Permit 1 CITY OF T MECHANICAL
` „ N�, ' .� DEVELOPMENT SERVICES O
PERMIT
h N , _ f�i 1, � PERMIT # • MEC98 -0327
13125 SW Hall Blvd., Tigard, OR 97223 (503)639-4171 DATE ISSUED: 08/06/98
l ' $ 1 j1 k , PARCEL: 2S114BB -06300
SITE ADDRESS...: 16069 SW 104TH AVE
SUBDIVISION • SWANSONS GLEN ZONING: R -12 PD
BLOCK • LOT :004 JURISDICTION: TIG
CLASS OF WORK..:OTR FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 1 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: 0 (= 10000 cfm: 0 GAS OUTLETS.: 0
FURN ) =100K BTU: 0 > 10000 cfm: 0
Remarks : Installation of exterior A/C unit. Unit cannot be placed within the
required setbacks.
Owner: FEES
CHERI RAWLINGS type amount by date recpt
16069 SW 104TH AVE PRMT $ 25.00 DLH 08/06/98 98- 308081
TIGARD OR 97224 SPCT $ 1.25 DLH 08/06/98 98- 308081
Phone #:
Contractor:
AIRE —FLO HEATING & AIR CONDITI
PO BOX 328
$ 26.25 TOTAL
HILLSBORO OR 97123
Phone #: 640 -3607
Reg #..: 000520
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -081 -0010 through OAR 952- 081 -0060. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue By: Permittee Signature: /6�/ --(—
+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
. CITY OF TIGARD Mechanical Permit Application Rec'd By 2=-1.-
i 13125 SW HALL BLVD. Commercial and Residential Date Rec'd P /d?
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, X304 Date to DST
Print or Type
�� Permit # Af C 5?
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
( f y j • , • ; < 1 4 - 0 - ) i - 1 4 ) Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite* A) Permit Fee -0- -0- 10.00
Address /k6 SA) /C'/ v1.
Bldg* City /State Zip 1.) Furnace to 100,000 BTU 6.00
77» LL2 ', [lQ. 9 including ducts & vents
Name (or name or business) 2.) Furnace 100,000 BTU+ 7.50 1
Owner ("Hr// ,= -1.J ).Q3 5 including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
/6 3c) /04" ! j - including vent
City /State n ZIp } Phone 4.) Suspended heater, wall heater 6.00
i i6 o g_ 97= or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pum air cond. 6.00
to 3 HP; absorb unit to 100K . a0
City /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"'
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
A) e _ ?� 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit ailing Address 9.) Boiler or comp, heat pump, air cond. 22,50
issuance, a copy 1 U i („ '--?-401-1-2.-- _C . 30 -50 HP; absorb unit 1- 1.75mii BTU"
of all licenses City /state Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if !-11 Li.Sce n -O d 9'7/ 3 /p FO 7 > 50 HP; absorb unit 1.75 mil BTU"'
expired in COT `Oregon Const. Cont. Board Lic.* Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database 5 7g2 r) 9 <j /,' - 17 - ? Q t /"
Architect Name 12.) Air handling unit 7.50
10,000 CTM+
or Mailing Address 13.) Non - portable evaporate cooler 4.50
Engineer City /state Zip Phone 14.) Vent fan connected to a single duct 3.00
I
Describe work New 0 Addition 0 Alteration Repair O 15.) Ventilation system not included 4.50
to be done Residential Non - residential O` in appliance permit
Additional Description of work: 16.) Hood served by mechanical exhaust 4.50
j riL.5 / `_ �) // /► J� /� 17.) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
building or property type incinerator
19.) Repair units 4.50
Proposed use of 20.) Wood stove 4.50
building or property
21.) Clothes dryer, etc. 4.50
Type of fuel - oil 0 natural gas). LPG 0 electric 0 22.) Other units 4.50
I hereby acknowledge that I have read this application, that the information 23.) Gas piping one to four outlets 2.00
given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State laws. 24.) More than 4 -per outlet (each) .50
Signat� of Owner/Agent Date 'SUBTOTAL • L
L n7 Ph o PLAN REVIEW 25% OF SUBTOTAL °. _ '` I 7,
Required for all commercial permits only. e v t , , ' ''
/ O N Ai 6 V e 0 $ ‘D7 �.- -.- , TOTAL � r �. .. i l� C�V
g
Minimum permit fee is $25 + 5% s
Resfde gial A/C re+uir site plan - showing placement of unit.
�6 . a- r
l:lmechprmt.doc rev 4/15/98 3{0 75
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6/16/00 Activities for Case #: MEC98 -00327
3:25:30 PM
Assigned Hold Updated ttei
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes 45)((14,
MECA007 Application received 8/6/98 DLH RECD DLH 8/6/98
I C
MECA008 Create Permit 816/98 DLH DONE DLH 8/6/98
MECA799 Final Inspection DLH 8/6/98
MECA715 Mechanical Insp 8/6/98 DLH 8/6/98
MECA060 (F) Issue permit 8/6/98 DLH DONE DLH 8/6/98
MECA750 Misc. Inspection 2/22/00 2/22/00 2/22/00 JMT DONE No Hold JMT 2/22/00 research inspection request
MECA880 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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