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Permit CITY OF T MECHANICAL ^ ii � DEVELOPMENT SERVICES PERMIT #PERMIT MEC97 -0478 -�1i DATE ISSUED: 12/19/97 PARCEL: 2S104AA -07400 SITE ADDRESS...: 12745 SW KATHERINE ST SUBDIVISION • BELLWOOD NO. 2 ZONING: R -4.5 BLOCK - LOT -111 JURISDICTION: TIG CLASS OF WORK..:ALT 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 • 0 DOMES. INCIN: 0 :LPG 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.: 1 FURN ( 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1 FURN > =100K BTU: 0 > 10000 cfm: 0 Remarks: Installation of furnace and gas piping. Owner: -- FEES TOM WALPOLE type amount by date recpt 12745 SW KATHERINE PRMT $ 25.00 TJH 12/09/97 97- 301568 TIGARD OR 97224 5PCT $ 1.25 TJH 12/09/97 97- 301568 Phone #: Contractor: - - - - -- MR FURNACE HEATING INC 16285 SW 85TH AVE $ 26.25 TOTAL TIGARD OR 97223 Phone #: 684 -9014 Reg #..: 000879 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 Unt Insp ___ _ __.. approved plans. This permit will expire if work is not started Heating Unt Insp within 180 days of issuance, or if work is suspended for more. Final Inspection ._ 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 001 -0080. You may __,__ _ obtain copies of these rules or direct questions to OUNC by calling (503)246 -9187. Issue B : D. Permittee Signature: V „6„ /� /,�I ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ Call 639 -4175 by 7:00 p.m. for inspections needed the next business day ++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++ Plan Check # CITY OF TIGARD Mechanical Permit Application Rec'd By 13125 SW HALL BLVD. Commercial and Residential Date Rec'd TIGARD, OR 97223 Date to P.E. (503) 639 -4171, x304 Date to DST Print or Type Permit# lq:C., 78 Called v Incomplete or illegible applications will not be accepted Name of Development/Project Description Table 1A Mechanical Code QTY PRICE AMT Job Street Address Suite# A) Permit Fee -0- -0- 10.00 Address '9 71.5 .S C,U !< (- heir - Bldg# o cakState Zip 1.) Fumace to 100,000 BTU Q 6.00 I ictqrd ci' 7 including ducts & vents . b CO - Name or name of business) 2.) Furnace 100,000 BTU+ 7.50 Owner /' a er1 WA--) PO 1 including ducts & vents Mailing Address 3.) Floor Furnace 6.00 Z7' SCA) f G, �ti/ N e including vent / C' State Zi Ph oonne 4.) Suspended heater, wall heater 6.00 r 1.4-r 0 re q . 6 - q 1 /7 or floor mounted heater Narhe (or name of business) 5.) Vent not included in appliance permit 3.00 Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00 to 3 HP; absorb unit to 100K BUT City /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00 3-15 HP; absorb unit to 500K BTU" Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00 10 A.rN 67r=c,_ 1--5 15-30 HP; absorb unit.5 -1 mil BTU"' Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50 issuance, a copy 162 Z SW j /"-► f Z 30-50 HP; absorb unit 1- 1.75mil BTU" of all licenses ci�/state Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50 are required if /1,q-� © 92 2 l33`/- go/ y > 50 HP; absorb unit 1.75 mil BTU'"' expired in COT O on Consr Cont. Board Llc.# i Exp. Date 11.) Air handling unit to 10,000 CFM 4.50 database ? 7*:1 7 / - Architect Name 13.) Non - portable evaporate cooler 4.50 Or Mailing Address 14.) Vent fan connected to a single duct 3.00 Engineer city/State Zip Phone 15.) Ventilation system not included in 4.50 appliance permit Describe work New 0 Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50 to be done Residential 0 Non - residential 0 Additional Description of work: 17.) Domestic incinerators 7.50 18.) Commercial or industrial type 30.00 Incinerator Existing use of 19.) Repair units 4.50 building or property 20.) Wood stove 4.50 Proposed use of 21.) Clothes dryer, etc. 4.50 building or property 22.) Other units 4.50 Type of fuel - oil 0 natural gas lie LPG 0 electric 0 . 23.) Gas piping one to four outlets ' 2.00 I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50 information given is correct, that I am the owner or authorized agent of the owner, that ns submitte are iempliance with Oregon State QTY. SUBTOTAL laws. _ �1 re - 4' -9 7' 2 • Signature Ow /A Date 'SUBTOTAL g Bi_/ i Mtc he (o 5% SURCHARGE 4 4/',` I).1 Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL TOTAL 1 r� i:\rmechpmt.doc (rev 9 'Minimum permit fee is $25 + 5% surcharge p "Residential NC requires site plan showing placement of unit. • 1 -)7 ®g 1 I 1 • ` , I + CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: — (? A.M. P.M. MST: Brit: Location: y /.A _ ,L _P ,I __ BUP: s. y � Tenant: Suite: Bldg: MEC: -- CJ Contractor: I iiid ,/_' _. _[1 L // ( .' one: Al g -- ' 0l PLM: Owner: 1 __.` Il/ ; 1L 1 Phone: _ 0 — 4" i ELC: J / _/�. . _'. 4 I 'rani NIT(1 0/ _ / ✓L.,i ELR: fI ./ : ' _.L. SIT: BUILDING BLDG (con't) / PLUMBING I CHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam ost/t3eam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In Ceiling Water Line Slab Framing Top Out s Lme Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct i y Reconnect Vault Bsmt Damp Drywall Storm i -%''` �� Temp Service MISC. Masonry Ceiling Rain Drain 0 - "I UG Slab Shear /Sheath Fire Spk1r /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved : • •rove.• Approved Approved Appr /Sdwlk Not Approved Not Approved mrzwA sproved Not Approved Not Approved FINAL FINAL K FIN • FINAL FINAL D Call for reinspection O Reinspection fee of $ required before next inspection D Unable to inspect Inspector: � "1- Date: l Page of