Permit Mrcr'LInM T r'n1 ,
PERMIT ,v,
CITY OF T PERMIT #
DATE ISSUED: 07 /2 ME 6 -0231
- COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 15 136 DB -026 01
SITE ADDRESS...: 11606 SW PACIFIC HWY
SUBDIVISION • ZONING: C -G
BLOCK • LOT •
•
CLASS OF WORK..:ALT FLOOR FURN • 0 1)AP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 T FANS...: 0
OCCUPANCY GRP..:B VENTS W/O APPL: 0 Vt SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOO • 0
FUEL TYPES - -- 0 -3 HP • 0 DOMES. I NC I N : 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 < lOOK BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Replacing one furnace to 100,000 BTU.
Owner: -- FEES -- - -- - --
APPLIANCE CONNECTION type amount by date recpt
110606 SW PACIFIC HWY PRMT $ 25.00 CJS 07/23/96 96- 281919
PLCK $ 6.25 CJS 07/23/96 96- -281919
TIGARD OR 97223 SPCT $ 1.25 CJS 07/23/96 96- 281919
Phone #:
Contractor: -.
HOLLAND'S HEATING
1445 SW 206TH
ALOHA OR 97006
Phone #: 591 -5636 $ 32. 50 TOTAL
Reg #.. : 75295
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp _
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mi sc. Inspection
applicable laws. All work will be done in accordance with Mi sc. Inspect ion
approved plans. This per•uit will expire if work is not started Final Inspection __ .
within l80 days of issuance, or if work is suspended for more _ ___
than 180 days. __ ___
,__
Permittee Signature: Q_ �lCCe�`_'[ar►—
(� _
ebGir_i_eS-__N /73,/d1_ _ -
Issued B y : --
Call for inspection - 639 -4175
City of Tigard k // / MECHANICAL PERMIT Planck/Rec. # ` G 814, 1x12 SW Hall Blvd APPLICATION Permit # mgc' -oa31
Tigard, OR 97223 »I ' L100 1 hs
503 639 -4171 g 00O aT kk
- Name of Development Description
A0-9 \ � � CC1 ,-, Table 3A Mechanical Code QTY PRICE AMT
Address 1 '� Q
Job (1 1x20 1( SO 9 \ c\ Ly 1) Permit Fee -o- -o- 10.00
Address I
— \
Cp r °Z q'7�3 2) Supplemental Permit 3.00
Name for name of bow ■i Furnace to 100,000 BTU
/t ` m9 n 1) incl. ducts & vents 1 6.00 (�
Wang ess -v Phone h Furnace 100,000 BTU +
ASS
9 incl. ducts & vents 7.50
Owner ' y S�W ,s 4. `� � Zp 2) Floor Furnance
RDeci rW 4 � 9 3) incl. vent 6.00
of tnrsm eno) Suspended heater, wall heater
Ari)A 9 \1 kTC P c n f d -io '\ 4) or floor mounted heater 6.00
Mahn us one Vent not incl. in
Occupant /1103(0c �A E‘ C 4��tay 63 -0 ( 5) appliance permit 3.00
C,t zm Repair of heating, refrig.
- ��� + O? (1 7Q3 6) cooling, absorption unit 6.00 •
me Boiler or comp, heat pump, air cond.
0•11,4-04..c , & ti C J .k. 7) to 3 HP; absorp unit to 100K BTU 6.00
stlme Address W U C Ph OAe &Lc Boiler or comp, heat pump, air cond.
La � � �„(_ $C1 8) 3 -15 HP; absorp unit to 500K BTU 11.00
Contractor A e e u�+ p, Boiler or comp, heat pump, air cond.
! ∎R 15.00
`� ■ 9) 15-30 HP; absorp unit .5-1 mil BTU
S , td `g r o ��l 11 �`-�� --. bus. as No.
„ , e � Boiler or comp, heat pump, air cond.
15 a 'S ; as s 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby ackno wledge tha 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
` ►� 7-( 7 _9 ( 16) included in appliance permit 4.50
gnetore (owner 0, Been " T Date Hood served by
17) mechanical exhaust 4.50
Describe work new 0 addition 0 alteration o epair o Commercial or industrial 30.00
to be done residential 0 non - residential f 18) type incinerator
Existing use of \\ . Other i.e., woodstove, water
building or property �� Qi i.4.--\ 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of � 20) Gas piping one to four outlets 2.00
�Q
building or property c-r , ►� ( � -
21) More than 4 -per outlet (each) 2.00
Type of fuel - oil Q natural gas LPG 0 electric 0
NOTICE
Minimum Fee $25.00 SUBTOTAL Z
PERMITS BECOME VOID IF WORK OR CONSTRUCTION r -,..y AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR z
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL L,�
AFTER WORK IS COMMENCED.
TOTAL 1 2�
• Special Conditions t-�
Date issued �� A' � by -0
H: \LOGIMDSTSIMECHPMT
3/27/00 • Activities for Case #: MEC96 -00231
5:38:24 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 7/19/96 CJS RECD CJS 7/23/96
MECC008 Permit created 7/19/96 CJS PEND CJS 7/23/96
MECC015 Routed to Plans Examiner 7/19/96 CJS ROUT CJS 7/23/96
MECCO20 Plan checked /Approved by P.E. 7/19/96 JF PASS CJS 7/23/96
MECCO25 Reviewed Plans Routed to DSTS 7/19/96 JF ROUT CJS 7/23/96
MECC799 Final Inspection CJS 7/23/96
MECC710 Mechanical Insp 7/23/96 CJS 7/23/96
MECC755 Misc. Inspection 7/23/96 CJS . 7/23/96
MECC755 Misc. Inspection 7/23/96 CJS 7/23/96
MECC090 (F) Issue permit 7/23/96 CJS PASS CJS 7/23/96
MECC095 (F) Reprint Permit 7/23/96 CJS 7/23/96
MECA880 Expired by limitation 3/26/00 HAP DONE No Hold AKJ 3/26/00
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