10640 SW 72ND AVENUE-1 r
10640 SW 72nd Ave. "'
W 11 W I14rW.
CITY OF TIGARD MECHANICAL PERMIT ,
Permit# -�
13125 SW HALL BLVD.
P. O. BOX 23397 Description
Table 3A Mechanical Code _— OTY_ PRICE AMTTIGARD, OR 97223 _ - _
(503)639-4175 1) Permit Fee 0 0 1U.00
Name of Developmc of 2) Supplemental f ermit 3'00 -
-- - Furnace to 100,000 BTU 6.00
Jr'j Address 1) incl,ducts&vents _
".,jdress —-- Furnace 100,000 BTU +
Tax Lot Map No 2) 7.5
incl.ducts&vents
Lot Block "utd ivuwm
Floor Furnace 6.00
Name
�J/w name of business) r� 3) incl.vel tt
a^ u `✓r��� Suspended heater,wall heater 6.00
Mailing Address y �10fe 4) or floor mounted heater
Owner �l'�' �ee <.rZ4'• 7z _.
city/state 5) Vent not incl.in 3.00
appliance permit
-� Repair of heating,refr ig., 6.00
N me(or name of busines 6)
cooling,absorption unit
Mailing Address Phone 7) Boiler or comp to 3 HP 6.00
Occupant absorp.unit to 100,000 BTU
Zip 8 Boiler or comp to 3 HP-15 HP 11.00
cityrstate ) absorp.unit to 500,000 BTU
�.� 9) Boiler or comp 15-30 HP 15.00
Name absorp.unit 1/2-1 million
Boiler or comp to 30-50 HP 22.50
Maillnp Addrrito Phone 1-71 1U) absorp.unit 1-1.75 million
3--:?o ,o4t1.1r7, �Q Boiler cr comp to 50 HP
Contractor City/State zip 11) 31.50
/�L�T/� 04 M. absorp.unit 1,750,000 BTU
ci Bus.Tax No. Air handling unit to 4.50
State Registration No. 12) 10,OOJ CFM
4-'l Air handling unit 7.50
I hereby acknowledge that I have read this ippliention that the information given is 13) 10,000 CFM +
correct,that I am the owner or authorized agent of the owner,that plana submitted are In
compliance with Slate laws,that I am registered with the State Builders'Board,that the 14 Non portable 4,50
number given is correct.(If exempt from State regVration picase give reason helow). ) evaporate coeler
15) Vent fan connected 3.00
-- — - to a single duct _
16) Ventilation system not 4.50
included in appliance permit
Hood served by 4.50
mechanical exhaust _
Signature(ownor or agent) -- -'---^— -- - Date 18) Domestic type 7.50
Incinerator
Describe work ❑ addition ❑ alteration Elrepair ElCommercial or industrial
to be dnne residential ❑ _ non-residential Ll 19) 30.00
type incinerator
Existing use of Othel i.e.,woodstove,water 4.50
building or properly - 20) heater,solar,clothes dryers,etc.
Proposed use of D°
building or property 21) Gas piping one to four outlets 2.00 Z
Type of fuel- oil ❑ natural gas t_1 LPG U electric O I
22) More than 4-per outlet
NQTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON 576 SURCHARGE �)
SI RUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ —
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED For A PERIOD OF 180 DAYS AT ANY TIME AFTER TOTAL7f C
WORK IS COMMENCED. --- -
Special Conditions
Da issued--- - --- __by_ — --
INSPECTION NOTICE
City of Tigard Building Department
P.O. Box 23397
Tigard, Oregon 97223
DhonP: 639-4175
Type of Inspection ���— -------- ----- --
Date Requested
//�t/ �`? Time, A\ A.M. P.M.
Address
/l /�7 L Permit # -F
Owner_ lot #
BuilderL1L_ —
The following Building Code deficiencies are required to be cr.i,ezte+
Presented to _� <— __ — kApproved
Inspector _ �� y 1�— ❑ Disapproved
Date _ — —� - ----
CALL FO:-
ZINSPECTION
(=] YE8 ❑ NO
CITY OF T1GA MECHANICAL PERMIT
��, RE:RMIT NO. : ME832139
CITYoi n6ARD
COMMUNITY DEVELOPMENT DEPARTMENT ONFOON D TE ISSUED: 10/16/89
13125 S.W Hall Blvd P 0.Dox 23397,Tigard,Oregon 97223.15031639-4175 �i I M PMT.NO. 832139
JOB ADDPESS: 10640 SW 72ND AVE
TAX MAR/LOT SUET: L1': BK:
LAND II,E:
LOT S 'E:
ITEM: NO: NO:
WORK CLASS: ALTERATION FURNACE (100K 1 AIk HANDI._R <10
USE TYPE: SINGLE FAMILY FURNACE 100K+ AIF; HANDL-P 10K
CONST.TYPE: FLOOR FURNACE EVAR.000LER
OCCUR.GRP. : HEATF"R VENT FAN
VENT VE NT.SYSTEM
PLR/COMP (3HP HOOD
NO.STORIES: BL.R/COMP 3-15HP INCINERATOR(DOM
DWELL.UNITS: BLR/COMP 15-30HP INCINERATOR(COM
FUEL TYPE PLR/COMP 30-50HP REPAIR UNITS
MAX. INPUT BLR/COMP 504-HP OTHER
FIRE: DMPRS? GAS PIPING OUTLETS 1
HIGH PRESS?
LOW PRESS?
REMARKS:
FEES:
C1 IindgLie$ter ron PERMIT g10,0O
W
N 10640 sw 72nd ave PLAN REVIEW
R tigard or 97223 FIXTURES E8,0q
STATE TAX 11;,90
OTHER
O ARROW MECHANICAL
N
t ARC'OW MECHANICAL
R 10290SW TUALATIN RD
C tualatirl or 97062
T PHONE (503) 692- 1565
R REGISTRATION NO. 5193—— TOTALe X18.98
RECEIPT_N0.
This permit is issued subject lathe regulations contained In Title 14
of the I'MC. State of Oregon Specialty Codes,toning regulations REQUIRED IN��ECTIONS
and all other applicable codes and ordinances, and It Is hereby GAS LINE
agreed that the work will be done In accordance with the plans and
specifications and In compliance with all applicable codes and
ordinances The Issuance of this permit does not waive restrictive
covenants Contractor and subcontractors shall have current city FINAL
business tax permits This permit will expire and become null and
void If work Is not started within 180 days.or if work Is suspended or
nhandoned for a pnrlod of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approved
Permittee Sign tire
Issued By CALL FOR IN3.pECTI0N 6:I9-4175 _-- _
SEPARATE PERMITS REQUIRED FOR WORK OTHLt: THAN DESCRIBED ABOVE