Permit A % CITY OF T D MECHANICAL
DEVELOPMENT SERVICES PERMIT PERMIT
cAl. — 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 1 1 /0 5/988 -0679
PARCEL: 2S112DD -00800
SITE ADDRESS...: 15670 SW UPPER BOONES FERRY RD
SUBDIVISION ZONING: C —
BLOCK LOT JURISDICTION: TIG
CLASS OF WORK. .:ALT FLOOR FURN 0 EVAP COOLERS: 0
TYPE OF USE COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:M VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES 1 BOILERS /COMPRESSORS HOODS : 0
FUEL TYPES 0 -3 HP • 2 DOMES. INCIN: 0
3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP ° 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: N 30 -50 HP ° 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP : 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 2 <= 10000 cfm: 2 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Add mechanical to an existing service station /convience store.
Owner: FEES
CHEVRON USA PRODUCTS CO type amount by date recpt
6001 BOLLINGER CYN RD BLDG L -1114 PRMT $ 46.00 JSD 11/05/98 98- 310584
SAN RAMON CA 94583 PLCK $ 11.50 JSD 11/05/98 98- 310584
5PCT $ 2.30 JSD 11/05/98 98- 310584
Phone #:
Contract or:
MENG HANNAN CONSTRUCTION CO
5906 SE 122ND AVE
59.80 TOTAL
PORTLAND OR 97236 -4607
Phone #: 761 -5290
Reg #..: 47283
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 Duct Inspection
applicable laws. All work will be done in accordance with Final Inspection
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 by 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 DUNG by calling
(503)246 -9187.
er ��'7/f/(/ e.:1 Issue B� ° � Permittee Signature:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
1
i Plan Check - -/ .
CITY OF TIGARD Mechanical Permit Application Recd By �--
13125 SW HALL BLVD. Commercial and Residential r Date Recd - - = -4 �
TIGARD, OR 97223 � `� ` Date to P
(503) 639-4171, x304 A� Date to Ds 7 L ll t� • , r Chtd
Print or Type Permit ovoe 9� 6 3
a Incomplete or illegible applications will not be accepted Called 07/ - 3/�'M-
P 9 PP P f-,4-3 d• s rPcC`
Name of Development/Project Description
77P .5 TJag C � Table 1A Mechanical Code Qty Price Amt
Job Street Address ( 7 p I N Suitex A) Permit Fee , ' 10.00
Address .SC/wirela�d FR R 1) Furnace to 100,000 BTU
including ducts &vents 6.00 rem
Bldg# City /State Zip g 2) Furnace 100,000 BTU+
f� Ae. � j OS including ducts & vents 7.50 i
Name (or name of business) I 3) Floor Furnace
Owner F12& DfAY.S.7 4c.&- including vent 6.00
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater 6.00
aM - As , 301 5) Vent not included in appliance permit
City /State Zip Phone 3.00
' ,4 NI AS 13 ) CHECK ALL 'Boiler Heat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
Comp
SA ,j I bL) - 6) <3HP;absorb unit to Z 6.00 / L �
Occupant Mailing Address 100K BTU
1 i t f 1+5 /JJtr 7) 3 -15 HP;absorb unit
City/State Zip Phone 100k to 500k BTU 11.00
E f -5 a � e 8)15-30 HP; absorb
R unit .5 1 mil BTU 15.00
Contractor Name HP; absorb
t 1 D ra A urn 1 -1.75 mil BTU 22.50
Prior to permit Mailing Address �.J 10) >50HP; absorb unit
issuance, a copy = 70L .s E 1 2. >1.75 mil BTU _ 37.50
of all licenses City/ tatf Zip Phone 11) Air handling unit to 10,000 CFM
are required if po t1 -. 1 Or 9 lo 91" 1 L f -J270 2- 4.50 a )
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 12) Air handling unit 10,000 CFM+
database (7 f -I3 - O G 7.50
i Architect Name 6 �,p 13) Non - portable evaporate cooler
V 4.50
or Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer City /State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New Repair O Replace with like kind: Yes O No O 7.50
Residential 0 Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: 19) Repair units
O J f H vAC Sy 5T 6N - 4.50
ADD 20) Wood stove
i N � ./e e C ■le1A.3 4.50
C s 't'a.-,E. E /'eak� 21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas 0 LP 0 electric O 22) Other units
4.50
I hereby acknowledge that I have read this application, that the information 23) Gas piping one to four outlets
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of Own r/Agen� Date `
Minimum Permit Fee $25.00 SUBTOTAL
46` 2 7 f 8 5% SURCHARGE r 3� �,. 66
Conta =lame ( Phone C�p3) PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only I
T OTAL "`rk 0
22`{ "P�4 -y S'e.I zv -' ,
*State Contractor Boiler Certification required
"Residential A/C requires site plan showing placement of unit
I:\mechperm.doc rev 07/20/98