Permit CITY OF TI QARD
COMMUNITY DEVELOPMENT DEPARTMENT MECHANICAL
13125 SW Hall Blvd. P.O. Box 23397, Tgard.Oregon 97223 (503)639-4175 PERMIT
PERMIT 1 ' : MEC93-06917
639-4171 DATE ISSUED: 01/15/93
SITE ADDRESS...: 12435 SW 181ST AVE PARCEL: 2S103BB-06900
SUBDIVISION....: ZONING: R-4.5
BLOCK ^ LOT ^
CLASS OF WORK ADD FLOOR FURN
^~: ^ EVAP COOLERS:
. TYPE OF USE ^OTR UNIT HEATERS..: VENT FANS...:2
OCCUPANCY GRP..:SR3 VENTS W/O APPL: VENT SYSTEMS:
STORIES.... .... :1 BOILERS/COMPRESSORS HOODS
FUEL TYPES 69-3 HP ^ DOMES. INCIN:
:/GAS/ / / 3-15 HP ^ COMML. INCIN:
MAX INPUT: BTU 15-30 HP ^ REPAIR UNITS:
FIRE DAMPERS?..:Y 30-50 HP : WOODSTOVES..:
GAS PRESSURE...:L 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: Add 4 bedrooms to care home. • Owner: — FEES
J & K LORINC . type amount by date recpt
12435 SW 121ST AVE PRMT $ 25.00 JH 01/15/93 —
PLCK $ 6.25 JH 01/15/93 - •
TIGARD OR 97223 5PCT $ 1.25 JH 01/15/93 —
Phone #:
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 32.50 TOTAL •
Reg #..
REQUIRED INSPECTIONS
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 Heating lint Insp
approved plans. This permit will expire if work is not started Duct Inspection
within 180 days of issuance, or if work is suspended for sore Fire Damper Insp
than 180 days. Final Inspection
<7
Permittee Signature : -- '
/
Issued By:
Call for inspection — 639-4175