Permit CI OF TIGARD PERMIT' # MECHANICAL
PERMIT° MEC95 -0056
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/16/95
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171
PARCEL: 1S1260C -01107
SITE ADDRESS ° °.: 09659 SW WASHINGTON SQUARE RD
SUBDIVISION ZONING: C —G
BLOCK LOT
CLASS OF WORK.. :ALT FLOOR FURN EVAP COOLERS:
TYPE OF USE °COM UNIT HEATERS °.: VENT FANS... :1
OCCUPANCY GRP. ° :B2 VENTS W/0 APPL: VENT SYSTEMS :2
STORIES : 1 BOILERS /COMPRESSORS HOODS
FUEL TYPES 0 -3 HP 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 :1 GAS OUTLETS °:
FURN > =100K BTU: > 10000 cfm:
Remarks: TI
Owner: FEES
SAM GOODY C/O STATE PERMIT type amount by date recpt
PRMT $ 29.50 JD 06/16/95 95- 266891
PD BOX 0224 PLCK $ 7.38 JD 06/16/95 95- 266891
KENOSHA WI 53141 SPCT $ 1.48 JD 06/16/95 95- 266891
Phone #: 800 -432 -2597
Contractor:
PROTEMP ASSOCIATES INC.
807 N. E. COUCH
PORTLAND OR 97232 -- --
Phone #: 233 -6911 $ 38.36 TOTAL
Reg #° ° : 38868
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 more
than 180 days.
Permittee Si nat�_�re 41011P 9
a •
Issued rof
Call for inspection — 639 -4175
. 07./21/95 10:29 /2503 684 7297 CITY OF TIGARD 12 1003/003
• .
City of Tigard MECHANICAL PERMIT Planck/Rec. # C ( 5b
13125 SW Hall Blvd- APPLICATION Permit* i
Tigard. OR 97223 -
(503) 6394171 • •
. . r 1•+.111...4 +6444 GOOF f Table 3A Mechanical Coda CITY PRIM AMT
Job !'' b vJ, . 4scitM 2 • 1) Permit Fee . -o- 10.03
Address m - -
...�, L ► . . - ' 22. m
T 2J Supplemental Permit . 3.00
. _.
la t.k4B4Q._ ?Ifo /2y.3 _ 450 1) ind. ducts 5 wants ' 6.00
+� Furnace 100,000 URI + ����
Owner _ p G,'I'ti AVE,. •7(� Z&40t, 2) k. is & ventS 7.50
ocean Cdr.. 4 a�Lo 4 3) Ind. vent - 6A0
Suspended heater. tall heater
APT Abl or-
�,. • 6 F'ar 1.i' 6-1 4) or door ranatvd heater 6.00
" ltiy n44;,� .m+ Vent not me. of
OCCUpard Zoe - 30 } 4 a22 8 � / � k3 _�_ _ 5) a nt
pe& 9.00
'_'� Pieper at har mg. tatng.
Vf-41064A , VI t " 0 1 2 7 141 6) cooing. Wastrel= unit 8-00
' ..� ewer or seep. treat pomp. or tom
117A7 l 17+ o {�QAm /A UC , 7) m 3 HP; abmtp tacit m at 100K DIU 6.00
.m... 1 coder or comp. M puma elf cond.
Ccnb Ct0t X07 N F G� +. 8) 3-15 HP; abs rp wait m 5011K BTU 11.00
ewer or comps pump. or cond.
zcl i. ot 1 7231 W - Oil 9) 1530 HP; absarp rink ,5.1 mI BTU 15.00
�J:�.. Hover or camp. ham pump. 0.r cond.
10) 3050 HP: absorp unit 1-1.75 mil 131U 2250
I rummy esietowledge that I have read thus applcaUOn. that the doter or comp, teem pump or oond.
anfonnadon given Is correct. that I am the owner or authorized agent 11) a 50 HP; abeorp wit 1.75 mil BTU 37.50
of the owner. that plans submitted are in =enplane; with State Air honeying una to
Wm. that I am registered wdh the Construction Contractor's Bawd. - 12) 10.600 CFM 050
that the number gkven Is coned. (If amnia tar Stata registration. Ar henpeg unit
please give mason below) 13) 10.000 CTIA + L 7.50 — 1 <o
• Non portable
14) evaporate soaler 4 .50
i / vent tan connected
-111"' � � - ) .
4 - - 7-
4 -- 2497 15) to a sirs* duct 3.00 3 Q,d
.�' apply / 1c / N O venom= cot •, -\ ' t7.6 16) • Included In applanoe ' Bo K 2 2 4S0 q Mod served try
• S 17) medtankal exhaust 4.50
Demme° worts nag Q wait= U �I> repair () Gommeroal or mdusotaF
to be done residential 0 non - residential 0 18) type incinerator 30.00
_ Rusting use of Other L e., woodstwve. water
building or property T � , � — 19) heater solar. dothee dryers. eta 4.50
•
Proposed use of '�% 4 - 20) Gas piping one m tour outlets 2.00
building property g 21) More than 4-per outlet
Type of fuel - el 0 natural gas 0 LPG 0 electric * ►
Mt E
Minimum Fee 325.00 SUBTOTAL 0—.1. 29,3
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED tS NOT COMMENCED WITHIN 190 DAYS, OR 5• SURCHARGE 9 9
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL 7 3 0_,
AFTER WORK IS COMMENCED. — /
• TOTAL i ..
S Condaons .....----0N....7--- penal
Data issued by --
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