Permit :_, i
4 CITY OF T MECHANICAL PERMIT
Wr A DEVELOPMENT SERVICES PERMIT #: MEC1999 -00261
�`" 1. " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 6/16/99
PARCEL: 2S 113AD -01800
• SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: ZONING: I -L
BLOCK: LOT: 011 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: F1 VENTS W/O APPL: 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: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Duct work only.
Owner: FEES
PACIFIC REALTY Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 PRMT DEB 6/16/99 $50.00 99- 316176
PORTLAND, OR 97224 5PCT DEB 6/16/99 $2.50 99- 316176
Total $52.50
Phone:
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Duct Inspection
Phone: 233 -6911 Final Inspection
Reg #: LIC 00038868
ELE 201JHA
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 m • opies of these rules or direct questions to OUNC calling (503)246 -9189.
CIssu By: , 4 ' / ,L,L ,,, ' Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections need d the ne t business day
Plan C -
CITY OF TIGARD Mechanical Permit Application Rec'd :17'
13 ?25 SW HALL BLVD. Commercial and Residential Date Recd -1 - -
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type • Permit it / X699 - Gtr '/
Called
Incomplete or illegible applications will not be accepted
yy�a�m9e of DevelopmenUPro)ect Description
T 5/0.AJ ,.,t >cZ oMci ' C I Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite* A) Permit Fee -0- -0- 10.00
Address .&-_,,:-, sip 5 (Ai 7,2m,I
1 Bldg* City /State Zip ■ .B) Supplemental Permit 3.00
T44Rn t Ii2 o2-r
Name (or name of business) 1.) Furnace to 100.000 BTU 6.00
Owner / �GT,(!uS J incl. ducts & vents
Meiling Address 2.) Furnace 100,000 BTU +
P5 5 i?i/ojA izZ&..f' 3o0 incl. ducts & vents 7.50
City/State Zip l Phone 3.) Floor Furnace 6.00
• e.pa4D 714 Irey- &3oo incl. vent
• Name (or name of business) 4.) Suspended heater, wall heater 6.00
c�1Sl St o.0 -ZetnZ72com.thq C or floor mounted heater
Occupant Mailing Address Vent not incl. in 3.00
/� WV atv '7,2 40. appliance permit -
City,State Zip I Phone 6.) Boiler or comp, heat pump, air cond. 6.00
011041! 47.2 ?V O - WOO to 3 HP; absorp unit to 100K BTU
Name 7.) Boiler or comp, heat pump, air cond. 11.00
e crrEdi9P ,A sec. 3-15 HP; absorp unit to 500K BTU
Contractor Marling Address 8.) Boiler or comp, heat pump, air cond. 15.00
')7 --tic GCY/C,4 15-30 HP; absorp unit .5-1 mil BTU
Attach copy of CAState Zip Phone 9.) Boiler or comp, heat pump, air cond. 22.50 .
Current Licenses /w. a 97a3R 2I3 - CAW 30-50 HP; absorp unit 1 -1.75 mil BTU
Oregon Const. Cont. Board Luc.# Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
3 V $G. $ > 50 HP; absorp unit 1.75 mil BTU
COT Business Tax «Metro • a Exp. Date - 11.) Air handling unit to 4.50
c• i'SS. 10.000 CFM
Architect Na1e 12.) Air handling unit 7.50
10,000 CTM +
Or Mailing Address 13.) Non portable 4.50
evaporate cooler
Engineer City/State Zip Phone - 14.) Vent fan connected 3.00
to a single duct
Describe work New 0 Addition 0 Alteration, - Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non - residential fZl included in appliance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4.50
17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrialtype " 30.00
building or property incinerator •
19.) Repair units 4.50
Proposed use of 20) Woodstove 4.50
building or property c -v 4 •v! .;;147.COfid'■N6Ai
, )& J7 i oA/ ()e,4 r 6 21) Clothes dryer. etc. 4.50
Type of fuel - oil 0 natural gasp' LPG 0 electric 0 22) Other units -��� LOOR.1/iN s.J ee-A0
I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets 00 7 2.00
information given is correct. that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State 24) More than 4 -per outlet (each) .50
laws. ����
/6 /y4
Signs of Owns gent Date QTY.SUBTOTAL `
• JEREMY 4' U 7- a 3 3 - 'SUBTOTAL n ,� �
Contact Person Name Phone 5% SURCHARGE O'
■ PLAN REVIEW 25% OF SUBTOTAL
TOTAL 5A,
i:'dstVmechpmtdoc (rev 7/96) *Minimum permit fee is S25 + 5% surcharge
e9 3/1( /