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CITY CF TIGARD MEPEAMTTAL
DEVELOPMENT SERVICES PERMIT #. . . . . . . : MEC98-0032:'
13125 SW Hall Blvd.,Tigard,OR 97223 (573)639.4171 DATE ISSUED: 01/29/98
PARCEL: 2SIlIBB-01700
SITE ADDRESS. . . : 1.4150 SW 103RD AVE
SUBDIVISION. . . . : TIGARDVILL-E HEIGHTS ZONING: R-12
BLOCK. . . . . . . . . . : LOT. . . . . . . . . . . . :001 JURISDICTION: TIG
------------------------
-------- ---------------
CLASS OF WORK. . :ALT _�— FLOOR FURN. . . . : 0 F_VAR COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTS W/O F',PPL_: 0 VENT SYSTEMS: 0
S f ORIES. . . . . . . . : Qi BOI1_.ERS/Ci1MF'RESSDF?3 MOODS. . . . . . . : P
TYPES------ ------ 0-3 F',P. . . . 0 DOMES. I NC I N: 0
FUEL
:GAS 3-15 rIF'. . . . ' 0 COMML. I NC I N: 0
MAX INPUT: 0 RTL! 10-31? HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : 0 WOODSTOVES— : 0
GOS, PRESSURE, . . r 50+ HP. . . . : 0 CLO DRYERS— : 0
NO. OF UNITS- - --- AIR HANDLING UNITS OTHER UNITS. : 0
TURN < 100K BTU- t <= 10000 c.f m: 0 GAS OUTLETS. : 1
�.1RN >=100K CTU: 0 ) 10000 cf m : 0
Remar-ks : Installing a furnace and gas piping
FEES ---------------
RICHARD JOHNSON type amount by date recpt
9812 SW KABLE LANE PRMT $ 25. 00 B 01/29/98 98-302885
TIGARD OR 97224 SPCT $ 1. 25 B 01/29/98 98-302885
Phone #:
Cont r'actor:
FITZPATRICK HEATING & ?FFRIGTN
77615 SW CHESTNUT STREET ----
$ 26. 25 TOTAL
TIGARD OR 97223
Phone #: 245-3870
Reg #. . .- 000527
--------- REQUIRED INSPECTIONS
---------
This permit i; issued subject to the regulations contained in the Gas Line Insp ---
Tigard Municipal Code. State of Ore. Epecialty Codes and all other Mechanical I 'sp ......
applicable laws. All work will be done in accordance with Final Inspect ion
approved plans. This permit will expire if work is not started --
within 189 days of issuance, or if work is suspended for more _ _______ ____ �_ _—• --- ----
t'ran IA days. ATTENTION: Oregon law requires you to follow rules
un adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-991-9919 through OAR 952-01-SOBA. You Bay
obtain copies of these rules or direct questions to Ol1NC by calling —�
7 15931246-9187. -
Lo -- -
J
�-� Permittee Signat�_tre:
i s �_t e '3 y
++++++++++++-F•++++++++++++++++++•F++++++++++++++++•+++++++4.+++++++++++ +++++++++++
Call 639-4175 by 7:00.1 p. m. for inspections needed the next bi_tsiness day
+++++++++++++++++++++++++++++++++++++++++++++++++4•+++++++++++++++++++++++4++4-++
Plan Check#
CITY OF TIGARD Mechanical Permit Application Recd 3y_
13.125 SW HALL BLVD. Commercial and Residential Data Read
T?jARD, OR 517223 Dote to P.E.-.--
(503)
.E. ,(503) 639-417,1, x304 Date to DST_
Print or Type Permit
Incomplete or illegible applications will not be accepted Called
Name of OevelopmenvPmlect Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee 0 -0- 10.60
Address Iof r S' '� , / p
Bldg# City/State i.ip 1.) Furnace to 100,000 BTU 6.00
/ 'J�',Vc including dud;&vents
Name(or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner " " ke �� H��U N including duds&vents
Mailing Address 3.) Floor Furnace 6.00
/ L e including vent
ity/ V+teip Pnone _ 4.) Suspended heater,wall heater 6.00
h 1) - �!3 or floor mounted heater
