Permit � � � - - '-�_-- ��_--- `'
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@N �� TIGARD � MECHANICAL ���N0� � ����
,: Clr�; PERM IT
����U�U���0N�Y��EVELOPN�Q�NTKDEPARTU�ENT PERPERMIT #.......: MEC92-121175
m1�mw Hall o�eo���.��.���� (503) ��1� � �
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6�_ LATE ISSUED: 66/04r-
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SITE ADDRESS...: 12195 SW 121ST AVE PARCEL: 2S103BB-06500
SUBDIVISION....: ZONING: R-4.5
BLOCK..........: LOT.............: •
CLASS OF WORK..:ADD FLOOR FURN....: EVAP COOLERS:
i TYPE OF USE....:SF UNIT HEATERS..: VENT FANS...: .
' OCCUPANCY GRP..:M1 VENTS W/O APPL: VENT SYSTEMS:
STORIES........:1 BOILERS/COMPRESSORS HOODS.......:
FUEL TYPES 0-3 HP :1 DOMES INCIN: .... .
f/GA8/ / / 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.. :
NO OF UNITS AIR HANDLING UNITS OTHER UNITS~:
FURN < 100K BTU: <= 100069 cfm: GAS OUTLETS. :4
FURN >=10QK BTU:1 > 10000 cfm:
Remarks:
Uwner: - ----- - FEES --------
PAT/OLIVER KERRINS type amount by date recpt
12195 SW 121ST AVE PRMT $ 25.50 JH 08/04/92 -
5PCT $ 1.28 JH 08/04/92 - •
TIGARD OR ,97223
Phone #: ' .
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Contractor: -
MULTN8MAH HEAT IN
MULTNOMAH HEATING
2553 NO. DIVISION ST.
GRESHAM OR 97030-0000 - -
Phone #: 503-665-5656 $ 26.78 TOTAL
Reg #..: 48545
REQUIRED INSPECTIONS -------
This peroit is issued subject to the regulations contained in the Final Inspection
Tigard Nonicipa\ Code, State of Ore. Specialty Codes and all other
appilicahie lams. All work will be done in accordance with _ ___
approved plans. This pernit will expire if work is not started
within 18% days of issuance, or if work is suspended for acre _____ _
than- MO days. __ ____
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Permittee Signature ______._ __ ______________ ___.____`___ _
—
Issued By: � ___ ____ -----'----'
- Call for inspection - 639-4175
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Receip4 i
MEeH ANICAL
SW HALL BLVD, . E ST ,
P. O. BOX 23397 Permit # `
Description •
TIGARD, OR 97223 Table 3A mechanical Code
OTY PRICE ANT
(50.3) 639 -4175
i) permit Fog -0- 0• 10.00
Name. of Dr+votoptrwnt
-err' S _ 2) Supplemental Permit 3.00 r
Job Address
S Furnace to 100,000 BTU `
Address I a f 9 S SW /021 , t incl. ducts & vents 6.00
Tarrant Map No. Furnace t00,0o0 6TU +
Lot BOO . `) incl. accts & ve n ts I 7.50 7 $d
Subdivision /
Na (or name of bu 7ness) /J 1".
Floor F
3 6.00
i GL t
D i / ve �C' t° r-rJ Yt S ) incl. vent
Mailing p ddr as -
Owner c� « (� 3 4)
Suspended heater, wall heater ,
�`, ! O 5 `� /O / . or floor mounted heater 6.00
C tty /S tare �,p Vent not m d . in ~
fa r� O/C 5) appliance permit 3.00
—y—
Ne?te name of pcs ness) Repair of heating, refr ig.,
t � )' r - his 6) cooling, absorption unit ,, \\ 6.OQ
Mailing Address . Phone ( 3 c — — 7) Boiler or comp to 3 HP tA-0 t
Occupant
ioZ / qS S� /�(
c)(4-.) — absorp, unit to 100,000 BTU 6.00 B
G ryr grate n zip 8 � Boiler orcomp to 3 HP -15 HP . 11.00
/ / "lam r -�X tit absorp. unit to 500.000 BTU '
Na Boiler or comp 15 -30 H ! y
L t • • 4 t IA .. r ) 9) absorp. unit ',�2. 1 million 15.00 .1 h Mailing Address t ^ • Phone 10 , i Boiler or comp to 30 -50 HP _
Contractor Z SS 3 N w bio+ ; I (n b 5 5 (-t� C — absorp- unit 1 -1.75 million 22.50
C /state Zi 11 f Boiler or comp to 50 HP �` --'
. O J Z 7 0 3 0' absorp, unit ; .750,000 BTU 31
State Registration No, City Bus. Tax No. 12) Air handling unit to 1
9 A 3 10,000CFM 4.50 J
I hereby acknowledge that I have read tn,s Air handling unit 1 Correct, that t am the owner or authorized agent of the ow that the nto maucn gluten is 13) 1 0,000 CFM �- 7.50 I
compflahee with Sate laws, that I am r 9 owner, that hear subm , t are in _
egiSfCrrid with th+! State Bul�(7C.5 Board, that the Non portable f
number given is correct (It exempt from State registration pleaso give reason belowi. 14) evaporate 4.50
porate cooler
15) Vent fan connected
to a single duct 3.00
6) Ventilation system not
included in appliance permit 4.50
( Hood served by
�� - - 3) y Z 17) mac exhaust 4.50
51gnature (Owner or agent)
Date Domestic type !
1 alteratio repair
Describe work ❑ addition 18) inc 7.50
to be done residential h.. non - residential ❑ Commercial or industrial
Existing use of Q t9) type incinerator 30.00
building or property . - .� �\
°Yw w� ,1 heater, solar,
20) Other i.e„ w , cloth ve, water
Proposed use of 1 , clothes dryers, etc. 4.50
building or property �W1i �
i 21) Gas piping one to four outlets p 00 �r>
Type of fuel — oil ❑ natural gas LPG Li, electric ❑
22) More than 4 -per outlet • I
NOILCE
THIS PERMIT BECOMES NI.' .I. AND VOID IF WORK OR CON- SUB- TpTAI. A'. Sr..
si' {
STRUCTiON AUTHORIZED NOT COMMENCED WITHIN 180 5%; SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR
�'a
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER PLAN REVIEW 25% OF SUB - TOTAL
WORK f$ COMMENCED. TOTAL lad
Special Conditions
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5/10/00 Activities for Case #: MEC92 -00175 •
1:10:40 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA010 Plan check by 8/4/92 JH 8/4/92
MECA799 Final Inspection 1/22/93 RT PASS BLT 1/22/93
MECA060 (F) Issue permit 8/4/92 JLH PASS JH 8/4/92
MECA800 Case Finaled 1/22/93 BLT 1/22/93
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