Permit MECHANICAL
CITY OF TIGARD PERMIT • PE RMIT # • MEC96 -0311
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 09/10/96
• 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 2S110CD- 00700
SITE ADDRESS...: 154421 SW ROYALTY PKWY
SUBDIVISION....: ZONING:
BLOCK • LOT •
CLASS OF WORK..:ALT FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 1 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 1
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..: 2
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
TURN ( 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS. : 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Converting a dryer, range, and fireplace to gas.
Owner: FEES - - --
JOHN BUD IHAS type amount by date recpt
15440 SW ROYALTY PKWY PRMT $ 31.50 CJS 09/10/96 KING CITY
SPCT $ 1.58 CJS 09/10/96 KING CITY
KING CITY OR 97224
Phone #: 620 -0811
Contract or
ABLE MECHANICAL INC
PO BOX 7176
BEAVERTON OR 97007 - --
Phone #: 640 -4141 $ 33.08 TOTAL
Reg #.. : 069114
- -- REQU I RED 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 Mechanical Insp _ -_
applicable laws. All work will be done in accordance with W o o d s t o v e Insp
approved plans. This permit will expire if work is not started Misc. Inspection
within 180 days of issuance, or if work is suspended for more Final Inspection —
than 180 days.
Permittee Signature: .faf l -Q — _
Call for inspection – 639 -4175
y _ _ 5 tr - eb ' 'Jb r N1 U.5: 46 1 I): I- HX NU: 14277 1
Plan Check # k.A--•
CITY OF TIGARD Mechanical Permit Application Reed By CJ
13125 SW HALL BLVD. Commercial and Residential Date ReC'd `3
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST, -� -9
{ Permit # M 9-6 -03 I I _
Print or Type Called 6-.y
Incomplete or illegible applications will not be accepted
Name of Development/Propel Description
Table 1A Mechanical Code orr Peace AMT
Job Street Address suttee A) Permit Fee -0- 4- 10.00
Address 1 VI _ .._. • . ±, \tom..
MO try is Zip 4 B) Supplemental Permit 3.00
V _
Name for name et business) , • - 1.) Furnace to 100.000 8TU . 6.00
Owner y� Q S incl. ducts & vents
Meiling Adereae 2.) Furnace 100,000 BTU + 7.50
l ‘0-\ '?0 �, p ,� , f Ind. ducts & vents
C� t aata ` :i ZIP Ptsone J 3.) Floor Furnace 6.00
e,i. s ., 41 t. `7.. •a0- incl. vent
erne of • eines)) 4.) Suspended heater, wall heater 6.00 CO.
:i11)(' or floor mounted heater
Occupant M!U►ng Address . 5.) Vent not ind. In 3.00
a :A. liana permit
City-state zip Phone 6.) Boiler or comp, heat pump. air cond. 6.00
to 3 HP; absorp unit to 100K STU
Name 7) Boller or comp, heat pump, air cond. 11 .00
/ D\e . cr lopr\c o\ 1 y , r . 3-15 HP; absorp unit to 500K BTU
Contractor 9 A el 8.) Boiler or comp, treat pump, air cond. 15.00
Nu 1 11 b t5-30 HP; absorp unit .5-1 m5 BTU
Attach copy of ._Sp. Zip pirne 9.) Boiler or comp, heat pump. air pond. 22.50
Current Licenses C 4 2. 9 4 `1 \ 30-50 HP: absorp unit 1 -1.75 mil BTU
Orsgon Conat. Coot eoard Lic# Exp. Date 10.) Boiler or camp, heat pump, air cond. 37.50
GC I l t + CI) I g I ID > 50 HP: absarp unit 1.75 mil BTU
guess Tax or metro a Exp. Date 1 t) Air handling unit to 4.50
) ISt I Zl0gco 1o,00o
12.) Air handling unit • 7.50
Arr:hlteCt 10,000 CTM +
or Mailing Amelia 13.) Non portable 4.50
evaporate cooler
Engineer c'h'ic"° Zip Phone - 14.) Vent fan connected 3.00
to a sin�uct
Describe work New 0 Addition 0 Alteration Repair 0 15.) Ventilation system not 4.50
t0 be done Residential 0 Non- residential 0 included In appliance permit 1 4.5)
Additional Description of work 16.) Hoed served by
` k LA N 'N Ca C 5
3, t\ Q c S c , n4 J mechanical exhaust 4.50
1 , 17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30
building or property _ -- .: incinerator
19.) Clothes Myers. etc. 4.50 (3,00
Proposed use of 20) Other units ' - 4.50
building Or property
21
0 electric 0 21) Gas piping one to four outlets 2
Type of fuel - pit 0 natural gases LPG Q. OD
1 hereby acknowledge mat have reap this application, that the 22) More than 4-Per outlet (each) .
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 ,F,L:.:..:ri= °or' .
laws. 'SUBTOTAL .;ti ' 1.-7. �
Signature of Owner/Agent pate y_.• • ,,,. Q
n 5% SURCHARGE '"ar •s.« .i ':'1 . 5 /7
n N ame Phone PLAN REVIEW 26% OF SUBTOTAL =;;.L • •;;,
Cants PerSO . - .,_'�, ;.: zae;::: 61_ J
TOTAL , =' °' "'-
t:ldstlmechpmt.doc 'Minimum permit fee is $25 + 5% surcharge
Rev 7196
•
4/19/00 ' Activities for Case #: MEC96 -00311
5:47:36 PM
•
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To . Done By Disp. Level By Updated Notes •
MECA007 Application received 9/6/96 RECD CJS 9/10/96
MECA715 Mechanical Insp 9/10/96 ' 9/30/96 KS APP KBS 10/7/96
MECA060 (F) Issue permit 9/10/96 CJS PASS CJS 9/10/96. •
MECA800 Case Finaled 9/20/96 MS PASS MRS 9/23/96
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