Permit _ •
COMMUNITY DEVELOPMENT DEPARTMENT
13125mw II Blvd. Tigard Oregon 9722308199 (503) 639w171
MECHANICAL
PERMIT
PERMIT #. . . . . . . : MEC95-0128'
639-4171 DATE ISSUED: 05/02/95
• PARCEL: 2S103BC-07100
SITE ADDRESS...2 12250 SW LANSD8WNE LN
SUBDIVISION....: FYRESTONE ZONING: R-4.3
BLOCK. . . . . . . . . . :
_____________
CLASS OF WGRK.. :_cQrT CUL-C FLOOR FURN... . r EVAP COOLERS:
TYPE OF USE....:SF UNIT HEATERS..: VENT FANS...:
OCCUPANCY 8RP..LR3 VENTS W/O APPL: VENT SYSTEMS:
STORIES.. ...... :2 BOILERS/COMPRESSORS HOODS... .. .. :
FUEL TYPES---'--------- 0-3 HP. . . . : 1 DOMES. INCIN:
:/GAS/ / / 3-15 HP....: C8MML. INCIN:
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS�
FIRE DAMPERS?..: 30-50 HP....: WOODGTOVES..x
CAS PRESSURE...: 50+ HP.. . . : CLO DRYERS..:
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS.:
FURN ( 100K BTU: 10000 cfm: GAS 3UTLETS.c1
FURN >=100K BTU: > 10000 cfm:
Remarks: INSTALL RESIDENTIAL AIR-CONDITIONING UNIT.
Owner: ----- --- - - - FEES ------�-------
NANCY JAMES type amount by date recpt
12250 SW LANSDOWNE LANE PRMT $ 25.00 SW 05/02/95 -
5PCT $ 1.25 SW 05/02/95 -
TIGARD OR 97223
Phone #:
Contractor: • ---------------
CLIMATE CONTROL HTS & A-C
3315 NW 26TH AVE
PORTLAND OR 97210 -- -----------
Phone #: 223-4393 $ 26.25 TOTAL
Re� 0..: 62196
------- REQUIRED INSPECTIONS -------
This peruit 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
applicabie.laws. All work will be done in accordanze with Final Inspection
aprnved plus. This peruit will expire if work is not started
within 18W days of issuance, sr if work is suspended for more ____
than I88 days. _
----- --' --- ---
Per mittee Signature _
_
I ssued By
Call for inspection - 639-4175
•City�.',of.T gard • MECHANICAL PERMIT Planck/Rec. # -;.
RECEIVED .. N:,:2.
•
• 13125 SW Hall Blvd. APPLICATION Permit # ivif:.q 0 1.25''' :'':
PO Box 23397 itilAY 0 1995 c
Tigard, OR 97223 CITY OF TIGARD ' � �-- Q �
(503) 639 -4171
- Nom» ol Dovekvnent .. -- Description •
Table 3A Mechanical Code QTY PRICE AMT •`
" � L ��.v110 1nI -1�1 '
Job 1 Permit Fee -0- -0- ["10� OO.r�
Address
Ti �I
� I rol t ( q-
.,.1� 2) Supplemental Permit 3.00
N t a
of ,...«. Furnace to 100,000 BTU • •
& I, ` -yam ' • 1) incl. ducts & vents 6.00
h on. Furnace 100,000 BTU + •
Owner
NW/
--. I .11 Ile , 2) incl. ducts & vents 7.50
^* � ,`� Floor Furnance
•
�1 (=11-7-) �
3) incl. vent
N.mo t nano of bit Suspended heater, wall heater 6.00
4) or floor mounted heater 6.00
Ma+ Addrons Phan. Vent not incl. in
Occupant 5) appliance permit - 3.00 •
C^WSw. aP Repair of heating, refrig.
•
6) cooling, absorption unit 6.00 .
\\ C 1 � D � P Boiler or comp, heat pump, air cond. r - _
Qr\C 7 ) to 3 HP absor p unit to 100K BTU 6.00 _�._
Boiler or comp, heat pump, air cond.
-2) � 5 V Y 1 9 t 1 -(-\ ?) 8) 3 -15 HP absorp unit to 500K BTU
Contractor V ` `v 2
Boiler or comp, heat pump, air cond. 11.00
W 9
-\dl q1� zP 9) 15 -30 HP absorp unit .5 -1 mil BTU 15.00
W F .r..on Coy au, Tax No. Boiler or comp, heat pump, air cond.
( �a lq L9 14t9 10) 30 -50 HP absorp unit 1 -1.75 mil BTU 22.50
•
I hereby acknowleage at 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
Vent fan connected
. 15) to a single duct 3.00
(� Ventilation system not ,
. y.....454 ,l� 1�l 4. a� •q -J 16) included in appliance permit 4.50
s�1.o.L or jai. Hood served by
17) mechanical exhaust . 4.50 .
Describe work new addition alteration 0 repair 0 Commercial or industrial .
to be done reside tia non- re 3idential 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 ` 2.00 Z (.
building or property
21) More than 4 -per outlet .50
Type of fuel - oil 0 natural gas LPG 0 electric 0
NOTICE oo
' Minimum Fee $25.00 SUBTOTAL 2 . m
PERMITS BECOME VOID IF WORK OR CONSTRUCTION •
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE 1.2F2
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. • 211).2F-7-
- -- - TOTAL --- -- - - -
Special Conditions
Date issued by
k. /UECHPMT
wadY.o,od.v •
Y
CIT OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath , Framing Q
PIbg.Und /Flr /Slab Plbg. Top Out Insulation -EI
Post/Beam Struct. Mech. Rough -in Gyp. Bd.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other: c
Date: 2 /7 / �A.M.�, P.M. Entry:
Addres : , G 'a—C7) 7 ` S
Tenant: T Ste: MST: c
� ,� c.� �J � �5' 9j - 612 d
Con • MEC:
_ /
O PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
•
vo w
Inspec r: Date: + l Ll -
PROVED DISAPPROVED /CALL FOR REINSP. CF CO
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