em (or name of business) 5.) Vent not included in appliance permit 3.00
v
OccupantMaillnq nd(Tr�sa 6.) Boik)r or comp,heat pump,air cond. 6.00
to HP;absorh unit to 100K BUT" _
Cny/Scare zip Ph.ne 7.) Boiler or comp,heat pump,air Gond. 11.00
_ 3-15 HP;absorb unit to 500K BTLI"
Contractor Name 8.) Boiler or comp,heat pump,air Gond. 15.00
/ ! 71--;,'C'1,( e r `ti 15.30 HP;absorb unit.5-1 mil BTU"
Prior to rermit illnq Ad as 9.) Boller or comp,heat pump,air Gond. 22.50
issuance,a copy , < 't�=ST n K T 30-50 HP;absorb unit 1-1.75mil BTU"
of all licenses City/State ZIP Prone 10.) Boiler or comp,heat pump,air cond. 37.50
are required if 7 1Av/� GI-) -�$ >50 HP;absorb unit 1.75 mil BTL,"
expired in COT orn�Ca. ,Corr.Board Llc.# Exp.Det' 11.) Air handling unit to 10,000 CFM 4.50
database
Architect Name 13.) Non-portable evaporate cooler 4.50
or Mailing Address u 14.) Vent fan connected to a single dud 3.00
Engineer c tyrState zip Phone 15.) Ventilation system not inrJuded in 4.50
_ appliance permit
UesoPtw _work New O Addkion O Alteration O Repair O iu.) Hood served by mechanical exhaust 4.50
to be done _ Residential _Non-residential O _
Additional Oescnption of work: 17.) Domestic incinerators 7.50
t2� 'u��.^�� 18.) Commercial or industrial type 3(1.OQ
�dlL C Iit,- e cJ u Incinerator _
Existing use of 7, 9.) Repair units- 4.50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer,etc. 4.50
building or property
22.) Other units 4.50
1
Type of fuel.oil O natural gas 9 LPG O electric O 23) Gas piping one to four outlets j 2.00
I hereby acknowledge that I have read this application,that the 24.1 More than 4-per outlets(each) / 50
information given is correct,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance with Or,gon State QTY.SUBTOTAL
la s.
tgnature of OwnerfAgent Date �. 'S1,BTOTAL
r`� T 5%SURCHARGE
Contact Porson ams Phone PLAN REVIEW 25%OF SUBTOTAL
TOTAL
t:vnechpmt.doc (rev 9 *Minimum permit fee is$25+5%surcharge
"Residential A/C requires site plan showing placement of unit.
. r
CITX Cr TIGARD BUILDING INSPECTION .DI'VISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
Date Requested: M. P.M. — MST:
Location: !�)5 5 ) I b 3 .•11 oL �v i _ BUR
Tenant: Suite: Bldg: MEC: —
h ! �:��9- ��/.3� PLM: ----
Contractor: ;-{�_I�.?�.r 'l.�t,�Uh—� Phon^:
Owner: _ Phone:
EI.R:
_ SIT: _
BUILDING BLDG(con't) PLUMBING C ECHANICAL ELECTRICAL SITE
Site Post/Beam Post/Beam I'nst/T3cam Cover/Service Sewer/Stony,
Footing Roof Undl'L/s1ah Rou h-In Ceiling Water Linc
Siab Framing Top Out ,as Lin�QT Rough-In UG Sprink;e'r
Foundation Insulation Sewer TToodTbuct Reconnect Vault
Bsmt Damp 1)rywnll Storm -Tum_�e� Temp Service MISC.
Masonry Ceiling Rain Thain A/C UG Slab
Shear/Sheath Fire Spkir/Alm Crawl/Found Ih�_.__.. (La'rump I:ow Volt _
Approved ApprovecQA tovc:d Approve 1 Approved
Appr/S(twlk Not Approved Not Appro+ed Notpproved Not Approved Not Approved
FINAL FINAL 7 ;' FINAL FINAL
t.�c_.�� T. -r�sT"' �Y ),,75-zL
—I�.41� S".� _ _y�Qi.e r-S L�L1et.2u�4�O•�.J 13siC� &D -
�� �i�i 6i�11�F�y ,�i,v�.,� i'•-153: �,.�.*fz� �SrJ--tS ----
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O Call for reins pec ' D Reinspection fee of S required before next inspection fl 1 Inable to inspect
Inspector:
Date- /— Cl J Page of_