Permit r
CITY OF TIGARD
MECHANICAL PERMIT
Iik DEVELOPMENT SERVICES PERMIT #: MEC1999 -00498
A "°�'` � �I � l 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/19/1999
11 J
PARCEL: 2S 112BD -02200
SITE ADDRESS: 14955 SW 79TH AVE
SUBDIVISION: DURHAM ACRES ZONING: R -4.5
BLOCK: LOT: 044 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: DOMES. INCIN:
LPG 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: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Gas insert and gas piping
Owner: FEES
ROBERT PRESTON Type By Date Amount Receipt
14955 SW 79TH AVE PRMT BON 11/19/19 $50.00 99- 319885
TIGARD, OR 97224 5PCT BON 11/19/19 $4.00 99- 319885
Total $54.00
Phone: 503 - 620 -2160
Contractor:
JAY JOLLEY
PO BOX 793
BEAVERCREEK, OR 97004 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 632 -8623 Misc. Inspection
Reg #: LIC 119836 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 copies of these rules or direct questions to OUNC by
calling (503)2 189.
Issue B Permit Sig n ature: /ci4V-/-1----- J � `Y- y: —MM
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan
�,CJP OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential • Date Recd) - - 41 1
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to D�ST�
Print or Type Permit # t" Ar- I- tl
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description .
ii /A _pri va fe_ k ovv Table 1A Mechanical Code Qty Price Amt
S treet Address Sufte# A) Permit Fee ' 16.00
Job 1) Furnace to 100,000 BTU
Address `{9 55 S W -11^VL including ducts & vents 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
TT.- d a(- 9 7 2:2.4 including ducts & vents 12.00
Name (or name of business) 3) Floor Furnace
Owner r- + A 4' Iwbc. /� i- I"rGS4a -v1 including vent 9.65
Mailing. Address 4) Suspended heater, wall heater
("1 S (,) - 7` , tc • or floor mounted heater 9.65
5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
r Of- ct7 2..9 (( -16 For items 6 -10, see or Pump Cond Qty Price Amt
e (or nam of business) footnotes 1,2 Comp ".
sow_ t G 6) Repair unit
8.40
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
City /State Zip Phone 8) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
Contractor Name �, 9) 15 -30 HP; absorb
J Jolle_y 1 0)t.5 -1 24.15
10)3 HP; absorb
HP; absorb
Prior to permit Mailing Address unit 1 -1.75 mil BTU 36.00
issuance, a copy Pd l31?X 193 11) >50HP; absorb unit >1.75 mil BTU
of all licenses ity /State Zip Phone 60.15
are required if t av tr((e.tll. -- O r- °-1 62 -g66- 12) Air handling unit to 10,000 CFM
expired in GOT Oregon nst. Cont. Board Lic.# Exp. Date 7.00
database O (1 O (0 t Ids l o I 13) Air handling unit 10,000 CFM+
Architect Name 11.85
Novi. 14) Non - portable evaporate cooler
or Mailing Address • 7.00
15) Vent fan connected to a single duct
• • 4.75
Engineer City /State Zip Phone 16) Ventilation system not included in
appliance permit 7.00
Describe work to be done: 17) Hood served by mechanical exhaust
7.00
New 0 Repair 0 Replace with like kind: Yes 0 No 0 18) Domestic incinerators
Residential • Commercial 0 Modification 0 12.00
19) Commercial or industrial type incinerator
Additional information or description of work: 48.25
(gas Pip ; 20) Other including ig 0 l
wopd stoves 1 7.00
NOTE: For CommerCil projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets 1 roof, require structural calcs. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL „,4 XU
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE .1V t
given is correct, that I am the owner or authorized agent of
g g PLAN REVIEW 25% OF SUBTOTAL
the owner, that plans submitted are in compliance with Oregon State laws. Required.for ALL commercial permits only Air frmV‘
Signature of Owner /Agent Date TOTAL ' 51. et
`c - )l- - P' 'i .11/10199 /
Other Inspections and Fees:
Contact Person Name Phone
n 1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
1 6 -r f f t _ O , o - Y1 P i e s1n - a'"1 4 0 2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$50.00perhour
Foonotes for commercial projects only:
3. Additional plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge one - half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
• units. * *Residential A/C requires site plan showing placement of unit
I:\rnechperm.doc rev 11/1/99 '