Permit Y OF TIGARD MECHANICAL
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1o1osownao�m.nnmm.o�m*n 97223.8199 }e� ) m��1r1 PERMIT # : MEC95-0219
639-4171 DATE ISSUED: 07/14/95
PARCEL: 1S1260C-01107
SITE ADDRESS...: 09625 SW WASHINGTON SQUARE RD
SUBDIVISION....: • ZONING: C—G
BLOCK ^ LOT ^
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1 CLASS OF WORK. .:ALT FLOOR FURN. EVAP COOLERS :1
TYPE OF USE.... :COM UNIT HEATERS.. : VENT FANS..
OCCUPANCY GRP..:B2 VENTS W/O APPL:1 VENT SYSTEMS :2
STORIES ^2 BOILERS/COMPRESSORS HOODS ^2
FUEL TYPES-- 0-3 HP ~ DOMES. INC IN:
:/GAS/ / / 3-15 HP : COML. INCIN
MAX INPUT: BTU 15-30 HP....: REPAIR UNITS:
FIRE DAMPERS?. .:Y 30-50 HP , : WOODSTOVES..
GAS PRESSURE. :11 504- HP..'': CLO DRYERS.':
NO OF UNITS---------- AIR HANDLING UNITS OTHER UNITS.:
FURN < 100K BTU: <= 10000 cfm :3 • GAS OUTLETS. : 1
FURN >=100K BTU: > .10000 cfm
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Remarks: Restaurant TI note! some items charged for on mec95-0136
Owner: — —_------------- ------- FEEq
L AND M DEVELOPMENT CORP' type amount by date recpt
3335 ,PARK DRIVE PRMT $ 25.00 CTR 07/14/95 —
PLCK $ 10.00 CTR 07/14/95 —
COLUMBIA CITY OR 97018 5PCT $ 1.25 CTR 07/14/95 —
Phone #: 397-0779
Contractor: — ---- —
DOLAN CONSTURCTION CO., INC.
3335 PARK DR
COLUMBIA CITY OR 97018
Phone #: 714-838-6444 $ 36.25 TOTAL
Reg #..: 106742
REQUIRED INSPECTIONG -------
This peroit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Heating Unt Insp
applicable laws. All work will be done in accordance with Fire Damper Insp
approved plans. This peroit will expire if work is not started Misc. inspect ion
within 180 days of issuance, or if work is suspended for more Final Inspect ion
than 160 days.
— — -
Permittee Signa
Issued By: °
Call for inspection — 639-4175
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City Of Ti MECHA PERMIT Pia c ec. #
13125 SW Hall Blvd. APPLICATION e - ir --,
Permit # r - °- =I
Tigard, OR 97223 /l
(503) 639 -4171 ` ) %G - O. I
Mow of Dovolosonord Description - -
c n.,.,� .....,A___ , Table 3A Mechanical Code QTY PRICE AMT
Al.if.M e
Job e‘ 4 '7 � P4' 1) Permit Fee -0- -0- 10.00
Address
MO / n:r12 2) Supplemental Permit 3.00
` rT � NNMS) Furnace to 100,000 B fU
L' ° D EFlc °/hair PAc /f /c 1) inc.!. ducts & vents 6.00
'"oira Massa P"01 Furnace 100,000 Bill +
Owner 7b0 s/ ,. 0 2) incl. ducts . vents 7.50
A la" a o Floor Fumance
5 ft7T( 6th'9 yeY/p S/ 3) incl. vent _6.00
Nom (« nitro a harms) Suspended heater, wall heater
Z 1/79 Q Q/6L O P4j8vl 4) or floor mounted heater ' 6.00
wary Occupant Manna """" Vent not incl. in
335 ph,e/( e ' /G� 5) appliance permit coobli• op Repair of heating, refng.
j e - umB//} Cny, qe 9 70/ ? 6) cooling, absorption unit 6.00
Boiler or comp, heat pump, air cond. _
, OQ(..A,) COAkSi C-120/-? 7) to 3 HP; absorp unit to 100K BTU 6.00
Mai "dd'°°° Phone Boiler or comp, heat pump, air cond.
Contractor 333s / AV( 0X • • 8) 3 -15 HP; absorp unit to 500K BTU 11.00
c ,, w ,„ ap Boiler or comp, heat pump, air cond.
G W4 Cocufrum Cry GuBus. e)A. 970 /i 9) 15 -30 HP; absorp unit .5 -1 mil BTU 15.00
t/ ]� Q t s� slate Napara°°n NO. q e. rate No. Boiler or comp, heat pump, air cond.
10(07 a . - 1l /-S 1, LILW 10) 30 -50 HP; absorp unit 1 -1.75 mil BTU .50
1 hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond. / / I ,
information given is correct, that I am the owner or authorized agent 11) > 50 HP; absorp unit 1.75 mil BTU 7,3 D
of the owner, that plans submitted are in compliance with State Air handling unit to R _ __ laws, that I am registered with the Construction Contractor's Board, 12) 10,000 CFM � � , _ — - — • . I , ''I
that the number given is correct (If exempt from State registration, Air handling unit _
please give reason below.) 13) 10,000 CTM + n -. 7.50
Non portable
14) evaporate cooler I 4.50 LI 1/
Vent tan connected
15) to a single duct 3.00
Ventilation system not
16) included in appliance permit /3 c p s 1 4.50 (-1 C)
� A ,4 r / p Hood served by
ffr micif /rI "`� c0 — / - 9S 17) mechanical exhaust; 4.
` "�cn .: w • new • a •neon • a teration •'r, repair • Commercial or industnal
to be don , residential 0 non - residential •.•1 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property D Clef 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets 1 2.00 frZ
building or property "..C_S /2f1
21) More than 4 -per outlet
Type of fuel - oil 0 natural gas p LPG 0 electric 0
NOTICE e-- % �l)
Minimum Fee $25.00 SUBTOTAL 'L5 i 0 r'''>k1'�(J
PERMITS BECOME VOID IF WORK OR CONSTRUCTION i �/
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE .f 7- 7
IF CONSTRUCTION OR WORK IS SUSPENDED OR I .!L /441
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WO IS COMMENCE / /,..---
v /ll TOTAL /4 /. - it
Special Conditions_
1-110;F late issued by (::. -
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