Permit 7"irCITYOF / MECHANICAL ^�~~TIRD PERMIT
° C��OFTWARD PERMIT #.......: MEC90-0274
COMMUNITY DEVELOPMENT DEPARTMENT OREGON
1o,osmm Hall Blvd. P.O. Box uoour Tigard. Oregon e7223 `` . ^ ^
n39-4171 ~ —~ DATE ISSUED: 11/28/90
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SITE ADDRESS...: 13930 SW 100TH AVE PARCEL: 1S23123-123 •
SUBDIVISION....:
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ZONING:
BLOCK..........4 , LOT.............x
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CLASS OF WORK..:NEW FLOOR FURN....: EVAP COOLERS: .
TYPE OF USE....:SF UNIT HEATERS..: VENT FANS...:
— OCCUPANCY GRP..:R3. VF14TS W)O'APPL: VENT SYSTEMS: -
STORIES........: BOILERS/COMPRESSORS HOODS.......:
FUEL TYPES------------ 0-3 HP....: DOMES. INCIN:
:/GAS/ / / 3-15 HP....: COMML. INCIN:
MAX INPUT: BTU 15-30 HP....: REPAIR UNITS:
FIRE DAMPERS?..: 30-50 HP,...: • WOODSTOVEG..:
GAS PRESSURE...: 50+ HP....: CLO DRYERS..:
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS.:
FURN < 100K BTU:1 <= 10000 cfm: GAS OUTLETS.:1
FURN >=100K BTU: > 10000 cfm: '
Remarks: need parcel information installing furnace
Owner: ---------------------------------- ---------------- FEES --------------
RONALD BROWN type amount by date recpt
13930 SW 100TH AVENUE PRMT $ 18.00 / /
PLCK $ 0.00 / /
TIGARD OR 97223 5PCT $ 0.90 / /
Phone #: 620-4365 PAYM $ 18.90 PLL 11/28/90
Contractor: -----------------------------
METRO—AIRE PORTLAND
PORTLAND METRO—AIRE
8875 SW HILLSDALE HWY
PORTLAND OR 97225-0000 ------------------------------------
Phone #: 000-000-0000 $ 18.90 TOTAL
Reg #..: 61219
------- REQUIRED INSPECTIONS -------
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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 Mechanical Insp _ ___
applicable laws. All work will be done in accordance with Final Inspection
approved plans. This permit will expire if work is not started Final Inspection ___ _________
within 100 days of issuance, or if work is suspended for more ` _
than 180 days. _________
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Permittee Signature: 7C _____ ___________�_
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Issued By ______________________. ____________�____
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Call for inspection — 639-4175
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CITY OF TIGARD MECHANICAL PERMIT Receipt # 7` 7j,/
1312 5 SW HALL BLVD.
Permit # `7�zL qa X7 7
P. O. BOX 23397 0;-c,.,
Description
TIGARD, OR 97223 /2$ � 0 Table 3A Mechanical Code QTY PRICE AMT
(503) 639 -4175 v 1) Permit Fee -0- -0- 10.00
Name of Development 2) Supplemental Permit 3.00
Job Address 11 Furnace to 100,000 BTU 6.00
incl. ducts & vents 630e)
Address .
Tax Lot Map No. 2) Furnace 100,000 BTU + 7.50
incl. ducts & vents
Lot Block Subdivision
Name (or name of ) , Floor Furnace 6.00
I`o yvc5.)1 1.> t� -rotil/ in incl. vent
Mailing A ss Phone 4 ) Suspended heater, wall heater 6.00
Owner /3 q3(, S iod#' 6.2o -1136s or floor mounted heater
City /State ZIP 5) Vent not incl. in 3.00
TI _ t r .1 O R appliance permit
Name ( ame of b ness) 6) Repair of heating, refr ig., 6.00
cooling,
vQ �
Mailing Address Phone 7 ) Boiler or comp to 3 HP 6.00
Occupant absorp. unit to 100,000 BTU
City/State bp 8) Boiler or comp to 3 HP -15 HP 11.00
absorp. unit to 500,000 BTU
Name 9) Boiler or com 15 -30 HP 15.00
P�>rN K 'a Md D -Ai absorp. unit' -1 million
Mailing Address t r Phone 10) Boiler or comp to 30 -50 HP 22.50
32.7S s, \A), -fr I I I 7.9-3 gCS absorp. unit 1 -1.75 million
Contractor City/State
( n � ( � Zip 11) Boiler or comp to 50 HP 31.50
rr ha ;v1/40 1 U k. Q 7 absorp. unit 1,750,000 BTU
State Registration No. d \ I City Bus. Tax No. 12) Air handling unit to 4.50
10,000 CFM
6 f 2 1 / - S / Air handling unit
I hereby acknowledge that I have read this application that the information given is 1 3) 10,000 CFM + 7.50
correct, that I am the owner or authorized agent of the owner, that plans submitted are in
compliance with State laws, that I am registered with the State Builders' Board, that the Non portable 4.50
number given is correct. (If exempt from State registration please give reason below).
14) evaporate cooler
ler
15) Vent fan connected 3.00
to a single duct
16) Ventilation system not 4.50
included in appliance permit
- 17) Hood served by 4.50
mechanical exhaust
Signature (owner or agent) Date 18) Domestic type 750
Describe work ❑ addition ❑ alteration ❑ repair ❑ incinerator
to be done residential' non - residential ❑ - 19) Commercial or industrial 30.00
Existing use of type incinerator
building or property )e 21 Cl , 20) Other i.e., woodstove, water 450
Proposed use of 1 heater, solar, clothes dryers, etc.
building or property e S 1 fL 21) Gas piping one to four outlets 2.00 2, p �
Type of fuel — oil ❑ natural gas j2r LPG ❑ electric ❑ .
22) More than 4 -per outlet
NOTICE . SUB -TOTAL /g, p0
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- V ' STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 S % SURCHARGE
. DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25% OF SUB -TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL ig. 9(f
Special Conditions G
Date issued //— O — �� by �(