Permit C ITY OF TIGARD MECHANICAL PERMIT
t r'� DEVELOPMENT SERVICES n PERMIT #: MEC1999 -00184
^`" „ 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171"/� DATE ISSUED: 5/11/99
1 /n PARCEL: 2S113AD -01900
V SITE ADDRESS: 16640 SW 72ND AVE B -10
SUBDIVISION: ROSEWOOD ACRE TRACTS i TlON: NING: I -L
BLOCK: LOT: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: S2 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of one new 3 -ton gas pack and relocation of one 20 ton a/c only rooftop unit.
Owner: FEES
PACIFIC REALTY Type By Date Amount Receipt
15350 SW SEQUOIA PKWY #300 PRMT DRA 5/11/99 $25.00 99- 315290
,PORTLAND, OR 97224 PLCK DRA 5/11/99 $6.25 99- 315290
5PCT DRA 5/11/99 $1.25 99- 315290
Phone: Total $32.50
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 233 -6911 Mechanical Insp
Reg #: LIC 00038868 Heating Unt Insp
Duct Inspection
S.D. Shut -down
Final Inspection
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 Noti • • Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You m obtain copies of these rules or direct questions to OUNC by (ling (503 246 -9189.
Issu By: 44 ,(P6bd. Permittee Signature:,- .e,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed t e next b iness day
Plan Check # 11- _rid
CITY OF TI chanical Permit Application Recd By Nr
13125 SW HA • 'Commercial and Residential Date Recd 4 /- a 'W - z9
TIGARD, OR 97 Date to P.E. . 919
(503) 639 -4171, x30` " �t " ' Date to DST C j S- *
Print or Type Permit # ete/fahenoi 'y
Called 5
Incomplete or illegible applications will not be accepted c soe4,_ ,.,�; ,-B
Mame of DevetopmenuPro)ecx Description
l G i si O, _ti rr Cp,144.1 7 Table 1A Mechanical Code OTY PRICE AMT
Job Street Address Surce# A) Permit Fee -0- -0- 10.00
Address /l„l yO ski 7,2 1419
Bldg# City/Slate q Zip B) Supplemental Permit 3.00
/ 0 / /Grkon (%.
N r name of 1.) Furnace to 100,000 BTU t 6.00
Owner �j /, uS j incl. ducts & vents ' 6
Malin Address Iv 2.) Furnace 100,000 BTU + 7.50 ior / S D � _t_0(.1„, incl. ducts & vents
ity/State (Ll) 02 97 y I Phone • 3.) Floor Furnace 6.00
1
J incl. vent
N (or name of business) 4.) Suspended heater, wall heater 6.00
%" 4- / T Cp,(//,U6 � or floor mounted heater
Occupant Mailing Address 5.) Vent not incl. in 3.00
appliance permit
City/State Tip I Phone 6.) Boiler or comp. heat pump, air cond. 6.00 // __ ,-- to 3 HP; absorp unit to 100K BTU / W
7.) Boiler or comp, heat pump, air cond. 11.00
.en7z,??,7 inr.SnG . 3-15 HP; absorp unit to 500K BTU
Contractor Mailing Address 8.) Boiler or comp, heat pump, air cond. 15.00
0 7 'Ur, Go•fc)c/ 15-30 HP; absorp unit .5-1 mil BTU
- (Prior to State zip Phone 9.) Boiler or comp, heat pump, air cond. 22.50
issuance a copy iv- t 7) , z 9"73.2 0733 - 9// 30-50 HP; absorp unit 1 -1.75 mil BTU
of all licenses are Oregon Cons. Cont. Board Licit Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
required if 3 g 5 - i s -9 9 > 50 HP; absorp unit 1.75 mil BTU
expired in C.O.T COT Business Tax a Metro IS Exp. Date 11.) Air handling unit to 4.50
data base) 4 /6 -- .S., 10,000 CFM
Architect Name 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 Newer Addition 0 Alteration.P Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non- residentia' included in appliance permit
Additional Description of wo � 16.) Hood served by mechanical exhaust 4.50
-JVCW t 3roA) A r -d Gjc
RReOc a7F 1 090 rc)J ,QC aveY ,eoOF TOP
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
21) Clothes dryer, etc. 4.50
Type of fuel - oil 0 natural gase LPG 0 electric 0 22) Other units 4.50
I hereby acknowledge that 1 have read this application, that the 23) Gas piping one to four outlets / 2.00 /f
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.
Signature of Owner/Agent Date QTY.SUBTOTAL
4/aa���9 'SUBTOTAL t c
Con ct P� ame Phol 5% SURCHARGE
J�2crn e �� kits 3 -c. ! f
PLAN REVIEW 25% OF SUBTOTAL
TOTAL `
i:kistlmechpmt.doc (rev 7/96) - Minimum permit fee is S25 + 5% surcharge