Permit '
A, CITY � TIGARD'
MECHANICAL
DEVELOPMENT SERVICES PERMIT
��~~�~~~~�~" »�»m~n�" ~~m~««�"��~~�� PERMIT #.-.....: MEC96-0376
• ...AN '1.1. /3/255N/ Hall 8Vv�.7��r�OR�7�B (503) GD�4/7/
-' Tigard, `'�+ ' DATE ISSUED:. 10/31/96:
PARCEL: 2S114AC-00200
SITE ADDRESS...: 16570 SW 93RD AVE. . � '.-
•SUBDIV`ISIQN:..~. CORNER' • - ' `^' ZONING: R-4.5 •
BLOCK..........: LOT ..... ........:2
CLASS OF WORK..:ADD FLOOR FURN....: 0 EVAP COOLERS: 0
TYPE OF USE ^SF 'UNIT HEATERS..: 1 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/O APPL: 1 VENT SYSTEMS: 0
STORIES ^ 0 ' '`'` BOILERS/COMPRESSORS- . HOODS....... 0
FUEL TYPES 0-3 HP ^ 0 DOMES. INCIN: 0
: � ^ '`� �.` .� 3-15HP.��.~«^0`.'` • COMML.°JNCIKL: 0, ''
MAX INPUT: 0 BTU 15-30 HP ^ 0 REPAIR UNITS: 0
'FIRE DAMPERS?..:` ' , ' `' 30-50 HP... G� • �. • WOQDSTQVES..: 0 .
GAS PRESSURE... : 51Z1+ HP.. .. : 0 CLO DRYERS.. : 0
NO. OFUNITS ' • AIR HANDLING UNITS.' ' OTHER UNITS~: 0`.' .
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN >=100K BTUn 0' • -`` , .' >` 0 • .
Remarks: adding gas piping & wall heater & vents
Owner: - FEES
RICH/SUE KASSON type amount by date recpt
16570• SW 93RD AVE • '. , • -` PRMT'$ ' • • 25.00 TAT 169/31/96.96-285974
PLCK $ 6.25 TAT 10/31/96 96-2285974
TIGARD OR 97224' • ' :. ' 5PCT $ . 1.25 TAT 10/31/9696-285974. .,
Phone #:
Contractor:
HOMESTEAD STOVE COMPANY
2729 NE BROADWAY
PORTLAND OR 97232 . -
Phone #: 503-282-3615 $ 32.50 TOTAL
Reg #..: 000857 •
- ' '' ` �` REQUIRED INSPECTIONS
This permit- is issued subject to the regolatiunscontainod.`in,the. Gas Line Insp
'TigardMonicipal Code, - State of Ore. • SpocialtyCodes andall other ` . Mechanical Insp `. ' ..°
—applicable done inaccurdanco'with .. '/- ' ' - Misz� Inspection • ,
approved plans.. This permit-will 'expire re -if work' is not started ` Final Inspection
within 180 days of issuance, 'or if work' is, suspended for wme'
than 180 days. `
. __–
�~ '' / •
_-_' .. __
Permittee Si : ��� a�6=� � r _____ —
I ssued By:
it
' '' � �` . .
Jr^^ ' 4 . _ _____ ___
.
' . ' /Ca for inspectiorrh^-'639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit # I
Tigard, OR 97223
(503) 639 -4171
1%1 Iyke_. (' (D
Nano of Dovoio Descnption .
Table 3A Mechanical Code QTY PRICE AMT
Job K + A)---q 1) Permit Fee -0- -0- 10.00
s
Addres y -
J h .,,, , 2) Supplemental Permit 3.00
3 0, •1 �`J/ Furnace to 100,000 Bl U
i t �M� 4-- rue 04 r e rit 1) incl. ducts & vents 6.00
" -I P Furnace 100,000 B rU +
Owne11.0S-70 E Ti' 3 G)0 1 ( 2) incl. duds & vents 7.50
Lp Floor Fumance
I
(1722,- 1 3) incl. vent 6.00
« i business) Suspended heater, wall heater
4) or floor mounted heater I 6.00
My °K Phone Vent not Incl. in
OCCU `� - —_ _ 5)_ appIiance_permit -__ _ - - - - __ ( _ 3..00 .5 —
vp Repair of heating, retrig.
6) cooling, absorption unit 6.00
kiintk€S ,/f Boiler or comp, pump, air cond.
�(� 7) to 3 HP absorp unit to 100K BTU 6.00
Boiler or comp, heat pump, air cond.
1 )-- at/wail i , 8) 3 -15 HP absorp unit to 500K BTU 11.00
Contractor u t4. Zip Boiler or comp, heat pump, air cond.
02 Z3 9) 15-30 HP absorp unit .5 -1 mil BTU 15.00
s• No. � . Tax No. Boiler or comp, heat pump, air cond.
S 7 01 0 7-307 10) 30 -50 HP absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I 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 31.50
of the owner, that plans submitted are in compliance with State Air handling unit to .
laws, that I am registered with the Construction Contractors Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Alf' handling unit
please give reason below.)g) Z —_?6 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
A 15) to a single duct 3.00
a
a ffiNIMMASM ) ap p Ventilation systtem not 16) included in appliance permit 4.50
Hood served by
17) mechanical exhaust 4.50
B - scn•,: ork • additf• fsidential alteration U repair U Commercial or industnal
to be done res • =ntial J� 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
building or property
21) More than 4-per outlet
Type of fuel - oil 0 natural gas oc LPG O electric Q
NOTICE. �)) - Minimum Fee $25.00 SUBTOTAL G
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Z
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 C9 &Z I
AFTER WORK IS COMMENCED.
TOTAL T)1-, D
Special Conditions
Date issued by
.
k.AIECMPMT
wad ) oon dov .