Permit CITY OF T MECHANICAL
a7 A DEVELOPMENT SERVICES PERMIT
PERMIT #........:. MEC96 -0358
Ts- -- . 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED:.. 10/17/96., '
PARCEL: 1S134CD- 03700`
SITE ADDRESS...: • 1 1960 SW 121ST AVE
SUB'DT.VISI'ON ;....: LERON HEIGHTS. NO. 3. - . ZONING: R -4a 5
BLOCK........... LOT. ....... .....:71
CLASS OF WORK..:ADD FLOOR FURN....: 0 EVAP COOLERS: 0
TYPE OF USE. °SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:A1 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES........: 0 BOILERS /COMPRESSORS.• HOODS.......: 0
FUEL TYPES----- 0 -3 HP....: 0 DOMES. INCIN: 0
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 °•.
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.: 1
FURN > =100K BTU: 0 .. > 10000'cfm: 0
Remarks:
Owner: -. FEES
BARBARA DURRETT type amount by date recpt
11960 SW 121ST PRMT $ 25..00..TAT;10/17/96 96- 285332
SPCT $ 1.25 TAT 10/17/96 96- 285332
TIGARD OR 97223
Phone #: 590 -5673
Contractor: -- - - - - -• -•
ABLE MECHANICAL INC
PO BOX 7176
BEAVERTON OR 97007 . • --
Phone #: 640 -4141 $ 26.25 TOTAL
Reg #..: 069114 - .
REQUIRED INSPECTIONS
This permit is-issued 'subject to the regulations contained in „the • Gas Line I n s p .
Tigard..Municipal Code, State. 'of' Ore. 'Specialty Codes and •.all other . M i sc. I n s p e ct d on
applicable laws. All work will ■ be done'in accordance' with - Final Inspect ion
approved 'plans. This pereit'•will- expiraeAf work is-not started... .
within 180 days of issuance, or df workcis suspended for more
than 180 days.
•
Permittee Signature:
Issued By: - -
Call fora• inspection' - . 639 - .4175';• •
i7
CITY OF TIGARD BUILDING INSPECTION NOTICE
D.---/
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing Mech.
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Appr /Sdwlk Reins.
Other: , -A.4ZJe e/ i` - �
Date: / I h3 ( Y P.M. Entry:
Address: / / v /.- / , -.S . /
Tenant: Ste: MST:
• BU
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Cor -' S MEC :
yearn *�,w.� PLC:
�° "'� °'ate ELC:
T.H.- 'e1CL0 ` 1 G CORRECTIONS ARE RECAP REi. ' '�--,
c -____ 1 ‘_.( Ai._.... 10 A 0 _ 0 _KA _4 _ ....... . )
'.: 4111 1 i nff-AWAff_ ...0 %.
-T i- -Ak._ 1 —u,,..tal 1
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•---„,
Ins ector: ` (AC Date: it 1 I �&I
APPROVED DISAPPROVED /CALL FOR REINSP. CF CO
•
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit # McCCi (o$°b - [
Tigard, OR 97223
(503)•630-4171 .
►..+ O.v.+opn.n Description '
Table 3A Mechanical Code QTY PRICE AMT
IVddr.w
. Job "DO .560 / /LS • 1) Permit Fee -0- -0- 10.00
Address zp
yykt.L v 1ZZ - 3 2) Supplemental Permit 3.00
�+j� / Furn ace to 100,000 BTU
r /Q- �' 1 a rl ret _ 1) Incl. ducts & vents 6.00
Medina Acidness Phone Furnace 100,000 BTU +
O 956,0 6O0 .1' 1,2 /-S4 5%0 -- 7,f 2) incl. ducts & vents 7.50
zP Floor Furnance (f
i ��t�t't" D tTQ-, f p 3) incl. vent 6.00 II
.myi}�.+ .� Suspended heater, wall heater
VV 4) or floor mounted heater 6.00 +
M.inp ... Phone Vent not incl. in '
Occupant 5 T f - r" 5) appliance permit 3.00 I;
ay5ou. - zP Repair of heating, refrig. 1
6) cooling, absorption unit 6.00
Nad fN.,,.. `� , ` Boiler or comp, heat pump, air coed. ;
i V I r c , (� 7) to 3 HP absorp unit to 100K BTU 6.00
• ►�srrro .� /� Phone Boiler or comp, heat pump, air cond.
COContractor raCtOr
�' ,,,. 54) l"0 h ni �' 8) 3 -15 HP absorp unit to 500K BTU 11.00
r Boiler or comp, heat pump, air cond.
if` yvO� d v 61100S 9) 15 -30 HP absorp unit .5 -1 mil BTU 15.00
.r ation No. G+T • TLC No. Boiler or comp, heat pump, air cond.
C /G -/ (/ If 10) 30 -50 HP absorp unit 1 -1.75 mil BTU 22.50 4`
I hereby acknowledge tnat 1 Ihave read this application, at 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 Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air handling unit I
please give reason below.) 13) 10,000 CTM + 7.50
Non portable I`
14) evaporate cooler 4.50 r
Vent fan connected
15) to a single duct 3.00 I
Ventilation system not
16) included in appliance permit 4.50
• sow.. « � Hood served by
r41.0d0:1164 l(i / y 7 17) mechanical exhaust 4.50 f
Describe w new � alteration repair 0 Commercial or industrial
to be done residential 0 non - residential 0 18) type incinerator 30A3 ,
Existing use o f Other i.e., woodstove, water
building or property 19 ) heater, solar, clothes dryers, etc. 4.50 ,
Proposed use of y. 20) Gas piping one to four outlets / 2.00 j f) cj
building or property .' jj iI
• ' 21) More than 4 -per outlet
Type of fuel - oil 0 natural gas)21 LPG 0 electric 0
. . ... 9asS 1)001-
NOTICE
Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION .
• AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE 1,2S I
IF CONSTRUCTION OR WORK IS SUSPENDED OR '
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL I
AFTER WORK IS COMMENCED. ■
TOTAL Q(p.6=25
Special Conditions
Date issued by ,
W/MECHPMT
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