Permit M E::C,IIr1N:C(.:AL.. G�I:Fli'i:C T'
CITY' OF TI RD �"� A � I:'I: "I1M.r. • T i�!(] . ML:.fI(3f �1 "a F)
CITY OF W
COMMUNITY DEVELOPMENT DEPARTMENT ° °` °°"
I:)A °fT::: ISSUED: 12/16/88
13125 S.W. Hall Blvd., P.O. Box 23397, Tigard, Oregon 97223, (503) 639 -4175 •
PRIM.PMT.NO. 882456
...J(:)I3 ADDRESS: 10505 SW T:I:G,ARDJ ST
FAX MAP/LOT SUB: LT: 1•:1<:
r...ANI:) USE:
LOT S I Z E :
ITEM: NO : NO:
WORK CLASS: ALTERATION' F'(.JPNAC,H <:I.00K Aa:l: I••IAND1_.F < :I.0
USE TYPE: COMMERCIAL FURNACE:: :1.00K+ :I. AIR I••IANOL..P 101<
(;(:1NS'T . TYPE : T= L..( :)c)n FURNACE IS:VAl ::. C()C)t._E l
(:)CC UP . ( :;PP . : HEATER VENT FAN
VENT VENT . SYSTI:::M
I:: :I...P / COMP < :31-Ip HOOD
NO . S'T'OP :LEE; : EL..P /COMP ••••15HP :I :N('.,:1 :NE.PA'T( :lFi (DC)M
•
I:)WI:.....I....UN :1 :15: FI...P /(OMP 45 -°301• :I :NC, :I :NEPAT(:)P((;fi'4
FUEL.. TYPE CAS Etl...f: /CC)MI 30••••Sol -IT' REPAIR UNITS
MAX.:I :NPt.J'T' E :L R /(:,( :)MP 5()• +•1••IF' ( :)'TI••IEl:
F':,:P1::: 1:)Pil: t S? GAS PIPING OUTLETS :1.
HIGH PRESS?
LOW PRESS'? YES
REMARKS:
O SC:F•IAEF'E R DON PEAM:I: T' 'H :1.0.00
w
N :1.05o5 SW 'T:1:GAPD ST PLAN REVIEW
E T:1:(:,AG;I'J OP 97223 FIXTURES S $9 . 5o
R
PHONE (503) 620••••0726 STATE TAX $.98
( :)THEP
C
O ARROW MI:::(::I••IAi'.:i:CAL.
T • ARROW MECI••IAN :1:( :iAL..
R :1.0290SW 'T'(.JAI...A'T :I :N PI:)
A
C is t.t a:L a i.:i. rt or 97062
T PHONE: ( 503) 692••••:1.565
A PE CT NC) . 5:1.93 TOTAL..: $20.4(3
RECEIPT NC) /6/
This permit is issued subject to the regulations contained in Title 14 _ _._........._......__.... ....._.._ ............._.._.....
of the TMC, State of Oregon Specialty Codes, zoning regulations
and all other applicable codes and ordinances, and it is hereby r•21"'W'I'I;I"I') INSPECTIONS •
agreed that the work will be done in accordance with the plans and (:.AS I...7NE:
specifications and in compliance with all applicable codes and POST & BEAM
ordinances The issuance of this permit does not waive restrictive ROUGH — IN
covenants Contractor and subcontractors shall have current city I..' :I.NAI
business tax permits This permit will expire and become null and
void if work is not started within 180 days, or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility of the permittee to assure
all required inspections are requested and approved.
27.4; •
Permittee Signature •
Issued B vl
y
CALL FOP: INSPECTION 639-4175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
A4f c gga`I SCo
UI I Y UI I iuAIID MECHANICAL PERMIT ' rVt.V4)'"
Permit # -
Description
' -- Table 3A MechenIcal Code OTY PRICE AMT
City of Tigar .. -
13125 S.W. Hall Blvd. 1) Permit Fee -0 -0- 10.00
P.O. Box 23397
Tigard, OR 97223 + 2) Supplemental Permtt • 3.00 q -
639. -4175 Furnace to t 00,000 BTU -
t) Inc! ducts & vents 6.00
Furnace 100,000 BTU +
2) incl. ducts & vents / 7.50
Name of Development Floor Furnace
/G, J 3)
/ l / �-� 3) incl. vent 6.00
. r ► C ��
Job -- -- Address , > cc - Suspended heater, waltheater _ -
-
= = -:. _Addre ;. /-._ :: . ; _ -_ - .- ...... -. ' ..'.. • )
4 . or floor mounted heater - - - - - - _ 6 - ... -
00
Tax lot Map No Vent not incl. in
Lot Block Subdivision 5) appliance permit 3.00
Name (a name of b ) Repair of heating, refr ig.,
6) cooling, absorption unit 6.00
I.akng Address Prone Boiler or comp t o 3 HP
Owner 7) - absorp. unit to 100,000 BTU 6.00 (�CJ� 1 � Q 1,-)re _P
- -- ciy/State . Zip Boiler or comp to 3 HP -15 HP
K 1 � 8) absorp. unit to 500,000 BTU 11.00
1
N 81 1 1B -'- ) Boiler or comp 15 -30 HP _
9 absorp. unit 1/2 -1 million - 15'00
.. Meteng Address - -. Boiler or comp to 30 -50 HP ,., -
�L 6' C Z � i � � �) t 0) absorp. unit 1 -1.75 million 22.50
• Contractor - - • Boiler orcompto -- • • - - -,•••• • - •
. 7/state , , Zip 11 . 31.50
absorp. unit 1,750,000 BTU -- - .
. . ■' .
State Registration No. City Bus. Tax Nov 12) A ir handlin unit to 4.50
10,000 CFM
this ) Air handling unit
application that the information given is 13 .10,000 CFM 4. 7.50
I hereby nowledge that I have read
correct. that I am the owner or authonzed agent of the owner, that plans submitted are in
compliance with State laws, that I am registered with the State Builders' Board, that the Non portable
number given is correct. (II exempt from State registration please give reason below) 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
Hood served by --
17 ) 4.50
mechanical exhaust
Signature (owner or agent) `•- Date Domestic type
18)
Describe work ❑ addition ❑ alteration (1) repair ❑ incinerator
to be done residential ❑ non - residential ❑ Commercial or industrial
19 ) type incinerator 30 00
Existing use of
building or properly Other i.e., woodstove, water
Proposed use of 20 ) heater, solar, clothes dryers, etc. 4•SO
building or properly 21) Gas piping one to four.outlets . / . - 2.00
Type of fuel - oil ❑ natural gas ❑ LPG ❑ electric ❑
• • . 22)- - More thari 4 -per outlet : - - - -- - . --
NOTICE
SUB -TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5°70 Mr. SURCHARGE
DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25% OF SUB -TOTAL - '
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER — - -- --
WORK IS COMMENCED TOTAL
Special Conditions
- - - - • - - - --- -- I )nt�t issued r1 . - . . hy