Permit '
A CITY OF TIGARD MECHANICAL
4104— ` ^ DEVELOPMENT SERVICES PERMIT
-- - ---' -'-'- ' --^ ~~ ^~~~~~- PERMIT # - MEC96-0359
=�� 13125 SW H�@�,���C����
Tigard, `' DATE ISSUED: 10/21/96
�~— I~~I ' ' PARCEL: 1S134CD-01600
SITE ADDRESS..-: 11770 SW KATHERINE ST
SUBDIVI'SION. . . . t LERON HEIGHTS NO.3 ZONING: R-4. 5
BLOCK..........: LOT.............:51
__ _ ___ __________ ____________
CLASS OF WORK..:REP 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
: � . 3-715. HP. . P. 0 `.`'/ ` COML.. 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.: 01
FURN < 100K BTU: 1 (= 10000 cfm: 0 GAS OUTLETS.: 3
FURN >=100K BTU: 0 >' 10000 cfmr 0
Remarks: WORKING ON FURNACE
Owner: --------- — — -- FEES --------------
KAY SHIRK type amount by date recpt
11770 SW KATHRINE PRMT $ 25.00 TAT 10/21/96 96-285444
5PCT $ 1.25 TAT 10/21/96 96-285444
TIGARD OR 97223
' Phone #: 646-2500
Contractor: ---------------------- --
COLUMBIA HEATING
PO BOX 230397
TIGARD OR 97281 ----------- —
Phone #: 624-2704 $ 26.25 TOTAL
Reg #..: 76359
-- 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 Final Inspection __
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.
___ __
__ ___ __ __ ___
Permittee Si tut e:
— _
6/ � . .
Issued By: , . _
��
/y ' � �� / * y � � -
— �� - ' _____
` .
/all for inspection — 639-4175
•
_____ � _
�
`
.
.
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW,Hail Blvd. APPLICATION Permit # (fECQ(0- 03.59
Tigar OR 97223
- (503) 639 -4171
Nam* o' wvdopm«u r � Descnption
3k Table 3A Mechanical Code OTY PRICE AMT
...
Job , / ,,, 776 6 I� 1 Permit Fee -0- -0- 10.00
Address LP .
flr i^/1
OK q'3 2) Supplemental Permit 3.00
12A1 Furnace to 100,000 Bl U
6hak ( e ":256 0 1) incl. ducts & vents 1 6.00 6.06
n. Phone Furnace 100,000 BTU +
Owner l t 0 ,(,(). t✓ hu o 2) incl. ducts & vents 7.50
Floor Fumance
j Of( q'3 3) incl. vent 6.00
Suspended heater, wall heater 4) or floor mounted heater 6.00
Ma l u Pnar. Vent not incl. in
Occupant 5) appliance permit • 3.00
Carysmi. Lp Repair of heating, refng.
6) cooling, absorption unit 6.00
M a 4.�, � Boiler or comp, heat pump, air cond.
7 to 3 HP; absorp unit to 100K BTU 6.00
0' 60X 0, / 6-2 Boiler or comp, heat pump, air cond.
Contractor G LP 4/'}C�/ 8) 3 -15 HP; absorp unit to 500K BTU 11.00
a
Boiler or comp, heat pump, air cond.
/ 1 �� Y. ��� 9) 15 -30 HP; absorp unit .5 -1 mil BTU 15.00
mrr`61a^0^ Gry Bus. Tax No. Boiler or comp, heat pump, air cond.
7k q.5-30,1 10) 30 -50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that ave re this application, that e 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 37.50
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
please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
��
15) to a single duct 3.00
//���,, t� `
ULtifi ` jk (�t�� I �� � �J
Ventilation system not
16) included in appliance permit 4.50
sgna . owrwr or y Pate 16)
served by
17) mechanical exhaust 4.50
Describe work new U addition U alteration U repair U Commercial or industnal
to be done residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50 /�/�
Proposed use of 20) Gas piping one to four outlets 3 2.00 2 00
building or property
Type of fuel -oil natural gas LPG 21) More than 4 -per outlet
T
YP 0 g 0 0 electric 0
NOTICE rr��
Minimum Fee $25.00 SUBTOTAL .7 .7•
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE /.25
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
- - - TOTAL - -- 6.c2-5
-
Special Conditions
Date issued by
ke/MECHPMT
word'comd,v
5 /19 /99 Activities for Case #: MEC96 -00359
2:36:41 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 10/18/96 TAT RECD TAT 10/21/96
MECA799 Final Inspection 11/5/96 GS N/H GES 11/5/96
MECA715 Mechanical Insp 10/21/96 11/4/96 GS N/R GES 11/4/96
MECA060 (F) Issue permit 10/21/96 TAT PASS TAT 10/21/96
MECA705 Gas Line Insp 11/6/96 GS APP GES 11/6/96
MECA715 Mechanical Insp 11/6/96 GS APP GES 11/6/96
MECA799 Final Inspection 11/6/96 GS APP GES 11/6/96
MECA799 Final Inspection 11/6/96 GES 11/6/96
MECA800 Case Finaled 11/6/96 GS APP GES 11/6/96
•
Page 1 of 1