Permit r+ ,p •
CITY . O F TIGARD =; MECHANICAL PERMIT
�r DEVELOPMENT SERVICES, PERMIT #: MEC2005-00410 .
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13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/8/2005
PARCEL: .2.2S1 02 B D -03000
SITE ADDRESS: 13035 SW PACIFIC HWY ZONING: C -G
SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT: 035 JURISDICTION: TIG
Project Description: Replace existing heat pump with like kind. Project Value: $4,950
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B' . 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: 'AIR HANDLING UNITS
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
TRUCK TERMINALS INC Description Date Amount
1825 SW PHEASANT.DR [MECH] Permit Fee 7/8/2005 $141.50
BEAVERTON, OR 97006 [TAX] 8% State Surchar€ 7/8/2005 $11.32
Phone: 503- 639 -9311 Total $152.82 .
Contractor:
JACOBS HEATING + A/C •
4474 SE MILWAUKIE AVE REQUIRED ITEMS AND REPORTS
. PORTLAND, OR 97202
Phone: 503- 234 -7331 ' • •
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 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 -33 '
Issued By —�-- �. Permittee Signature: n �.
Call 503 - 639-4175 by 7:00 a.m. for inspections that business day.
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 Application FOR OFFICE USE ONLY
City of Tigard . Date/By: 7�0• Permit No.: /kiL A 4 ..42) /d
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 4nwd Date/By: Other Permit:
Inspection Line: 503.639.4175 e! I Date Ready /By: See Page 2 for ■ Internet: www.ci.tigard.or.us Notified/Method: jj'�:v_ ® Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 11. 1 (::?),C'r
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ l- and 2- family dwelling t Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: Air conditioning or heat pump
�� 7 �� * 7 . �' .:2---)V yy � (requires site plan showing placement) 14.00
City/State /ZIP:--r�, �--)TR Q J Furnace 100,000 BTU (ducts/vents) 14.00
Li' ' ' Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name; " .r--(3( LC
:J D ^ Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
2 1'('O Y=) - }-tea --, 1-- -1- -r1 .. „, -n Flue vent for water heater or gas
/� fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ,'TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: i r. ) ex; 2,? i c e - r - i 31 L�1.--1-- Environmental exhaust and ventilation
Address Range hood/other kitchen
p �� _ ,) C) 1 ,S,' --l-, equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Phone: 5? - ?3 (I Fax: ( ) toilet t exhaust (bathrooms,
coompmp artments, utility rooms) 6.80
, APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Business name: Other: 10.00
3�c��� �' ^�-�? °d 1 C_ Fuel piping
Contact name: J $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:J� C , # ) b - C �r--sc *l/ G Other:
Address: G:;.F� 1....y---.1 I I ^ , r ,, f 0 MECHANICAL PERMIT FEES*
City /State /ZIP: - =1. .. J �� Subtotal
rC T Minimum permit fee ($72.50)
Phone: t ^ ) 0p. -}`- �. R I Fax: (,),)) g)
_c-
Plan review (25% of permit fee)
CCB lic.: , .,-F41 State surcharge (8% of permit fee)
^ TOTAL PERMIT FEE
signature: Q� i-, This permit application expires if a permit is not obtained within 180
Authorized si
g f �� (� Q ., days after it has been accepted as complete.
Print name: s ol s _ tom _ _- . s Date: ' `.- - • Fee methodology set by Tri- County Building Industry Service Board
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CITY OF TIGARD ,
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: MEC2005- 00410
Phone: (503) 639 ,,,, oo d1)1 7/8/2005
Inspection Requests (24 Hrs.): (503) 639 -4175 _ - I_..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
74274200E 7:15AM 53
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 13035 SW PACIFIC HWY LOT #: TYPE OF USE:
PROJECT NAME: NORTH TIGARDVILLE ADDITION 035
DESCRIPTION: ALEXIN ANALYTICAL LABS
Replace existing heat pump with like kind. Project Value: $4,950
OWNER: PHONE #:
CONTRACTOR: TRUCK TERMINALS INC, PHONE #: 503-639-9311
JACOB HEATII4C + NC 603 231 7331
Inspection Request Scheduled For: Date: Pour Time:
7/27/2005
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012212 -01 503-234 -7331 N
Corrections /Comments /Instructions: •
b .le..,;ctI PO ( 0K_
00
[PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL •. C' L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: igi Date: Phone #: (503) 718-
/
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