Permit •
C !TY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC1999 -00464
'''' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/27/1999
I r�
PARCEL: 1 S136AD -00200
SITE ADDRESS: 11203 SW 65TH AVE
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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: 1 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: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Oil to gas furnace
Owner: FEES
BARR, MARIANNE CAROLYN Type By Date Amount Receipt
11203 SW 65TH AVE PRMT BON 10/27/19 $50.00 99- 319382
PORTLAND, OR 97219 5PCT BON 10/27/19c $4.00 99- 319382
Total $54.00
Phone:
Contractor:
AIR PRO HEATING + A/C
7405 SE POWELL BLVD
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 771 -7871 Misc. Inspection
Reg #: LIC 00072086 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 ob copies •f these rules or direct questions to OUNC c. g ( e 4)246 - 9189.
f Issue By: l� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Plan Check
CI TY OF TIGARD M Pe r m it Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd (() -7.7-1
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit# �i %f ‘
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address / Sure# A) Permit Fee ;' 16.00
Address / / Z 0 3 S�J 6 S ✓c 1) Furnace to 100,000 BTU
including ducts &vents see footnote 1,2 ( 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
Owner ` C.-.r c. / e 3' r , including vent see footnote 1,2 9.65
Mailing Address r /J 4) Suspended heater, wall heater
/ �� or floor mounted heater see footnote 1,2 9.65
//2-01 U, b a 5)' Vent.not included in appliance permit / 4.75
C ity /State Zip Phone Ch eck all that apply: *Boiler Heat Air
7 .
d 4./ f 51 _ ZLtS_y207 For items 6 -10, see or Pump Cond Qty Price Amt
Nam (or na of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU 9.65
Occupant Mailing Address 7) 3-15 HP;absorb unit
1001$ to 500k BTU -`+ 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
9) 30 -50 HP; absorb •
Contractor Name !� unit 1 -1.75 mil BTU 36.00
A ir Pi- ,, 7176 >t ,7c Z-. c 10) >50HP; absorb unit
Prior to permit Mailing Address >1.75 mil BTU 60.15
issuance, a copy •7yi0 S 3 /_. Po,,. -,e // i9/v ( 11 Air handling unit to 10,000 CFM
of all licenses Cj '/State Zip Phone 7.00 .
are required if I c.) / Oi ' 72- o t; 777/ - 7S 7 / 12) Air handling unit 10,000 CFM+
expired in COT Oregon Const. Clint. Board Lic Exp. Date 11.85
database . 7 2-0 3 6 n -
• fro /7 53 _ 3' - S -2.4 °' - 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: 1 / 17) Domestic incinerators
(J �� h�S �v �n. 12.00
New 0 Repair 0 Replace with like kind: Yes 0 No PK 18) Commercial or industrial type incinerator .
Residentiah 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 talcs. See footnote 1 ( 3.75
Type of fuel: oil 0 natural gas, LPG 0 electric O 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL g )
hereby acknowledge that I have read this application; that the information
8% SURCHARGE W
given is correc 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 DO
Sign of rl A Date � "' �� �
, . y Other and Fees:
1 . Inspections ections coons o outside of normal business hours (minimum charge -two
Contact Person Name Phone hours) $50.00 per hour
/ 2. Inspections for which no fee is specifically indicated (minimum
C IC,/ /C I- o L A... e 5 -61 3 _. 7 7 7 S 7/ 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
*State Contractor Boiler Certification required
units. ,
"'Residential NC requires site plan showing placement of unit
1:\mechperm.doc rev 7/19/99 _____