Permit CITY OF TIGARD MECHAN I CAL
•- /4,0 h E, . \ DEVELOPMENT SERVICES PERMIT
al'j PERMIT # • MEC97 -0468
- !+� '� � 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 11/25/97
PARCEL: 2S101AA -09800
SITE ADDRESS...: 12570 SW 69TH AVE #102
SUBDIVISION • MLP95 -0013 ZONING: MUE
BLOCK . • LOT •001 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS : 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
•
. 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.: 2
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Tenant improvement, addition of ducting & grills to existing unit.
Owner: FEES
J T ROTH JR type amount by date recpt
12600 SW 72ND AVE. #200 PRMT $ 25.00 GEO 11/25/97 97- 301236
TIGARD OR 97223 PLCK $ 6.25 GEO 11/25/97 97- 301236
5PCT $ 1.25 GEO 11/25/97 97- 301236
Phone #:
Contractor:
TRI— COUNTY TEMP CONTROL /HEATNG
13651 SE AMBLER RD
$ 32.50 TOTAL
CLACKAMAS OR 97015
Phone #: 654 -3115
Reg #..: 000007
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Duct Inspect i o n
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by 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 -9187.
/
Issue B : I � .�, _ Permittee Signature:
By i
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Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
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I IVMRIJ InC'I1a1111.au rC1Iu1111..MFJt7UU.auvlI Recd By JJQ
1 W HALL BLVD. Commercial and Residential Date Recd ii A,a - 9 7
TIGARD, OR 97223 5 / ' y /1 611 Date to P.E. //-0
(503) -939 -4171, x304 p qi - /11 / Date to DST � .2.s 9 7
L1d i Pri or Type Permit to M tic. 97 - OI/k
Called
Incomplete or illegible applications will not be accepted
Name or Dave topmentl Description
17 gt Table 1A Mechanical Code OTI PRICE AMT
Job Street Address Su tere - A) Permit Fee -0- -0- 10.00
Address / SW 6? /02
Bag. " City/State zip 1.) Furnace to 100,000 BTU 6.00
79 • az- 97 3 including ducts & vents
Name (or name otfus 2.) Furnace 100,000 BTU+ 7.50
Owner J J. / ` 42 including duds & vents
Mailing Address 3.) Floor Fumace 6.00
/ .7(D) SW 2Zkd o including vent
Citys Zip I Phone 4.) Suspended heater, wall heater 6.00
l tereLf ( at 14759 x.39 or floor mounted heater
Nam (or name of le 5.) Vent not included in appliance permit 3.00
Occupant M Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State ZIP Phone 7.) Boiler or comp, heat pump, air cond. 11.00
• 3.15 HP; absorb unit to 500K BTU"
Contractor 8.) Boiler HP; mil comp, heat pump cond. 15.00
or to
(Prior to 7,Q, t Co U � 7 h t5-30 HP; absorb unit5.1 mil BTU °
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant /3G„$,/ .5 ..14b-r lee 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all �5� 5/15 10.) Boiler or comp, heat pump, air cond. 37.50
contractor (�►t..+ 97 Zi > 50 HP; absorb unit 1.75 mil BTU"
license crow const.
3 Cont Board Lice . Cate 11.) Air handling unit to 10,000 CFM 4.50
information
for COT COT Business Tax or Metro Exp oats 12.) Air handling unit 10,000 CFM 7.50
database). / /,24, 3-/7
Architect Nan3pD N 4 13.) Non - portable evaporate cooler 450
or Mailing Address aCe 14.) Vent fan connected to a single duct 3.00
Engineer Crtereve,eact bp 1 Phone 15.) Ventilation system not included in 4.50
DX ' �/ 5 appliance permit
Describe work New (8 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 8
nal
Additioo Description of work T' �- ,,, 17.) Domestic incinerators 7.50
dc - a7 fie - y e-q ,-4. s fa
LL 18.) Commercial or industrial type 30.00
e/d- CS v im! Incinerator
Existing use of i s , c - 19.) Repair units 4.50
building or property 140-44-1 7 r 4 -
20.) Wood stove 4.50
Proposed use of /' /J 21.) Clothes dryer, etc. 4.50
building or property o / (.P w� -de.� a-!i
22.) Other units 4.50
Type of fuel - oil 0 natural gas ® LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application. that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner/Agent Date 'SUBTOTAL ✓
� s
/� S.:. g. 45 z1 311 S 5 % SURCHARGE
Contac P erson Name Phone PLAN REVIEW 25% OF SUBTOTAL / 25-
b
TOTAL )1- 5".4-
i:kdstlmechpmtdoc (rev 9 'Minimum permit fee is S25 + 5% surcharge .
"Residential A/C requires site plan showing placement of unit.