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13410 SW ASH AVEMJE }
MECHANICAL PERMIT
CITY O F T I G A R D
DEVELOPMENT SERVICES 'PERMIT#: MEC1999-00321
13125 SW Hall Blvd.,Tigard, OR 97223 (f03) 1�7 I PARCEL: 2S 102CA-00907DATE ISSUED: 7/28/99
SITE ADDRESS: 13410 SW ASH AVE
SUBDIVISION: VILLAGE GLENN ZONING: R-4.5
BLOCK: I-OT:007 .;'JRISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANC I GRP: R3 VENTS W/O ADPL: VENT SYSTEMS-
STORIES: _ BOILE_RSICOMPRESSORSHOODS:
_ FUEL TYPES _ 0 - 3 HP: DOMES. INCIN:
I PG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTL 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
OAS PRESSURE: 50 + HP: CLO DRY'-*RS:
FURN < 1 JOK BTU: 1 _ Alk HANDLING UNITS OTHER UNI fS:
FURN >-100K BTU: <= 10000 cfm: GAS OUTLr.TS:
> 10000 cfm:
Remarks: Installation of gas furnace.
Owner: FEES
DAVENPORT, -COTT J + Type By Date 4� Amount Receipt
KRfSTINA,1 PRAT DEB ^7/28199 $50.00 99-317203
13410 SW ASH AVE 5PCT DEB 7/28/99 $3.50 99-317203
TIGARD, OR 97223 P1IF
Phone:
Total $53.50
1 � �1 � ��,� -- —
'ontractor:
,JACOBS HEATING +A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Heating Unt Insp
Phone:503-234-7331 Final Inspection
Reg#:LIC 1441
This permit is issued subject to the regulations contained in the Tigard Municipal CoxJe, 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 00 1-0010 through OAR 952-001-0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246-9189.
Issue Ry: o- .� Permit+ee Signature: i�/
Call (503) 639.4175 by 7:00 P.M. for inspections needed tho ne t business Jay
Plan Ctlsek#
CITY OF TIGARD Mechanical permit Application Recd�y _ �/E
13125 SW HALL BLVD. Commercial and ResidentWC'- Dare Roc'd._"7 ._
TIGARD, OR 97223 Date to P.E.
i503) 639-4171, x304 JIM �t. r 1�a�4 Date to DST ------
Print or TypeUmil;4 Permit#
�Mi
EV)LUI' Called
Incomplete or illegible applications WA& a accepted --
Name of nevelopmen"Proiecl Description
Table to Mechanical Code Oty Price Amt
Job Street Addrosc A) Permit Fee____ 16.00
Address 13A-41C)
1) Furnace to 100,000 BTU
l^� C�'
Cdy%sta" zip including ducts&vents see footnote ,2 965 Cl
Bklyp -- --- 1 1 --
2) Furnace 100,000 BTU+
including ducts&ventssee footnote 1,2 12.00
Name(or name of business) 3) FloorFurnace
Owner T<`( I-j q-,,(- r�--nJQ<1 including vent_ see footnote l,2 -- 9.65
Mailing Address 4) Suspended heater,wall heater
or floor mounted heater see footnote 1,2 9.65 _
5) Vent riot included in appliance ermit _ 4.75
city/state Zip Phnne Check all that apply "Boiler Heal Air
C For Items 6-10,see or Pump Cond City Price Amt
Name(orbusiness) footnotes 1,2 Comte _-
6)<3HP;absorb unit to
_�
100K BTU 9_65
Occupant Mailing Address - —-=-+---P 7)3.15 HP;absorb unit
100k to 500k BTU _ 17.65 _
Ctty/StateZip Phone 8)15-30 HP;absort,
- -- - — unit.5-1 mi!BTU 24.15
Contractor Name 9)30-50 HP;absorb
unit 1-1.75 mil BTU _- 3600 _
10)>50HP;absorb unit
Prior to permit Meiling Addroee >1.75 mil BTU _ _ 60.15
Issuance,a copy ��.I-)A� _ (moi ��JG,�-� -� 11 Air handling unit to 10,000 CFM
of all licenses rcuy�rstat _ 21p Phone _ 7.00are requires!if `GC �`` �� � J-> ��.' 1 '��� 1<)Air handling unit 16,000 CFM+ -------
are
in COT Oregon Const.CCI.Board Lk.p Exp.Date _ 11.75 _
drt_abane_ )'`� , 13)Nen-portable evaporate cooler -
Architect Name _ _ 700
i4)Vent fan connected to a single duct
or Mailing Address 4.75 -
15)Ventilation system not included in
_ _a pp lian hermit - 7.00
Engineer Cfty/State Zip Phone - 16)Hood served by mechanical exhaust---
100
Describe work to be done: 17)Domsstic incinerators
12.00
New O Repair O Replace with like kind Yes k) No O 18)Commercial or industrial type incinerator
Residential) Commercial 048.25
_ 48.25 _
19)Repair units
Additionai Information or description of work: 8.40
20)Wood stove/gas FP/other units/clothe dryer/etc
7.00
NOTE: For Cnmmercatprojects only;Units over 400 lbs.require 21)Gas piping one to four outlets
structuralsomas cakes _ - See footnote 1 _ _ _- 375
Type of fuel: ell O natural gas k. LPG O electric O 22)More than 4-per outlet(eac� .75
Minimum Permit Fee$50.00 SUBTOTAL
I hereby acknowledge that I have read this application,tha_t the lnfnrrmation _ - -- 1 $%SURCHARGE
given is correct,that I am the owner 6r authorized agent of - PLAN REVIEW 25%OF SUBTOTAI_
the owner,that plans subn,itt:�rl are In compliance with Oregon State laws. Required for ALL commerclal hermits onl
TOTAL
Signature of towner/Agent � Date
cother Inspections and Fees:
1. Inspect.ions outside of normal business hours(minimum charge-two
Contact Person Name efions hours) $50.00 per hour
2. Inspections for which no fee is specifically Indicated (minimum
charge half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes,additions or revisions to
1 provide full schematic,of existing and proposed gas Imc and pressure plans(minimum charge-one-half hour)$SJ.00 per hour
2. Provide drawines to scale showing existing rind proposed mechanical
'State Contractor Boiler Certification required
"Residential A1C requires site plan showing placement of unit
1:Wwchperm dor•, rw 02/4/99 ?3
"76