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CITY OF T MECHAN I CAL,
DEVELOPMENT SERVICES PERMIT
13125 SW Halt Blvd., Tigard,OR 97223 (503)639.4171 E,`-RM I T #. . . . . . . : MEC97••-0036.
r)ATF ISSUED: K:11.8/97
PARCEL: 2S102BD-00801
I'TE ADDRESS. . . : 12650 SW GRANT AVE
+JBD I V I S I ON. . . . : NO. T•I GARDV I I_LE ADT)T T T.ON AMEND. ZONING- R---12
1...00F!. . . . . . . . . . . L_C1T. . . . . . . . . . . . .
'..ASS OF WORK. . :AL..T FI_.00R FURN. . EVAF' COOL.ERS: 0
YPF_ OF USE. . . . :SFA UNIT HEATERS- -. 0 VENT F-ANS. . . : 0
)CCI.IP"INCY GRa R3 VENTS W/O APIPI...: 0 VENT SYSTEMS: Vi
sTORIE.S. . . . . . . . : 0 BOIL.ERS/COMPRESSORS HOODS. . . . . . . : 0
1 UEl_ 0-3HP. . . .. 0 DOMES. I NC I N: 0
' /GAS/ / / 3-17 HF-. . . , : 0 CCIMML. I NC I N: 0
MAX INPUT: 0 RT..I 15--31,, HP. . . . : 0 REPAIR UNITS. 0
FIRE DAMPERS?. . : 30-•50 HF'. . . . : 0 WOODSTOVES. . : 0
F 1)9 50+ HF'. . . . ; 0 CL.O DRYE'.RS. . : 0
NO. OF UNITS----_--------- AIR HANDL_.I NG UN I'TS OTHER UNITS. : 0
F-'URN ( 1.001.11 BTU: 1. <.-= 1O000 cfm : 'A GAS O+_1TL_.F TS. : I
FURN > -tOOK PTU: 0 > 1.0000 cfm : 0
1,,emar•ks : Installing fi_rrnace to 1.00, 000 BTUIs and gas I-) ipi.ng
"ARRF ISI PROPERTIES I-1..0 type amoi..rnt 1i date recpt
v
1280 SW GOTH AVE PRMT `t; y. 0V, B 02/18/97 97-2904LII
'0PTL.nND OR 972E'31
'hone it:
'ontract c,r:
OUTHVIEST SHFET METAL..
1.0415 SW 72ND
,URT•LAND OR 9722:",
'hone #: `54'+? �:.'4E, f,;'r',�,. t PF-,. 25 TnTAI_
REQUIRED INSVI CTIONS
`his pewit is issued subject to the regulations contained in the Gas Line Insp
xgard Municipal Code, Stete of Ore. Sperialty Codes and all other Mechanical Insp -- _
,pplicable laws, All work will be done in accordance with Final inspection
approved plans. phis pEreit will Pxpire if wv+ is not started
within IN days of m9a0ce, or if work is suspended for sore
"a+ IN days.
A4 . ......
Call for inspection — 639-4175
Plan Check#
CITY OF TIGARD Mechanica; Permit Application Recd By 6 � A.-
13125 SV: HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P 2
(503) 639-4171, x304 Cate to DST
Print or Type Permit# tt�C'47 CCS
Called
Incomplete or illegible applications will not be accepted
(� Name of DevalopmenuProiect - Description
ble I tion
Table A Mechanical Code uT`r PRICE AMT
Job Street Address n.l mea A) Permit Fee 0 -0- 1000
Address
L— al C ty'stete /;•ip B) Supolemental Permit 300
�t (T Y71z _�i
Name for name of businesel n 116 to 1 Furnace to 100.000 BTU 600
Owner
-t wwlrv,( rnf t ncl ducts&vents
�T _ _
Mallin q.tddrots 2) Furnace 100,000 BTU+ 7 50
ncl ducts&vents
Cdy/5tats Zip Phone 3 1 Floor Furrace� 600
( I E)/ v C 7 j. incl vent
me
Na ( name of businesl) 4) Suspendeo healer,wall neater 600
or floor mounted heater
OccupatA Mailing Address 5) Vent not incl.in 300
appliance permit _
City/State Zip Phone 6) Boder or comp,heat pump,air cond 600
to 3 HP absorp unit to 100K BTU_
— Name 7) Fioder or comp,heat pump,air cond' 1 i 00
3-15 HP absorp unit to 500K BTU
Contractor Mailing Address 8) Bnder or comp,heat pump,air cond. 1500
& , S �js(� �� I 15-30 HP.obsorp unit 5-1 md'STU _
(Prior to city joe Zia Phone ,/ 19) Boder or cn:�ip,heat pump,at, cond. 22.50
issuance a copy J✓ -ly4 b�gr7 313.50 HP, absorp unit 1-1.75 and BTU _
cf all licenses are O orlonat.Cont.Board Lic.x Exp.Date 10) Boder or comp,heat pump,air cond. 37.50
required 4 j(/ >50 HP,abaorp unit 1 75 and BTU
expired in C O T CDTCusneis Tax orMetroa p.ONa 11 ) Air handling unit to 4 50
data teasel I I 10,000 CFhi
Architect Name 12) Air handling unit 7 50
10,000 CTM+ _
or Mailing Address 13) Non portable 4.50
evaporate cooler _
Engineer CtyiState Zip Phone 14) Vent fan connected 3.00
_ to a single duct _
Describe work New O Addition O Alteration 0 Repair 0 15) Ventilation system not 4 50
to be done Residential O Non-residential O included m appliance permit _
Additional Description of work 16.1 Hood served by mechanical exhaust 4.50
_171 Domestic incinerators 750
Existing use of --T 18) Commercia dustnaltype 3000
building c!property�l1O U 1 �� incinerator
19) Repair un,s 4 50
r ,prised use of
20) Woodstove 450
t,uilding or property
21) Clothes dryer,etc _ 450 —
Type of fuel-oil O natural gas PG O electric O 22) Other undd 4 50
I hereby acknowledge that I ha,,e read this application,that the 23) Gas pioing one to four outlets 2.00 2
Information given is orrect,that I am the owner or authorized agent of
the owner,tt�iat P1,09 su itted are in compliance with Oon S`la 24) More than 4-per outlet (each) 50
laws d ` - I. t J_.- i L 1
11j L �a
Signature of Owner/Agent Date Qn SUBTOTAL
SUBTOTAL
Contact Person Name °hone 5%SURCHARGE 2S
PLAN REVIEW 25%OF SUBTOTAL
—TOTAL �I
P\dsftmechpmt doc (rev 7198) 'Minimum permit fee is S25+5%surcharge