Permit d
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2000 -00115
' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 04/06/2000
PARCEL: 2S111 BD -01900
SITE ADDRESS: 09805 SW PEMBROOK ST
SUBDIVISION: CLOUD CAP ZONING: R -3.5
BLOCK: LOT: 001 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: 1 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace existing heat pump and air conditioning unit. A/C unit cannot be placed within the required setback
areas..
Owner: FEES
HORNBECK, WILLIAM H J + Type By Date Amount Receipt
WAHLER, KRISTIN E • PRMT GEO 04/06/20C $50.00 0001213
9805 SW PEM BROOK STREET 5PCT GEO 04/06/20C $4.00 0001213
TIGARD, OR 97224
Total $54.00
Phone:
Contractor:
JACOBS HEATING + NC
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Heating Unt lnsp
Phone: 503 - 234 -7331 Cooling Unt Insp
Reg #: LIC 1441 Final Inspection
•
EXP ED O R\ G N AL
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 -918 •
Issue By: I /.0 j' Permittee Signature: �,f,
Call, 03) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Apr- 00-00 09:41A Jacobs Heat 8139258 P_02
Plan Check tx
CITY OF TIGARD Mechanical Permit Application Recd By -
13125 SW HALL BLVD. • Commercial and Residential Date Recd
TIGARD, OR 97223 • Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit OfF. ? OeO 0 /S
In complete or Illegible applications will not be accepted Called
Named Development/Project Desctiptlon
Z r 1 i 1'40(N le- Table 1A Medtanical Code D Price Amt
A) Permit Fee 18.00
Job 1) Furnace to 100,000 BTU
p S C deeR Address
Address /p0J b r+mbY00):-..S+ including duds & vents see footnote 1,2 9.65
erdkilr I C H / '' u° 2) Furnace 100,000 BTU+
including duds & vents see footnote 1,2 12.00
' Name (a morns or business) Sect 3) Floor Furnace
Owner f t I \ I N Sect including vent
4) see footnote 1,2 9.65
Maw Suspended heater, wall heater
n 1 _ or floor mounted heater see footnote 1,2 . 9.85
9 5j S L&) PPiyrt ln oat S t - , 5) Vent not Included in appliance permit 4.75
cny/state Lp Phone Check all that apply: *Boller Heat Air '
T i cue -I G o- 9 v 616. . 309/ For Items 6-10, see or Pump Cond Qty Price Amt .. �rstneac) footnotes 1,2 Cam •
hianiAor name or
8) 4 3HP;ebsorb unit to
100K BTU 1 9.65 ?4,S
Occupant Mailing "Tress 7) 5-15 HP;absorb unit
100k to 500k BTU 17.65
Vey/Suite - Zip - Phone B) 1530 HP; absorb
unit .5-1 m0 BTU 24.15
9) 3050 HP; absorb
Contractor N unit 1 -1.75 mil BTU 36.00
SbgC'O(, )16:4 tot) 6 A, 10) >50HP; absorb unit
Prior to permit Muting Md rese VV '1.75 and BTU 60.15
issuance, a copy My 7 % 01 I Joie ,.4 . 11 Air handling unit to 10,000 CFM
of all licenses LG�r�rs��e tip Phone
i _ / 7.00 7. d O
are required if mr r nt 02 flas , 234- 735 ! ` 12) Air handling unit 10,000 CFM+
expired In COT Oreaon Const. Cost, Board Lic ii. Exp. Data 11.75
database 1 ' y ) 13) Non - portable evaporate cooler
Architect N - 7.00
14) Vent fan connected to a `, ..�' •i i:',Ist Fro
M ang Address 4.75
Or 15) Ventilation system not included in
. appliance permit , 7.00
Engineer • CIE phone 18) 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% No 0 18) Commercial or industrial type incinerator
Ftssidentlatie, Commerdal0 48.25
19) Repair units
Additional information or description of work: - _ _ 8.40
20) Wood stove/gas FP /other units/dothe dryer/etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
si udural gas calce. See footnote 1 3,75
Type of fuel: oil 0 natural gas 0 LPG 0 electric pc 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $60.00 SUBTOTAL 50, ('j(,)
( hereby ac that I have read this application, that the Information $ X% SURCHARGE a, p
given Is coned, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
her, t t plans submitted are in compliance with Oregon State laws. Requited for ALL commercial permits only
n_c c J 'V - 67 ' Ch 0 TOTAL 7' ,
S gnature ofr nt Date ` OG
S / 1 e �31/ - 7331 Other Inspections and Fees:
n r 1. Inspections outside of normal business hours (minlnum charge -two
Contact Person 'tame Phone hours) 550.00 per hour
2. Inspections for which no fee Is specifically Indicated (minimum
. charge -half hour) $60.00 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) 660.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
units. - State Contractor Boiler Certification required
• "Resldendal A/C requires site plan showing placement of unit
I:trnechperm.doc rev 02/4/B9
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