Permit CI1YOFTIGARD MECHANICAL
'' DEPARTMENT PERMIT
13125 SW Hall Blvd. Tigard, Oregon e722303199 (503) 63e-4171 PERMIT #. . . . . . . : MEC95-0416
DATE ISSUED: 12/05/95
PARCEL: 2S104AA-03600
SITE ADDRESS...: 12515 SW KAREN ST
SUBDIVISION....: BELLWOOD ZONING: R-4.5
BLOCK..........: LOT.............:369
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CLASS OF WORK..:NEW 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
:/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.: @
FURN < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN >=100K BTU: 0 > 10000 cfm: 0
Remarks: Install new carrier gas furnace.
Owner: ---- -- — FEES ------- —
ART MARTINEZ type amount by date recpt
12515 SW KAREN PRMT $ 25.00 TMP 12/05/95 95-273522
5PCT $ 1.25 TMP 12/05/95 9 5-273522
TIGARD OR 97223 •
Phone #
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Contractor:
OWNER •
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Phone #: $ 26.25 TOTAL
Reg #.
REQUIRED INSPECTIONS —
This peroit 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 Misc. Inspection
approved plans. This peroit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days,
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Permittee Signature: ��', ./�^��; ___ _ ___
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Issued By:
Call for inspection — 639-4175
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City of irigdrd MECHANICAL PERMIT Planck/Rec. # 95 01 .72say
13125 SW Hall Blvd. APPLICATION Permit # Mr-�9,s -c4',
Tigard, OR 97223
(503) 639 -4171
Nam. a o..«apn«r Description
• Table 3A Mechanical Code QTY PRICE AMT
Job ' 5 Sv3 KCAC -Q >■ 1) Permit Fee -0- -0- 10.00
Address- .
2) Supplemental Permit 3.00
Nam. or nan. .r w..,..., Furnace to 100,000 BTU I 6.00 .�.0- OD
C 4_ (Y1G { --\ ( 7 _ 1) incl. ducts & vents
Mrrg Aabx. Pna» Furnace 100,000 STU + ,‘
Owner ► .3‘r . Kot (-P c 2) incl. ducts & vents 7.50
a,y,Sca. Floor Fumance
^, ��- (-_.(z_ G 1 ' 3) incl. vent 6.00
Nm (a of tur.m.6.0 Suspended heater, wall heater ,
4) or floor mounted heater 6.00
Ma.g r:aks..a Vnor. Vent not Incl. in
Occupant 4. 0
5) appliance permit
c.Y,so.. Repair of heating, refrig.
• 6) cooling, absorption unit 6.00 .
Nam. Boiler or comp, heat pump, air cond.
7) to 3 HP absorp unit to 100K BTU 6.00
Mairy ACdrw Pn n. Boiler or camp, heat pump, air cond.
8) 3 -15 HP absorp unit to 500K BTU 11.00
Contractor A so.. z.p Boiler or comp, heat pump, air cond.
9) 15 -30 HP absorp unit .5 -1 mil BTU 15.00
Sm. R.gi.r.aa, No. an Bus. Tax N. Boiler or comp, heat pump, air cond.
10) 30 -50 HP absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I have read this application, that the 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 31.50
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
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Vent fan connected .
• 15) to a single duo 3.00 •
Ventilation system not
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M _Q-Qr - . Q C \C_C \ x , r .r r I,) 1,, Ion 16) included in appliance permit 4.50
.,,. (,.,., y
,, ,�. oa Hood served by
17) mechanical exhaust 4:50
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Describe work new E5) addition 0 alteration 0 repair 0 Commercial or industrial
to be done residential 0 non- residential 0 18) type incinerator 30.00
Existing use of Other ie., woodstove, water '
building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
. building or property
21) More than 4 -per outlet
Type of fuel - off Q natural gas ZR-- LPG O electric Q
NOTICE
Minimum Fee $25.00 SUBTOTAL \ c2S,C(.,
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE I o<
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 ab• O5
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Special Conditions — C `1 'r ( e__,' e__,' — —
G2) T ry (Q Date issued )02 - 5 ^ 95 by
Y.4.4a14 Mr
.aemmd..
i f li '-, ,, --4r--- ;' 3 1.1--- C Z I ( oiltl■ 41(
.)-' ?c-tril,,—(2_X -. ' P
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 - 4171.2-5
Date Requested: R" /1 q A.M. P.M. MST:
Location: 5L5 `l 2 f Ail At, BUP:
Tenant: Suite: Bldg:. MEC: 95 ( f ,
Contractor: a, Phone: 7 PLM: q '--oo l I
Owner: . I .j4 : , A ..�1 / r 1 _ L/ /./LI_ . !i • hone: ELC:
um ! c • I I C r / A ► i LR:
;File citify yr �� i'/ r� ►/iii n, r v- 4 0 r ' i ii •
SIT:
BUILDING BLDG ( on't) � a�`iC11ik I C • CAL ELECTRICAL SITE
Site Post/Beam . v 1 • . Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Ro -In UG Sprinkler
Foundation Insulation Sewer VP t Hood/D_ uct econnect Vault
Bsmt Damp Drywall Storm 1 i G : urn-as Temp Service MISC.
Masonry Ceiling Rain Drain 1 UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved roved Approved Approved .
Appr /Sdwlk Not Approved • , ved of • oved Not Approved Not Approved
1? `
FINAL � i FINAL FINAL
Al ' i ' X.' ' r;_') c/ ev--ai,,,,,4
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i J. / , A1 f
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II -Call- for - reinspection - - - - -- —O Reinspection fee of $ - - -- - required - before next inspection - O Unable to inspect- - - -
Inspector: / 7 /...2 Date: 2//_31g Page of