Permit . CITY OF TIGARD MECHANICAL PERMIT
A DEVELOPMENT SERVICES PERMIT #: MEC2002 -00019
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/10/02
PARCEL: 2S1 04AB -06000
SITE ADDRESS: 12228 SW 131ST AVE
SUBDIVISION: MORNING HILL NO.4 ZONING: R -4.5
BLOCK: LOT: 089 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Replace existing gas furnace with like kind.
Owner: FEES
BROWNING, RONALD E + LYNDA K Type By Date Amount Receipt
12228 SW 131ST PRMT CTR 1/10/02 $72.50 2720020000
TIGARD, OR 97223 5PCT CTR 1/10/02 $5.80 2720020000
Total $78.30
Phone:
Contractor:
A -TEMP HEATING + COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 650 -5014 Final Inspection
Reg #: LIC 71878
EXPIRED
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other 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 in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952 - 00 . may •bt.' copies of these rules or direct questions to OUNC by calling
(FfW4R_ai Ra . .
Issue By: 1 ti , j Permittee Signature:. A l A
Call (51 639 -4175 by 7:00 P.M. for inspections needed the next business day
SAN -08-2002 15:20 A TEMP HEATING 5035572990 P.02i02
. w Mechanical Permit A.pplrcalion , 9 / ®� P N�� -o� .
. •: Daterocoived: tno•
• d projeot/appl.no.: Expire dam;
• f Tigar
® FM Rprnjpt n0.:
i
..44-`.11. press: 13125 S W H all Blvd Ti rd, 9 97 :sued:
City of Tigard phone: (503) 639-4171 JA �I 1
Fax: (503) 598'4960 CITY OF TiGARD na.: .
Land use approval :: 'II I k , ii 14.1:101
4.1:10 =1'-'` Iiuitdin8permit
T1'PF Of FLW 1IT
Q N(ttlti family ❑ Tenant improvement
0 2 family dwelling or accessory 0 Commercial/industrial 0 Oth
o New construction 0 Addition/alteration/replac
JOB SITE ;1 FORM TJON COMMERCIAL N 44111.1ATION SCIEDl:1.E
Indicate equipment quantities in boxes below, Indicate the dollar
Bldgg . ao.:o.: Suite no.: n : _ value of ail rnct an al materials, nquipmertt, labor, overbead.
B profit. Value $
Tax map/tax lot/accountno -:
Lot: Block: Subdivision; 'See checklist for important application information and
jurisdiction's fee schedule for reeidetttial . ' it fee.
Project name: : C _ • 1 S 1 r x DA %'ELLING PEIVAMIT FEE SCHEDULE
Clty/c:ma/1: i • • ZIP: • Ivh GO tl�1l:RIC:�LflI�DLIS7'IZI AI.lrQ1 IPI�1F!Vl SC71EDlTLE
to : • friar_ .. Fastest.) Total
ripti t . • alto of r ez -e . pre / 4_, • _ _ ` ma y, Faste t.) Total
l( Description Est. date of completion/inspection: li sC: ,
Tenant improvement or change of use: Air handling unit C
Is existing space heated o r con4itioned? 0 'Yes 0 No Air coaditiarung (Bate plan . u ad) Sri
aceinsulate_d. 0 Yes C1 No ,glees tone existing VA stem = ��
I9 existing space ' Seiko/compress=
MECHANICAL COIvTIi.�iC State boiler permit no.: 8 , � ,.
a. • a HP Tons — III
$ttsitlG6s name' - - s. • • . • ' •: • �� - uelsmokc •crelduetsjn4ke taro r�_
Address: ir11 i•1•s� eal . •(sto•1"sequ _• OM - NMI
��!+� �. � 'l �,�`� Install/rep furnacerourner, ,B . fi �
Cone: ii�'$� instil i ePis lers —. 11111 CCE no.: � 1 Air instil
or floor mounted
City/metro lie. no.: want or • •i an Mace 1� —i
Name (please P:int):� r `�i.7J , 4, ,,,. , ,. • 1, . • + , • . . . , getattow fia -
CONTACT PERSON Absocpcianuturr B'IV/H aM
Chi7krs E l =�
Addrtss:�
Name: o . A ! i� �: a A Con. rc3sots 1 MM
• Saris e xhaust and veirt4on:
State: ZIP: APP llancevant
Phone: E•masl: D oods, ype u es, tthettlriar.mat ■��
•
O��'1TR hood fire suppression system
miimmi
Exhaust fen with single duct (bath fins) - _
• 11 r it a Exhaust _ stem a • : from Winn - or outlets) M�— •
Mailin: address: / g �� piping and • istribahon (up to MM.
EMOMMOMMIngill sEa[e QL 7�':`JI! /�1� type LPG IsIG Oil
Prue p ; eocn a�diaonal over outlets = �� NM
Phone; Xi� , tear piping (schematic required)
ENGINEER Number of outlets 1111111M11
flier IT. app a or . , /dent .
Name: De
City: ; �' ppdgmve/pclldsDDVC �_
phon �,. -��
Date:
Permit fee . • $ _--' --
Name (pant); P .
eeu j „ rly6""I /or m l°e"dm' permit application 1 ---i
xa an i+e4ad;ctlooc � ms�c eeida P1'1" Notice: This pe PP ti Nli f Q vies _ expires if a permit is not obtained Plan review (at %) $ -- _
t:fada cycd n¢� within tan days sitar it has been State sut+cha a (896) . , S _�—�
Q 7 f � .� � :...,.+.. -.�=—, - aeneptc asCOmF1etc TOTAL S .^.�—
%. , m` ��i1 •-' -- ` _ . ui _ EXPIRED (Conniaavll
TOTAL P.02