Permit �, CITY OF TIGARD MECHANICAL PERMIT
iii DEVELOPMENT SERVICES PERMIT #: MEC2002 -00137
�� II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/8/02
PARCEL: 2S1 10C D -04400
SITE ADDRESS: 15595 SW ROYALTY PKWY
SUBDIVISION: KING CITY NO. 2 ZONING:
BLOCK: LOT: 029 JURISDICTION: KIN
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
OTH 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Repair 25' gas line.
Owner: FEES
DUNKIN, CLARA E Type By Date Amount Receipt
15595 SW ROYALTY PARKWAY PRMT BB 4/8/02 $72.50 KING CITY
KING CITY, OR 97224 5PCT BB 4/8/02 $5.80 KING CITY
Total $78.30
Phone:
Contractor:
ALL TEMP PROFESSIONAL
8230 SE 72ND ST
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503- 654 -1111 Final Inspection
Reg #: LIC 58513
EXPIRED
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other 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 in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: _ 4 ° _, � , _ ' Permittee Signature: � � i h. `—
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the ne t business day
0d 11:47 5036393771 CITY OF KING CITY PAGE 02/02
Aiwa — ov137
10/01/2001 13:35 5036393771 CITY F KING CITY FAGS 04
TRI -COUNTY
SERVICE CENTER Mechanical Permit i6 4 0 � . OFI OFFICE USE ONLY
v !!° l - i no.
, , -• City of King City % • rUca v ed: 6 -D7/ e �fm
13125 SW Hall Blvd . , � , Ptojecdappl. no.: • . Expire date: _
` Tigard OR 97223" `) Dat issued: 13y Receipt no.: •
Multnomah n isi
(503) 639-4171 FAX: (503) 613€119f UP I i(7 t71e no Payment type: •
. Washington BUILDING DNISI ,
C O u N t I E E Land use approval; Building permit no . •
TYPE OF PERMIT
./"`t & 2 family dwelling or accessory 0 Commercial/Industrial U Multi- family 0 Tenant improvement
Cl New construction Cl Addition /alteration /replacement 0 Other
inn SI'Z'E INFORMATION COMIMERCIAL VALUATION SCHEDULE
Job address: I M I FITAr� ► . / t , P • Indicate equipment quantities in bvxtsa below. Indicate the dollar . .
13 idg. no.: Sul - no.: value of all Mechanical materials, equipment, labor. overhead,
Tax mapftax lot/account no.; profit Value S .
Lot: Block: . Subdivision: • '"See checklist for important application inf oration and
Project name: 1 1 _4 Jftrisdictinn's fee schedule • r residential permit fee.
City /cotntty: e _ ZIP: li set I IS: 2 FAMILY (WELLING PERMIT FEE SCHEDULE
.De -• • •onani loaati . flv• an premises: rfre"" , ANl) COMMLRICAI.liNI)Uti7'Rt1L EUu1P11IENI' SCIIEDIJLE
/, - • / Fee (ee:) Total
• Est. data of corn • letionfins • - ti,00 Dcsimi • tion N1. Res. opl Res. oaly •
Tenant improvement or change of use: A�jr hang unit CFA?
Is existing apace heated or conditioned? GI Yes CI No qr coodidrnhuhG (sire plan required)
•
Is existing space insulated? CI Yee O No Alteration of existing 1ivAG tyat m -
' MF-ClIANICAL CONTRACTOR Boiler/compressors •
inesa naive: �)• State boiler permit no,t
Rus
� / ■tl ai / L/ L a l __ 1)L / HP Tons BIU/H
• : IiiT � t�ilh�il2 F re/smoke dam, rs/dvct moo 4 detectors -
it - t$J n , aJ IP:'j, iI Next pum s e, ante•uited)
KRIM P hone: I �t[`' Ins , rep ace name- •urner BTtJ/Ii • il . •
. . GCB rho,: �+�igioa Tncludinit dactwafldvertt liner U Y o$ D No _ .
staU/replace/te acute haatnre - stuspend ,
City/me-0v lie. Ito.: r • • • ��er wall. or floor mounted •
Name (please print): ; - L i %iiir A - 17 ` i 1 vent for . , lianas other than furnace
CONTACT PEH't;)N wizera 'n° 1111 Absorption units BTWH
Name: k 7, Chill= ' . HP 1111 .
Address: /, ./ rtia7tr& Corn seers _ _ I
mental et6sastanti ventilation:
City; State: ZIP: • , Hanoi vent • .
Phone: Fax; . E -mail: Dryer exhaust '
. OWNER Hoods. Type r res. kitchen/hiuinat MI
Name alffiri- hood fire suppression sysa�m
_ /1// i .. i �� Exhaust fan with sin .1a duct (bark fans) r
Mailin _ a • • Pa! , - 4 . 1P-�iijlli A_�I.I . / .l�T���; r ' ' use S stem + • From heating or At
MI
City: L.: vj„ //F2iI 7 t . ! Fuel piping and diet ' , :on (up to a our as I .
/ ll , • ; • LPG NO tit
Phones � i!".S
E-mail: Fu • g each addi area over 4 outlets
ENGINFElt Process pip mg (sc entitle recto' • • )
NAM: Number of outlets
• ,other listed appliance or equipment;.
Address: • Decorative fireplace
City: State 7_1P: insert - type . - •
• I'- . - aodstov- • - et stove
Phone: Fax • E -mail:
Alp • , lfcunt's signature; late: .. .
oiler: '
Name (print): ... .
- • •
•
Net all lurtdlctioes eec...l credit drtreB. pfmte Mil iuridlctice ter more information.' . Permi fee $ � A
a +riea D MasterCard . • Notice: This permit applkallon • Minimum fee $ __ . 5
expires (to permit is «tit obtained
!milt ord member; Em - within ISO days gfier it has been Plan view (qt _ '1 ' c) _
State surcharge MO - - - -- $ $ _ • •
N a m of rnr'dholdcr.as fhowo De cedlr card accepted as co
co
s�� TOTAL $ _ • [raga
Cardhaldcr si nnture Amo,nr 4404.17 ' ,' /COW