Permit A, CITY OF TIGARD MECHANI CAL
DEVELOPMENT SERVICES PERMIT
1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PE RM I T # ° �MEC99 -0129
-14 DATE ISSUED: 03/29/99
PARCEL: 2S1O2DC -02000
SITE ADDRESS...: 09360 SW EDGEWOOD ST
SUBDIVISION....: EDGEWOOD ZONING: R -4.5
BLOCK LOT :018 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/O 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 < 1O0K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Installation of a/c unit and gas piping. A/C unit must comply with
standard setbacks.
Owner : FEES
GABREILLA KANDZORA type amount by date recpt
9360 SW EDGEWOOD STREET PRMT $ 25.00 DEB 03 /29/99 99- 314042
. TIGARD OR 97223 5PCT $ 1.25 DEB 03/29/99 99- 314042
Phone #: 423 -8397
Contractor:
CLIMATE CONTROL INC
3315 NW 26TH AVE
26.25 TOTAL
PORTLAND OR 97210
Phone #: 223- 4393
Reg #..: 6219E
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 Cooling Unt Insp
approved plans. This permit will expire if work is not started Final Inspection
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- 001 -0010 through OAR 952 -001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Is .ue By: ,l /i .,A.l.d_ Permittee Signature: A/
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
+ +++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan C eck #
CITY OF TIGARD Mechanical Permit Application Recd ,N ,
13125 SW HALL BLVD. Commercial and Residential Date Recd 3 -,Q9 "7
TIGARD, OR 97223 Date to P.E.
(503) 6394171, x304 Date to DST ---- �J
Print or Type Permit # /`;
Called
Incomplete or illegible applications will not be accepted
Name of Development/Proled Description
Table 1A Mechanical Code Qty Price Amt
S treet Address Suite#
A) Permit Fee - . =„i >=;:= €i,'l: '.
z'i 10.00
Job r � 1) Furnace to 100,000 BTU
Address \ ��� ` c 1� \'- l,7.t C . including ducts & vents 6.00
Bldgtt City /State UUU Zip 2) Furnace 100,000 BTU+
C 02 C , including ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
\^ ,�, including vent 6.00
Owner , 11 \ �' L 1�7_�(Z� 4) Suspended heater, wall heater
Mailing Address or floor mounted heater 6.00
• t:)
\ C� C _ - _ %e-��� S 5) Vent not included in appliance permit
City /State Zip Phone 3.00
P ~c• 'tt).-S3ci7 CHECK ALL 'Boiler Heat Air
Name ('or name of business) THAT APPLY: or Pump Cond Oty Price Amt
Comp
C Ac. V r..T- -"T.OfC . 6) <3HP;absorb unit to 1 I o •Occupant Mailing Address ` 100K BTU
1 ` 6.00
C4-s:1(2) .jj E& r✓`,�;CC:'e� CST 7) 3 -15 HP;absorb unit
City /State ' Zip Phone P4A 100k to 500k BTU 11.00
�l t> r c 1 t Z" S� 8) 15 -30 HP; absorb •
�{ c Cj ZZ unit .5 -1 mil BTU 15.00
Contractor Name f' t�`k k 9) 30-50 HP; absorb
C j% C1 CG c 11 i unit 1 -1.75 mil STU 22.50
Prior to permit Mailing Address 'n. 10) >50HP; absorb unit
issuance, a copy � \ S �L� Z A&1. -fit_ >1.75 mil BTU 37.50
of all licenses City /State Zip Phone 11) Air handling unit to 10,000 CFM
are required if c -'t• - 9 , rC,Z qiZ10 - --22.3 4.50
expired in COT Oregon Const. ant. Board Lic.tt , Exp. Date 12) Air handling unit 10,000 CFM+ •
database _S) ( \1 f ZS ( 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
M ailing Address 14)-Vent fan connected to a single duct
or 3.00
• 15) Ventilation system not included in
Engineer City /State Zip Phone appliance permit 4.50
• 16) Hood served by mechanical exhaust
Describe work to be done: 4.50
.
17) Domestic incinerators •
New 0 Repair 0 .Replace with like kind: Yes 0 No O 7.50
Residentiahp Commercial 0 . 18) Commercial or industrial type incinerator 30.00
Additional information or description of work: • 19) Repair units •
• 4.50
�f I (
\ Y - ' i� � C, L 0 20) Wood stove
4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gases LPG 0 electric O 22) Other units
4.50
I hereby a lowledge that I have read this application, that the information 23) Gas piping one to four outlets
I 2.00 2-c
given is rrect, that I am the own
co: o authorized agent of
the own r. tb pia' N)' 7/ n corn lQ fiance wjth Oregon State laws. 24) More than 4 -per outlet (each)
AI Signature of Owner gent t ate t ; , T .r a
Minimum Permit Fee $25.00 SUBTOTAL ; ,
��^
.2-3- on �3 9._ 5 %
SURCHARGE r., ^ :- -,_,
. r_ , Contact Person m e Phone PLAN REVIEW 25% OF SUBTOTAL ad ., ,,, >
Required for ALL commercial permits only F ' ! _
TOTAL _.. , • Z� Zs ---
*State Boiler Certification required
"Residential NC requires site plan showing placement of unit
I:lmechperm. doc rev 07/20/98
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