Permit MECHANICAL .�
CI1YOFTIGARD PERMIT # PERMIT A1EC95-0250
COMMUNITY DEVELOPMENT D`EP°ARTMENT DATE ISSUED: 07/31/55
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 2S114BA -00900
SITE ADDRESS...: 09985 SW SERENA WAY
SUBDIVISION • PICKS LANDING NO.2 ZONING: R -4.5 •
BLOCK • LOT • 130
CLASS OF WORK..:REP 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 :1 DOMES. INCIN:
3 -15 HP COMML. INCIN:
MAX INPUT: BTU 15 -30 HP • REPAIR UNITS:
FIRE DAMPERS ?..: 30 -50 HP • WOODSTOVES..:
GAS PRESSURE...: 50+ HP • CLO DRYERS..:
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.:
FURN < 100K BTU: (= 10000 cfm: GAS OUTLETS.:
FURN ) =100K BTU: > 10000 cfm:
Remarks:
Owner: - - - -- FEES
DENISE MCCARTHER type amount by date recpt
9985 SW SERENA WAY PRMT $ 25.00 B 07/31/95 95-
5PCT $ 1.25 B 07/31/95 95—
TIGARD OR 97224
Phone #:
Contractor:
PORTLAND METRO —AIRE
10010 SW BEAVERTON HILLSDALE HWY
BEAVERTON OR 97005 — --------
Phone #: 626 -7818 $ 26.25 TOTAL
Reg #..: 61219
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Final Inspection
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 sore
than 180 days.
Permittee Signature: (
Issued By: t
Call for inspection — 639 -4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125`SW Hall Blvd. APPLICATION Permit # Alec- Is -oz-so
Tigard, OR 97223
•
(503) 639 -4171
- Name of Development Description
Table 3A Mechanical Code OTY PRICE AMT
Ada...
Job 99 GG 5 W v e ev - Gi ( 1) Permit Fee -0- -0- 10.00
Address t.ty/ l O 1I
r cA 97 ZY 2) Supplemental Permit 3.00
Name tot G z- ' a of hotness) Furnace to 100,000 BTU
e tv `2243 Al c. A fi r 1) incl. ducts & vents 6.00
tg da
Phone Furnace 100,000 BTU +
Owner 639- 0361 2) incl. ducts & vents 7.50
Gy/State w Floor Furnance
3) incl. vent 6.00
Name fa name el bosoms) Suspended heater, wall heater
4) or floor mounted heater 6.00
Madng Address Phone Vent not incl. in
Occupant 5) appliance permit 3.00
CtyISIOIO r� Repair of heating, refng.
6) cooling, absorption unit 6.00
Name ^^ Boiler or comp, heat pump, air cond. r
Fart / • 1 e Tp - i J r 6 ' 7) to 3 HP; absorp unit to 100K BTU I 6.00 CX
adn Mans ' hpAe Boiler or comp, heat pump, air cond.
Contractor 10010 9,A) Bec =PI 1 be,k0a- 8) 3 -15 HP; absorp unit to 500K BTU 11.00 zw Boiler or comp, heat pump, air cond.
73- . R 7 D U S 9) 15 -30 HP; absorp unit .5-1 mil BTU 15.00
State Regonanon No. C ty Boa. Tax No. Boiler or comp, heat pump, air cond.
6121 9 igo 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
16) included in appliance permit 4.50
agnattte (owner a agent) Data Hood served by
17) mechanical exhaust 4.50
Describe work new 0 addition 0 alteration ({) repair 0 Commercial or industrial
to be done residential 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. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property
21) More than 4 -per outlet (each) 2.00
Type of fuel - oil 0 natural gas S) LPG 0 electric 0
NOTICE
Minimum Fee $25.00 SUBTOTAL 2L
PERMITS BECOME VOID IF WORK OR CONSTRUCTION r
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE / 2
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
Special Conditions n I
Date issued 7 — 2, / /S by 11 • l �/k r ,
NALLOGIMDSTStMECHPMT
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: & (1 ( ( v A.M. P.M. MST:
Location: l l S J - ^ Q/l 2.4 "J BUP: '\
Tenant: Suite. Bldg: MEC: C , 5 — dolc56
1 s t � � ( c -- 7571g Phone: PLM:
Owner: C.J 6 n o i Phone: ELC: 7S 0_ I t
r� ) J ft C 1(O_t ci 7 AQ ELR:
SIT:
BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL FINAL FLNAL FINAL
,
•--- (...-c...-yt.,a... , .t 4 -..e• 0 -
420.---
,,,,, .
O Call for reinspecti V' r O Reinspection fee of $ / uired before next inspection O Unable to inspect
Inspector: �r Dat Page of