprparcel no,
Other fuel appliances --- ...-
• I . :• .:• '' • • DEsOitnioN: Of...W.Ottk:" ..... ' .. .. . Water heater ....,_ 10.00 •
---TR i • . . .......-... --------____,
- L C•
s - tat)._ 1 eit=kr,\-10 Clas lin:place . .
Flue vent kV Wager heater or Etas . 10.00
limpltrec 10,00
_
_._---.-:---_____- — Log *Net (nos) 10 00
Wottt . ......_
j
Wood fireplace/insert 10.0o_ i
ronevilinerifl or/vent ..I C.00 i
.)5U1ROPF,ILTV:OWNHR!.... .• ..... /- - . 1 . ...... .,- '',...'i 1 . . .: .:•••:::::.:. CHi
--7- — ,
..........-....... ,,(2ther: 10.00
_ .,_
Name : G e .,-. 1 t. 9.„.4.,..cig,..+4 Environmental C012uxt Slild vengilition
Range hoodfuther kitchen • •
Address:
.. 10.00 . I
CilyiStmeTI,I P: . 'Clotho-dryer exhaust ram)
"
— Single-duct exhaust' (bathrooms.
Phone: (3'03) 6 1 - / 1 e l.. fax: ( ) toilet compartmen(s. utility morns) I 6.1w
0 ' .4P 1 .'t.i0.4r 4 i: • • i■ ;;:...:::' : .."0 . . •:, At ticfcrawlSpace fans 10,00
Other: Mill To.00
ausinegs namc:
pueriqrng
Comet name:
55.40 for first Enur51.00 for each dd ;clonal _.
Address: Furnace. etc.. i._L____L__._,
. _,,,,......_,.
Gas rttif pump di . h.
City/State/ZIP:
SuS,Pcit e unit cater
P bon: ( ) Fax: : ( ) 1 Water.hearer
" - • .
• - .. I Pirsplace -. 1
•
i Ranat —1---••-•••
, . -.I__
! • . . .CO.tr ! .. :••-.:. :::Y • • •• .: :.:,:i ' - ..: Barbecue
.............. •• . .••. --- • -
, Clotbm dryer (gns) ,
[ —
11usiness name: Jacobs Heating & Air C.:onditioning
Other:
• - •
Address: 4474 iii:. Milwaukic " . • • • • -:!. ::ttiEcitkrbitcAL•pkasirr:Fr.s. •
......_ ,
City/Slott/ZIP: Portland. OR )7202 — - Subtotal al
Phone: (5113)234.7331 FaN: (503) 30 Minimum permit fee (572.50) "
8.9108 - ---,------
, _ Inn reviem.(25% of permit fee) 1
Cal lie.: 1441 I , State surcharge (12% of perrnit fee)
— r -
- .rOTAIL PERMIT FEE kl) 7 ,11iLit
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Tlii Penni' 2 rIlircZoelrims ira perfall.b110011)Inittc4 wa J.
Autharir.e.1 signature ilk,
: - Avnra 11 1 r21. 111111°-
dot aftcuit RIA% tkevhortiveil a3 opipine.
Print name: ,,g j ..,, • • ...1. . lir 4 , I Date: ( - /1-6 7 1 . Fre methodology sct by Tri.-County minding ind se n,,J
1 '1 dos Or tvi It • 4.16.46 171' ( I 1, VICOMAVEn I / 7
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