Permit A .
CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2000 -00274
- �!P� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 D ATE ISSUED: 7/10/00
PARCEL: 2S1 02 B D -02900
SITE ADDRESS: 13025 SW PACIFIC HWY
SUBDIVISION: NORTH TIGARDVILLE ADDITION ZONING: C -G
BLOCK: LOT: 036 JURISDICTION: TIG
CLASS OF WORK: FLOOR FURN: EVAP COOLERS:
TYPE OF USE: UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: •
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install (1) <3HP unit
Owner: FEES
RUCK TERMINALS Type By . Date Amount Receipt
825 SW PHEASANT DR PRMT GWL 7/10/00 $50.00 0003579
EAVERTON, OR 97006 5PCT GWL • 7/10/00 $4.00 0003579
Total $54.00
Phone:
Contractor:
ACOBS HEATING + A/C
474 SE MILWAUKIE AVE
ORTLAND, OR 97202 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503 - 234 -7331 Final Inspection
Reg #: LIC 1441
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 -9189.
Issue By: Permittee Signature:
Call (50 639 -4175 by 7: P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit A Recd B yck#
Recd By VIl\r,. :
13125 SW HALL BLVD. Commercial and Residential Date Rec'd f - 3 0 -4
TIGARD, OR 97223 JUN 3 61 2000 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or TyF1MMUNiri DEVELOPMENT Permit# '4 l-2av- CO27 t.J
ei
Incomplete or illegible applications will not be accepted Called rte w .'1,<
Name of Development/Project Description
Genre. ` JG.r r t Table 1A Mechanical Code Qty Price Amt
treat Address Suitt A) Permit Fee 16.00
Job Ioa s W �Cick�t G 1) Furnace to 100,000 BTU
Address 4-.4- including ducts & vents see footnote 1,2 9.65
Bldg# City /state Zip 2) Furnace 100,000 BTU+
\ J a rd OR '?3 including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner 1. e,vk.2, _ t�aY r ertt 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
FS 02. 5 Si.-' . PP.C..t Q i 1 i4w � 5) Vent not included in appliance permit 4.75
City /State Zip Phone Check all that apply: *Boiler Heat Air
-r\ rot 61- 9 7 .. 6417- 9 j S1 For items 6 -10, see or Pump Cond Oty Price Amt
Na i (or name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU jr 1 9.65 /, OS"
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
N ame 9) 30 -50 HP; absorb
Contractor unit 1 -1.75 mil BTU 36.00
T\ 1 CC t', S i 42e_JA wC 10) >50HP; absorb unit
Prior to permit Mailing Address J >1.75 mil BTU 60.15
issuance, a copy Li4 r-( S., On t I w CL4 .t •Q - 11 Air handling unit to 10,000 CFM
of all licenses City /State Zip Phone 7.00
are required if Po rH.Gnc. O2 4'?aCP 23 -733 J 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.75
database 1 Li J 13) Non - portable evaporate cooler
Architect Name 7.00
14) Vent fan connected to a single duct
4.75
or Mailing Address
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 0 No O 18) Commercial or industrial type incinerator
Residential 0 Commercial 48.25
19) Repair units
Additional information or description of work: 8.40
20) Wood stove/gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial 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 0 LPG 0 electriell 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL ,56c:r)
I hereby acknowledge that I have read this application, that the information % /6. SURCHARGE 1 /, OC
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL
the owr;ter that at plans submitted are =rice compliance with Oregon State laws. Required for ALL commercial permits only .
,J ' -44./ .�� IQ • �3 . OQ TOTAL
Signature of Owne Ag�nt Date
Q �; Other Inspections and Fees:
C� t v 1 b • 1. Inspections outside of normal business hours (mininum charge -two
Contact Persollline Phone hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum
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
I:trnechperm.doc rev 02/4/99
aOO(0 ,- 3 -OOI D