Permit CITY OF T MECHANICAL
� 11 1 1 1�,i D DEVELOPMENT SERVICES PERMIT # MI J - MEC98 -0057
Tigard DATE ISSUED: 02/ 19/98
PARCEL: 1S125DB -08900
SITE ADDRESS...: 07107 SW LOLA LN
SUBDIVISION - THE RAZBERRY PATCH ZONING: R -4.5
BLOCK - LOT -009 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/0 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.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Moving gas meter
Owner: FEES
KIM DORSING type amount by date recpt
7107 SW LOLA LN PRMT $ 25.00 B 02/19/98 98- 303428
BEAVERTON OR 97005 5PCT $ '1.25 B 02/19/98 98- 303428
Phone #:
Contract or:
OWNER '
$ 26.25 TOTAL
Phone #:
Reg #..: 999999
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 Final Inspection
applicable laws. All work will be done in accordance with
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. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -y1;1 -0010 through OAR 952-001 -0080. You may
obtain copies of these rules or direct questions to OUNC.by calling.
(503)246 -9187. S
Issue By: _ Y Pe rmittee Signature:. %4.11.//'
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 Z. - 1
TIC'ARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit# ME`C - 72)57
Called
Incomplete or illegible applications will not be accepted
Name // go � fff"00velopme � gt/Project, Description
/&J� /i 0 VS/ 1• Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address f /0 7 S.W t01'
Bldg# City/State Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name (or name of W _ 2.) Furnace 100,000 BTU+ 7.50
Owner Kj M VO Y5 /!V / / including ducts & vents
Mailing Address J '' ,p, Lit `` 3.) Floor Furnace 6.00
0 7 S' vi, liD Lig r including vent
City/State Zip Phone Suspended heater, wall heater 6.00
T� o / 7 e0 or floor mounted heater
Name (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
WW- 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 30-50 HP; absorb unit 1- 1.75mi1 BTU"'
of all licenses City /State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if > 50 HP; absorb unit 1.75 mil BTU"`
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database
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 II Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 6 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 e 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) l .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws.
Signature of Owner /Agent Date `SUBTOTAL 200 / r
i� Do V s; 1U Z
. 07 O 5% SURCHARGE - ZS
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL '
TOTAL 5 /
i:\mechpmt.doc (rev 9 *Minimum permit fee is $25 + 5% surcharge �`'
**Residential NC requires site plan showing placement of unit.