Permit PICLrHIV 1 ILL
PERMIT
C ITY QF T I GARD 9PETE RE I SSUED: X5/01/96
COMMUNITY DEVELOPMENT DEPARTMENT / ` .(700' S w 7. - �ARf,
13125 SW Hall Blvd. Tigard, Or on 97223.8199 (503)1339-4171
F'f I ;=S 1 1 L.DC —�� 100
SITE ADDRESS...: SW 72ND AVE
SUBDIVISION • SP TIGARD INDUSTRIAL PARK ZONING: I —L
BLOCK • LOT °2
CLASS OF WORK..:ALT FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 6 VENT FANS...: 1
OCCUPANCY GRP..:B2 VENTS W/0 APPL: 2 VENT SYSTEMS: 0
STORIES • 1 BOILERS /COMPRESSORS HOODS • 1
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: 4 GAS OUTLETS.: 1
FURN > =100K BTU: 3 > 10000 cfm: 0
Remarks: Tenant improvement
Owner: FEES
NIKE — TETRA type amount by date recpt
ONE BOWERMAN DRIVE PRMT $ 108.00 JMH 05/01/96 96- 278730
PLCK $ 27.00 JMH 05/01/96 96- 278730
BEAVERTON OR SPCT $ 5.40 JMH 05/01/96 96- 278730
Phone #: 503- 671 -2017
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 140.40 TOTAL
Reg #.
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp
applicable laws. All work will be done in accordance with Hood Inspection
approved plans. This permit will expire if work is not started Duct Inspect i o n
within 180 days of issuance, or if work is suspended for more Fire Damper Insp
than 180 days. Final Inspection
a1
Permittee Signature: �� , `' ,.,yzA2 k
• �. ' �
Issued By: � . G // �/, .1 /A
if Call for inspection — 639 -4175
City of Tigard., MECHANICAL PERMIT Planck/Rec. #
13125 5W Hall Blvd. APPLICATION Permit # d11WGF1b 0O
- (v�o
Tigard, OR 97223 if
(503) 639 -4171 /A006
Name of Devebpment Descnption -
5" 7e Table 3A Mechanical Code QTY PRICE AMT
Address J
Job SL..J 72 1) Permit Fee -0- -0- 10.00
Address cyy,S,a a LP
C. # vt. 64.. 2) Supplemental Permit 3.00
Name (or name of busses) Furnace to 100,000 BTU
1) incl. ducts & vents I 6.00 b. 01)
uassq Address Phg1Q Furnace 100,000 BTU +
Owner 2) incl. ducts & vents 3 7.50 ZZ. St
Cary /State ZD Floor Fumance
3) incl. vent 6.00
Name (or name albumen) Suspended heater, wall heater r�T
f ,e}.- q , n S Li 7 4) or floor mounted heater 6.00 ��
• Liming AaGess phone / Vent not incl. in
Occupant 5) appliance permit 3.00
°ry'Stete 4 Repair of heating, refrig.
6) cooling, absorption unit 6.00
lea 1 n J oiler or comp, heat pump, air cond.
U. L • l M.to Co • vic.-474:1 7) to 3 HP; absorp unit to 100K BTU 6.00
usin Address Phone Boiler or comp, heat pump, air cond.
s3`/ U SC /ta.,,.� 1.44 8) 3-15 HP; absorp unit to SOOK BTU 11.00
Contractor
1A h✓L Boiler or comp, heat pump, air cond.
vqZ 3_ -r 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
Gabon No. Cd r Bus. Tax -No. Boiler or comp, heat u
p pump, air cond.
_27 (..,1 - 22G Z_.. 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that have rea is application, that the Boiler or comp, heat pump, air cond.
0 information given is correct, that I am th owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted re in compliance with Air handling unit to 18
State laws, that I am registered with the onstruction Contractor's 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from State Jr A handling unit
registration, please give reason below.) `(� '/) / 13) 10,000 CTM + 7.50
Alc , �"/ W V 14) eva orate cooler 4.50
Vent fan connected
15) to a single duct 1 3.00 3
Ventilation system not
16) included in appliance permit 4.50 C r . ao
e ( egen!) ��
Hood served by
/ /��Date '� 17) mechanical exhaust / 4.50 (i. 0
Describe work new 0 addition 0 alteration repair 0 Commercial or industrial
to be done residential 0 non - residential 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
building or property p�
21) More than 4-per outlet 1 /• eo Cr. (Z)
Type of fuel - oil 0 natural gas tG Q electric O
NOTICE 1 03 o
Minimum Fee $25.00 • SUBTOTAL
• PERMITS BECOME VOID IF WORK OR CONSTRUCTION 7�
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE 5 L ip
IF CONSTRUCTION OR WORK IS SUSPENDED OR
III
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL 2,7 0 b
AFTER WORK IS COMMENCED.
TOTAL / CFO n
Special Conditions .,,i
Date issued by
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