11523 SW PACIFIC HIGHWAY -" 11523 SW PACIFIC HWY
ME.01ANICAl PIEPMI'T
CI7Y OF T'GA RD NO. : ME890321.
CITY01i'MAD
COMMUNITY DEVELOPMENT DEPARTMENT 00110001
13125 S.W.Hall Blvd.,P.O.Box 23397,Tigard,Oregon 97223.(503)6394175 L.;!ii IJEED : 2/22/89
I (I IAWI
I-OND
'I' NEW NO
ALTEAVVITON FIANDI 1:4 <1 0
I YVIE* ' F01:4NAC'E: 11.001<4 1. ASP 1AANDI-f4 101(
IleplT ..
WK04 F F AN
VT.'NT M:*N I . SYSI 1::.M
11-411.JOD
P INCAME-KRAI OP MOM
OWFA.I.. t.)N.1' i,!:i 0 1 A F J:N(:,']:Nl*.-*.,1:4A'T'(:)R MOM
TYj:tl:: A i '30--'-b0HP UNIA5
'IAX . :I'Nl::,(.)T' U I HEA
GA15 PTIPINt'; 01.11VE'A'S I.
U-4-41144
1.4 E,M 1)1:4 K 5
W I.,I:,,(.)N 1 1:" ITN 1' 4110 0 o
N 1 :1 !:,W I[' I My FSI..A 1`4 Vl E"V 1.E.W
E
R 1 .1('-APE.) 014 97�.Ie.M I TX H 1411-:5
I+A*1 F'. 'TAX $1. k2o
C
0
N 0AV11.)
T [:I0Iff!F.:.N 011- (:1)
R
A 1" 0 DOX .1,10:36
G I POV41 T 1 .0)ND 97c!1 11
T
0
R
;')I'PeAt"I'TON NO 100/1 TO TAL r.-?5 ii?0
This permit is issued subloct to the regulations contained In Title 14 PF;:(:,E:J1"'*1NO
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and It is hereby 1'I`QU:I*I:fl;:.I:) I NS PE'UT1(INS
agreed that the work will be done in accordance with the plans and
specifications and in compliance with all —3plicable codes and
ord!nanceq The issuance of this permit does not waive restrictive IAN(:,I... 11YSITA
covenants Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and I Wit.
void if work Is not started within 180 days,or If work is Suspended or
abandoned for a period of 180 dayv any time after work has
commenced It shall be the responsibility of the permittee to assure,
all re red inspections are requested and approved.
. I 144-1
Per RittF!Signatu
Issued By
SEPARATE PERMITS REQUIR'FD FOR WORK OTHER THAN DESCRIBED ABOVE
r
LA 1 Y Ui- 6 IUAKU MECHANICAL PERMIT Permit Nn i - -
w.crlptlon
Table 7A MacMn"Coda OTY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
RO Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
6,49-4175 Furnace to 100,000 BTU
I) incl.ducts&vents 6'00
i F urnace 100,000 BTU + _ 750
incl.ducts R vents L 7
r Name ofev lopnern_ �. 3) Floor Furnace 6.00
i �I� 1 incl.vent
Job Address Suspended heater,wall heater
`'- 4) or floor mounted heater 6'00
Addross 1 , Qt 1�to-. _---- - - --
Tax lot Map No. Vent not incl.in
Lot Block subdivision 5) appliance permit _ 3.00
--
N name of business) Repair of heating,refrig.,
6) cooling,absorption unit 6.00
co
Mai*9 Addirm ptwm 7) Boiler or comp to 3 HP 600
Owner f 2C 15'i1.,! 19 _absorp.unit to 100,000 BTU
ci /State �•7/U Boiler or comp to 3 HP-15 HP
8)
absorp.unit to 500,000 BTU 11.00 —
_ Ns,,,. Boiler or comp 15-30 HP
rSLIM?4) f,&r G 9) absorp.unit'A-1 million 15.00
Maikrg Address � D Prwns
Boiler or comp to 30.50 HP
10) absorp.unit 1-1.75 million 22.50
Contractor Cltyi Boiler or comp to 50 HP
_ 11) absorp.unit 1,750,0008TU 31.50
State Registration k4,/G1�S", cky t a.1w No. 12) 10,ir 0000 CFMunit to -- G.50 t
OG��C7! 7� J f,
I hereby acknowledge that I have read this application that tx Information given is 13) Air handling unit 7.50 [,
caned,that 1 am toe owner«eutoriisd agont of the owner,that plain autxhhittad are In 10,000 CFM + ----
compliance with State laws,that I am registered will,Uhe Slala BuNde"'Board,that tM Non portable
number given is coned.(11 exempt from;tate registration please give reason below) t 4) evaporate cooler 4'50
_
1'5) Vent fan connected
L to a single duct 3.00
Ventilation system not
16) included in appliance permit 4.50
Hood served b odb
17) mechanical exhaust 4.50
Sig al a(owner« nQ L Dale Domestic type
Describe work O addition [I alteration C3 repair ❑ 18) incinerator 7.50to be done residential ❑ non-residential ❑ Commercial or industrial
- -- 19) type incinerator 30.00
Existing use o1 _� _
building or properly _ ) Other i.e.,woodstove,water 4.50
Proposed use of
_20 heater,solar,clothes dryers,etc.--- --
buildinc or property_ 21) Gas piping one to four outlets 2.00
Type of fuel- oil 1-7 natural gas ❑ LPG ❑ electric []
22) More than 4-per outlet
NOTICE SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- --- -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ S% 446 SURCHARGE
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 - -
WORK IS COMMENCED TOTAL
Special Conditions
f)alr.issued