Permit CITY OF TIGARD MECHANICAL
" "��'`' ( ' , DEVELOPMENT SERVICES PERMIT
PERMIT # MEC96 -0438
! :_.. 13125 SW HaII Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 12/16/96
PARCEL: 1S125DA- 07900
SITE ADDRESS...: 09155 SW 69TH AVE
SUBDIVISION : KINGS VIEW ZONING: R -4.5
BLOCK . LOT °74
CLASS OF WORK..:ALT FLOOR FURN ° 0 EVAP COOLERS: 0
TYPE OF USE :SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:A1 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES ° 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
: /GAS/ / / 3 -15 HP.... 0. • COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP....: 0 WOODSTOVES..: 0.
GAS PRESSURE...: 50+ HP ° 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: add furnace, ducts, vents, gas piping
Owner: FEES
JEFF PAINE type amount by date recpt
9155 SW 69TH AVE PRMT $ 25.00 TAT 12/16/96 96- 287734
5PCT $ 1.25 TAT 12/16/96 96- 287734
TIGARD OR 97223
Phone #:
Contract or:
COLUMBIA HEATING
PO BOX 230397
TIGARD OR 97281
Phone #: 624 -2704 $ 26.25 TOTAL
Reg #..: 76359
REQUIRED INSPECTIONS
This permit is issued subject .to. the regulations contained in the• Gas Line Insp
Tigard Municipal Cade, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with • Misc. Inspection.
approved plans. This permit will expire if work is not started - Final Inspect ion
within 180 days. of issuance, or if work is suspended for more
than 180 days.
Permittee Signature:
Issued By:
Call for inspection 639 -4
. - •
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125,SW Hall Blvd. APPLICATION Permit # mlccg6- 61/3 �'
Tigrd, OR 97223
(503) 639 -4171
NIT* Descnpuon
I ��QV I- Table 3A Mechanical Code QTY PRICE AMT
Job •w " 1) Permit Fee -0- - 10.00
Address a 1 5 g 'f•`` Ad, -0
O1 w.n..•
[1( /7�? 3 2) Supplemental Permit 3.00
0Atainkg Furnace to 100,000 Et i U
f'atn e 1) incl. ducts & vents ( 6.00 V , LO
•'• MOM Fumace 100,000 BTU +
Owner 6 110 51i). (/ f % IIU'p . 2) incl. & vents 7.50
ao 4 — �� � fi 3) incl. vent 6.00
"ale la Male �,•,•;• Suspended heater, wall heater
4) or floor mounted heater 6.00
a re P aar.
M eV rncne Vent not lncl. In
Occupant 5) appliance permit 3.00
516'0 - - - - Repair -of heating,- refng.- - -- — — —
6) cooling, absorption unit 6.00
. Boiler or comp, heat pump, air cond.
. .. JI /4 _ ., a I d _ i 1 7) to 3 HP; absorp unit to 100K BTU 6.00
•M / . Boiler or comp, heat pump, air cond.
Contractor G • •- _ ,' / -' 8) 3 -15 HP; absorp unit to 500K BTU 11.00
OK �� Boiler or comp, heat pump, air cond.
9) 15-30 HP; absorp unit .5 -1 mil BTU 15.00
�°°°^'� n 7Y "e• Boiler or comp, heat pump, air cond.
if a 351 -1b -,% 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowl : age that have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized agent 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with State Air handling unit to
laws, that 1 am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit
please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent tan connected
t,.� ) / 15) to a single duct 3.00
gla `���LV�7■U F /I ../41/71 Ventilation system not
16) included in appliance permit
ee•^ oar Hood served by 4.50
17) mechanical exhaust 4.50
Descnbe work new U addition 0 alteration 0 repair (� Commercial or industrial
to be done residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets ) 2.00 a,i9 W
building or property
21) More than 4 -per outlet
Type of fuel - oil 0 natural gas 0 LPG 0 electric 0
NOTICE �� W
Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE
' IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL c G
Special Conditions
Date issued by
Its4AECHKft
wadbomdev
RECEIVED
DEC 16 1996
COMMUNITY DEVELOPMENT