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11325 SW BASSWOOD COURT
CITY OF TIGARD MECHANICAL
FCRM I 1'
COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #. . . . . . . : MEC96-0308
13126 SW Hell Blvd.Tigard,Oregon 97223.8199 (503)639.4171 DATE ISSUED: 09/05/96
PARCEL: 1SI34AB-0::000
S I 11_. 1,:,, :tj SW 1:+k5SWOOD C 1
SUBDIVISION. . . . : ENGLEWOOD ZONING: R-4. 5
'il_.00:K. . . . . . . . . . . LOT. . . . . . . . . . . . . :77
------------------------------------------------------------------
CLASS OF WORK. . :ADD FLOOR FURN. . . . : 0 EVAf COOLI RS. 0
"i YPE OF USE. . . . :SF UNIT HEATERS. . : 0 :'ENT FANS. . . : 0
CICLUPANCY GRP. . :R? VENTS W/O APPI-: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FULL TYPES--___._.__._.___. 0-3 HID. . . . : 0 DOMES. INC1N: 0
• 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UN I T5: 0
F IRE: DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS---------•--- AIR HANDLING UNITS OTHER UNITS. : 0
F'URN ( 100K BTU: 0 <= 10000 cfm : 0 GAS OUTLETS. : 1
FURN )=100K BTU: 0 > 10000 cfm: 0
fr?marks : Installing gas piping for gas range
(.1wner: -------____.______.__._______.__.____________._ FEES
JOHN WINTHROP, type amount by date r ecpt
11325 SW BASSWOOD C PRMT $ 25. 00 B 09/05/96 96-283634
TIGARD OR 97223 SPCT $ 1. 25 B 0: !/05/96 96--2836.34
I-1h on e #: 590-5425
Contractors _----- -----.__..-•---_.___..___.__....--
HCILMES INSTALLATION SERVICE
RAYMOND FLANDERS
200 SW 141ST AVE #55
BEAVERTON OR 97005 ___._-_.-------------.____.---...--------.-.._
Phone #: : 26. 25 TOTAL
Reg #. . s 102473
-------- REQUIRED I NSPECT I GINS - ---
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspectionapplicable laws.laws. All work will be done in accordance with
approved plans. This pereit will expire if work is not started
within 18N days of issuance, or if work is suspended for morethan 1110 1118 days.
er•mittee SiqAatUtle , /L
I s s u a d B y : _ .__r � Vii' . ll,�
Call far inspection - 639-4175
Application Plan Check*
CITY OF TIGARD Mechanical Permit A _
Pp Recd
13125 SW HALL BLVD, c'
Commercial and Residential Date Reecd _
TICARb, OR 97223 Date to P.E.
(503) 6394171, x304 Date to DST
—
Print or Type Permit 111 CC 70--
Incomplete
-Incomplete or illegible applications will not be accepted called
Name of DevelopmenVProiect Description
Table to Mechanical Code OTY PRICE AMT
Job Street Adtlreu SuAee A) Permit Fee _---
Address Al f� j �, QS t..k v (► 10.U0
logo 44/stau( Zlp B) Supplemental Permit--- 3
ft,r3 ) 1 l-�
00
dame la name of business
/ 1.) Furnace to 100,000 BTU
Owner incl.ducts&vents 6.00
r Mauling Address r lC' ^^ 2.) Fumace 100,000 BTU+ 7.50
S �Z' S ��' o U C 1 incl ducts&vents
iSt°ts Zippie _ Furnace
--- _
I ` r CTL 3) Floor Furnace``
jL 1 incl vent 600
Nam for name of business) 4) Suspended heater,wall heater —'
Occupant Mailing Iddress or floor mounted heater 6
V.1`..t_ /�S 'pA ��,� 5) Vent not n .in 300
appliance peimd _
Catyistele Zip =Phone— Boller or comp,heat pump,air cond.
6.00
to 3 HP,absorp unit to 100K BTU
4AS 7) Boiler or comp,heat pu mp,air Gond. 1100
3-15 HP,absorp unit to 500K BTU
Contractor Mailing Address�- 6) Foliar or comp,heat pump,air Gond. 15.00
15-30 HP,absorp unit.5-1 mil BTU
Attach copy of yrstat r r Zp Phone 9) Boiler or com heat um air Gond
Current licenses s*ti to,"i Y ,' �.11.- r + �j y y( �`:f'! p' o p 22.50
30-50 HP;absorp and 1-1 75 mil BT
Or on const Cont pard Lic N Exp gate 10) Boiler or comp,heal pump,air Gond.
37.50 --
� f �' >50 HP;absorp unit 1 75 mil BTU
CUT Business Tax a Metro a Ex-p'�-D-a`te-f- 11.) Air handling unit to
_ 4.50
- 10,000_CFM
Architect N°n1° 12.) Air handling unit
7.50
10,000 CTM+
Or Mailing Addrow
13) Non portable 4.50
evaporate cooler
Engineer crtyrstate A-- zp Phone 14) Vent fan connected
��_ 3 00
to a single dud
Descnbe work New U Addition Alteration O Reoalr U 15.) Ventilation system not 450
to be done Residential O Non-residential O included in appliance permit
Additional Description of work (I 16) H
cclod served by
1 u l
mechanical exhaust 4.50
F*- P(A-Af 17) Domestic incinerators --
7.50
Existing use of _
building or property.__
16) Commercial or industrial - 30 00
type incinerator
19) Clothes dryers,etc 4 50
Proposed use of 20) Other units i4 50
building or property_
Type of fuel-oil O natural gas LPG O electnc O 21) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application,that the 22) More than 4-per outlet leach) 50
infofmaGon given is correct,that I am the owner or authorized agent of
the owner that plans s bm ed are�in compliance wp, rego Sta
laws de QTY,SUBTOTAL
. . 1
Signatu of dwiedAgent ate 'SUBTOTAL
5%SURCHARGE
Contact rson Name Phone
PePLAN REVIEW 25°te OF SUBTOTAL
rklst4nechpmt.dgc -- — — _ TOTAL
Rev 7/96 'Minimum permit fee is$25+5%surcharge