Permit MECHANICAL
CITY OF TIGARD P ERMIT #. PERMIT : MEC "'96 -0235
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 07/23/96
13125 SW - Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S103BC -06900
SITE ADDRESS...: 12230 SW LANSDOWNE LN
SUBDIVISION....: FYRESTONE ZONING: R-4.5
BLOCK........... LOT........ ..... :8
CLASS OF WORK.. :ALT FLOOR FURN....: 0 EVAP COOLERS: 0
TYPE OF USE'.... :SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP.. :Al VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES.......,: 0 BOILERS /COMPRESSORS HOODS.......„ 0
FUEL TYPES -- - - -- 0 -3 HP....: IZI 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....: €1 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP....: 0 CLO DRYERS..: 0
NO. OF UNITS -- AIR HANDLING UNITS OTHER UNITS.: 1
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN >=100K BTU: 0 ' > 10000 cfm: 0
Remarks: Installing gas logs
Owner: -• -- - FEES
PETER BAXTER AND SUSAN BAXTER type amount by date recpt
12230 SW LANSDOWN LN PRMT $ 25.00 JSD 07/23/96 96- 281772
5PC 7 $ 1.25 JSD 07/23/96 /23/96 96 -28 1772
TIGARD OR 97223
Phone #:
Contractor: ----- - --
ABLE MECHANICAL INC
PO BOX 7176
BEAVERTON OR 97007 ' - - -. - --
Phone #: 640 -4141 $ 26.25 TOTAL
Reg #t..: 0691.14
-• REQUIRED INSPECTIONS --
This peroit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection - _ _
applicable laws. All work will be done in accordance with ___ ___�,_
approved plans. This peroit will expire if work is not started ________ -,-,-
within l2O days of issuance, or if work is suspended for pore _ ,.
than ISO days. — _________
' (-7 71/1 ( A4V 7
P e r m i t t e e Signature: — �__
Call for inspection - 639 -4175
I
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd. APPLICATION Permit # ,4 G.c 9
Tigard, Tigard, OR 97223
(503) 639 -4171
Name of Development Descnptlon
Table 3A Mechanical Code QTY PRICE AMT
adareu
Job ) 223) 6ti izinr-L owne #(.n. 1) Permit Fee -0- -0- 10.00
Address W .
I grad d / Qk 97aa3 2) Supplemental Permit 3.00
Name name 01 bueneee) Furnace to 100,000 BTU
lox teA •520 -9108 1) incl. ducts & vents 6.00
Meing Address «1e Furnace 100,000 BTU +
Owner 1aa30 5(.J ,LQnt(sc ne /_.,r,. 2) incl. ducts & vents 7.50
atytatete Do Floor Furnance
T; Qo (c. , OR 9 too 3 3) incl. vent 6.00
Neme4r name of baseless) Suspended heater, wall heater
4) or floor mounted heater 6.00
M °b " a 7ddress Phone Vent not incl. in
Occupant 5) appliance permit 3.00
cdy /State Do Repair of heating, refrig.
6) cooling, absorption unit 6.00
Name Boiler or comp, heat pump, air cond.
Al1g MP.PE ,e0J T� 7) to 3 HP; absorp unit to 100K BTU 6.00
avn °° ° Boiler or comp, heat pump, air cond.
,,(� ` /1(" 010 8) 3 -15 HP; absorp unit to 500K BTU 11.00
Contractor h
u""5role Do Boiler or comp, heat pump, air cond.
8eavei+or, 9ya07 9) 15-30 HP; absorp unit .5 -1 mil BTU 15.00
State Regsvabon No. Gty Bus. ,as No. Boiler or comp, heat pump, air cond.
19//4 1/Ai 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 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handling unit to .
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from State Air handling unit '
registration, 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
A t 4 A LM (A f , ; ,� t- 7/j g /c/ 16) included in appliance permit 4.50
atur er o g ent Date Hood served by
17) mechanical exhaust 4.50
Describe work new 0 addition 0 alteration repair 0 Commercial or industrial
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.W f 4.50 ! W
Proposed use of 20) Gas piping one to four outlets I 2.00 200
building or property
21) More than 4 -per outlet (each) 2.00
Type of fuel - oil 0 . natural gas ( LPG 0 electric 0 •
NOTICE
Minimum Fee 525.00 SUBTOTAL ,,z
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE f ,a5
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 ;CYO< 25
Special Conditions
Date issued by
NtLOG I MD.STSSMECHPMT