Permit ,.'
CITY TIGARD MECHANICAL PERMIT
'' I�` DEVELOPMENT SERVICES PERMIT #: MEC1999-00218
�,� � 1,:, 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/9/99
J PARCEL: 2S113AB -01201
SITE ADDRESS: 16260 SW UPPER BOONES FERRYRD
SUBDIVISION: FANNO CREEK ACRE TRACTS ZONING: I -L
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 3 DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: M 50 + HP: WOODSTOVES:
FURN < 100K BTU: 3 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm: GAS OUTLETS: 1
Remarks: Mechanical TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Type By Date Amount Receipt
15350 SW SEQUOIA PKWY PLCK GEO 6/9/99 $14.25 99- 316004
STE 300 PRMT GEO 6/9/99 $57.00 99- 316004
TIGARD, OR 97224 5PCT GEO 6/9/99 $2.85 99- 316004
Phone: 624 -6300 Total $74.10
Contractor:
PROTEMP ASSOCIATES INC
807 NE COUCH
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 233 -6911 Mechanical Insp
Reg #: LIC 00038868 Duct Inspection
ELE 201JHA S.D. Shut -down
Final Inspection
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ORIGINAL
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 copi these :'es or direct questions to OUNC • calling (50 )246 -9189.
Issue By: / Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections need: • the next • usiness day
Plan Check # - 5
CITY OF TIGARD Mechanical Permit Application Recd By 5G )
13125 $W HALL BLVD. Commercial and Residential Date Rec'd ' ° - 1/
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST 1 2g[ r
60 �p/�' Print or Type Permit # fAEC(' ry - 002.('6
Called G-8-5.
CO plete or illegible applications c � will not be accepted 4,0.4.e_ r
Name otDevelopme /
t 2J 2r O PAQ,,r Table 1A Mechanical Code OTY P - ICE AMT
Job Street Address Surle# ' A) Permit Fee -0- -0- 10 00
Address /Q 5 SookE5 Fc"gRr
Bldg# City /State Zip 1) Furnace to 100,000 BTU 4 6.00 Q
77 , ?i7 .0) including duds & vents L D
Np or name of business) 2) Furnace 100,000 BTU+ 7.50
Owner -/-q G 7•• j including ducts & vents
Mailing Address "0 3.) Floor Fumace 6.00
f 577G731 /UC l61 r 4 .-c, including vent
Ci sta ,Q Zip Phone 4.) Suspended heater, wall heater 6.00
( 44 t • q7 U (0Z ' or floor mounted heater
Name name of business) 5) Vent not included in appliance permit 3.00
Y�U
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /state Zip I Phone 7) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. - 15.00
(Prior to j" 2oTc,49P 4SS ®L. Tx.)c. 15-30 HP; absorb unit.5 -1 mil BTU"
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant 'C'7 R/ LQ'j',r,/ 30-50 HP; absorb unit 1- 1.75mil BTU"
must provide all 9.iNSiaie Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor - p rzit1 BD &? ` 7c23V c233-air of > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Const Cont. Board Luc # Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
information 3$ 86. g ..- $ -61
for COT COT Business Tax or Metro # Exp. Date 12.) Air handling unit 10.000 CFM 7.50
database). e,/S .--
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer Crty/State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration e' Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non-residential jie
Additional Description of work 17.) Domestic incinerators 7.50
-
18.) Commercial or industrial type 30.00
PeeIA0 IDidUt *,pl• 4 u Incinerator
Existing use of vV 19.) Repair units 4 50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units A 4.50 /,
Type of fuel - oil 0 natural gasfe LPG 0 electric 0 23.) Gas piping one to four outlets • �/ 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
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 ✓ 1 /
laws.
Signature of Owner /Agent Date 'SUBTOTAL
°4;( 6h1 5% SURCHARGE
Contact Person ame Phone PLAN REVIEW 25% OF SUBTOTAL l y
TOTAL (,�
J mY WOAJ r C73Z -X911 . 7 161
OdstUnechpmtdoc (rev 9
t ii imit ilinim . um permit fee is $25 +
"Residential 5% A/C surcharge req uires site plan showing placement of unit
c 5 - 4/ /1°461-
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