Permit CITY OF TIGARD jy;* DEVELOPMENT SERVICES MECHANICAL PERMIT
PERMIT #: MEC1999 -00523
DATE ISSUED: 11/29/1999
1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S111 CD -08900
SITE ADDRESS: 15910 SW SERENA CT
SUBDIVISION: KERWOOD ESTATES ZONING: R -4.5
BLOCK: LOT: 037 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: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Replace gas furnace and install air conditioning unit in single family dwelling.
Owner: FEES
TOWLE, JANET C Type By Date Amount Receipt
15910 SW SERENA CT PRMT KJP 11/29/19E $50.00 99- 320064
TIGARD, OR 97224 5PCT KJP 11/29/19. $4.00 99- 320064
• Total $54.00
Phone:
Contractor:
JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 503 - 234 -7331 Cooling 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 obtain co ' f these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: Permittee Signature: '2-n- Gin ..C,P
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
•
CITY OF TIGARD Mechanical Permit Application Rec'd By
Plan Che
13 SW HALL BLVD. Commercial and Residential Date Rec'd
e TIGARD, OR 97223 RECFr " °" Date to P.E.
(503) 639 -4171, x304 Date to DST
NOV 2 ) 199c Print or Type Permit# e� Mg
Incomplete or illegible applications will not be accepted Called
Name of Developmept/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suites A) Permit Fee I 16.00
Address 1S' il7
c C 1) Furnace to 100,000 BTU
- v, including ducts & vents see footnote 1,2 1 9.65 q•Co 5
Bldg# City/State Zip 2) Furnace 100,000 BTU+
7 i C( c 9 -.) 21 including ducts & vents see footnote 1,2 12.00
Name (or name of business) ° 3) Floor Furnace
Owner J -- a v' ( - -r-0,_31-e including vent see footnote 1,2 9.65
Mailing Address 4) Suspended heater, wall heater •
or floor mounted heater see footnote 1,2 9.65
1,C1 I 0 .-.-J 6 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
T i C9 O0(z-- GI'ior j (� -- 2D -- For items 6 -10, see or Pump Cond Qty Price Amt
Name (o J am of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU . 1•■ I 9.65 ° I (a
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
'' ,,, rr unit 1 -1.75 mil BTU 36.00
,---9 t•
cA -f-' -%< CI 10) >50HP; absorb unit
Prior to permit Mailing Address D >1.75 mil BTU 60.15
issuance, a copy I7 4 rYl (�ak..j.j 11 Air handling unit to 10,000 CFM
of all licenses C ' st to Zip Phone 7.00
are required if l_ CI 7G � . -13'9 12) Air handling unit 10,000 CFM+ •
expired in COT Or I ons . Cont. Board Lic.# Exp. Date 11.75
database 13) Non - portable evaporate cooler
Architect Name 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 0 Repair 0 Replace with like kind: Yes), No 0 18) Commercial or industrial type incinerator
Residential 6k Commercial 0 48.25
19) Repair units
Additional information or description of work: 8.40
) tr\SA ->! 5 r (Ne LO o4 Ac IC, 20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commerci 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»' LPG 0 electric O 22) More than 4 -per outlet (eac .75
Minimum Permit Fee $50.00 SUBTOTAL .5D DO
I hereby acknowledge that I have read this application, that the information " Tit% SURCHARGE 1 4.00
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 '
TOTAL
Signature of Owner /Agent Date 5
tr\ .J C,k IY1 - 11,A_ f _ I 1 N k Other Inspections and Fees:
` 1. Inspections outside of normal business hours (mininum charge -two
p ) I
Contact Person Name ne hours) $50.00 per hour
^� -Q G >'1 ■ _ M c MLA i - � _ 33 2. Inspections for which no fee is specifically indicated (minimum
' V ' T '�
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 NC 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 a AM PM BLD
Location /5/0 .4e//€44,4* Suite t f � 9 62.?5a 3
Contact Person Ph PLM
Contractor Ph SWR C
BUILDING Tenant/ - e7 P (5-9 ( X
Retaining Wall 6 '76 342 ELR
Footing Access: / �
Foundation 0 - -e ,n �v"" FPS
Ftg Drain �' / SGN
Crawl Drain Inspection Notes:
Slab p. n SIT
Post & Beam
Ext Sheath /Shear .�� �� J g , 36-(0 .� 0 d lT m
1 .
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm .r S WS-
Susp'd Ceiling ∎te_- �•' -, _-
Roof
Misc:
Final
PASS PART FAIL ,�
PLUMBING c /s 1;a1
Post & Beam
Under Slab
Top Out , / 7 T Water Service —� 7,ij U
Sanitary Sewer
Rain Drains
Final //
P T FAIL � J\\ y� 6
HAN
Post & Beam
Rough In
Gas Line A
e Dampers r
FFAIL
Service
(4
Rough In
UG /Slab
Low Voltage
F' - Alarm
'02r-.- � 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 /' Oth /Sidewalk Date / 2 /i 3 /' 9 Inspector ," / Ext
Final /
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.