10650 SW 121ST AVENUE-2 r
10650 5W 121ST AVENUE .�
CITYOFTIFARD ME::CHANICAL PERMIT
cay&n Arta PE=RM T T NO . : ME891()49
COMMUNITY DEVELOPMENT DEPARTMENT \ OREGON
13125 S.W.hall Blvd-'1.0.Boy 233 7 p,ard.Oregon 97223.(503)639-4175 \, DATE 1 S SUED : 5/ 9/89
891 OA9
I
JOB ADDRESS •1;.650 ,W 121ST AVE.
TAX MAP!'_O'T SUB : L..T 1:-V
LAND
LOT SIZE:
ITEM: No NO.
WORK CLASS : AL-,EPATION FURNACE <1.00K ATR HANDLP <'.I 0
USE TYPE: 5+ FAMT:LY FORNACE 10OK4- AIR HA':E)l_R 10K
CONST , TYPE: i i..00R FURNACE E::VAP . C'OOLE1I
OCCUP. GRP. . HEATER Vr_.N'T' FAN
VENT VE::N; SYSTEM
BLR/COMP <31•4P HOOD
NO. STORIES : BLP/COMP 3-1.51-11P INCINF..'RATOR(DOM
DWELL.UNTT!*, PLA/COMP 15•-30HP INCINE PATOR(CUM
FUEL 'T'YPE HLP/COMP 30•--501-0) QEPAIR UNITS
MAX . INPUT DLP/COMP 50.1-1-IP OTHER
FIRE DMPRS'{ GAS PIPIN.; OUTLETS 1
HIGH PRESS'?
REMARKS :
GAS LINE. FOR POOL.
O
WGLE:NSOROUGH MTG. c ORFS prRMI i •10 . 00
6700 SW 109TH AVE
E PLAN RE:V.[FW
R TIGARD OR 972P3 FIXTURES $3. 00
A2. 00
STA'`'E TAX
—�� —
OTHER
C
O
N NORTH WEST POOL SERVICE-
R
ERVICEF NUP-1H WEST POOL SEIIVICE
A 9911 SW OAK S','
C T-IGINPU 01-19'72i?3
T
O PHIONE (903) 249-1.18a
R REGISTRATION NO. NWPOOL.
_ _-- TOTAL : +118 . 60
This permit is issued suolect to the regulations contained In Title 14 RECEIPT NO.
of the TMG State of Oregon Specialty Codes,toning regulations
and all other applicable codes and ordinances, and it is heret•v REQUIRED INSPECTIONS
agreed that the work will be done in accordance with the plans And GAS L IKF:.
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
business tax permits This permit will expire and become null and
void if work Is not started within 180 days.or II work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the Permittee to assure
Fill required Inspections are requested and approw,cl
Permittee Signature
C l
Issued By /xk
CALL FOR INSPECTION 6:39-417"1
SEPARATE PERMITS REQUIRED FOR WORK OTHF_R THAN DESCRIBED ABOVE
Q fl![ W WIN
U1 I Y UI' I IUAHU MEGHANVi FAL PERMIT Penni) NM
Description
Table]A Mectwnkal Cods OTY PRICE AMT
City of Tigard
1,3125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 — _ - ----
Tigard, OR 97223 2) Supplemental Permit - 3.00
639-1175 Furnace to 100,000 BTU
1) incl.ducts&vents _ 6
Furnace 100,000 BTU +
2) incl.d_urts 8 vents 7.50
Name o(Develorxnent Floor l,'-trnace l
3) 6.00in6.vent
Job metas41 St,vended heater,wall heater
Address �,� /�/ -. ' or 16,,r mounted heater 6.00
It.tall Map N,, Vent not incl.in
.00
Lot t Subditd.iorl 5) appliance permit 3
Narnerwkollbusiness) Repair a(heats refrI�,�'� �.� __ ��� 8) cools ,absorptiion unitt6.00
C� Li1LLk�_�P)�l h� � dY
Mi:tbte AddressptaM Boiler Or comp to 3 HP
Owner _VQ J
3
612sliewabsorp.unit to 100,000 BTU 6.00 c ap Boiler or comp to 3 tip-15 lip
9) absorp.unit to 500,000 B T U 11.00
--- - ---- -
Na,rta Boiler or comp 15-30 N P
absorp.unit 112-11 million 15
Mai"Address Mane 10) Boiler or comp to 30-50 HP 22.a�22.53C.L) �Q absorp.unit 1-1.75 million
Contractor cityisule Boiler or comp to 50 HP
-i 1 C y r 4 Z 11) absorp.unit 1,750,000 BTU — 3 1.50
State laegistration No
coy e;,,,jtia No. 12) Air handling unit to
10,000 CFM 4.50
`'- I I%S Air handling unit
I hereby acknowledge that I have road Itis application that the Inlormstim given is 13) 10,000 CFM + 7.50
00"W,that I am ate owner or auttxxi[ed agent of the punter,that plans sure brnitied ain —_-
compbance weh State laws,out I am registered with the Stale Builders'Board,that the Nor)porlable
number given is coned.(11 exorno from State registration please give reason below). 1�) evaporate Cooler 4'S�
_- --_��_--------_--
1 ) Vent fan cooneded --
3.06to a single euct
- - - Ventilation system not
t 6) included in appliance permit 4.50
Hood served by
1 mechanical exhaust 4.50
Signalwe(owner or agent Date ) Domestic type 7.50Describe work ❑ addition El alteration [_1 repair ❑ 18 incinerator _
to be done residential ❑ non-residential [1 _ Commercial or industrial
1 g) type incinerator 30.00
Existing use o1 ..
huildinr;or properly _ ) Oth;;r i.e.,woodstove,water
-- 2.0 heater,solar,clothes dryers,etc. 4.SO
Proposed use of --- _
building or property _ 21) Gas piping one to lour outlets 2.00
Type of fuel- oil U natural gas El LPG ❑ electric fl
2) More than 4-per outlet
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON SUB-TOTAL
STRUCTION AUTHORIZED IS NOT COMMENCED r,111THIN 180 S610 46 SURCHARGE
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS Al ANY TIME AFTER
WORK IS COMMENCED TOTAL
Special Conditions
_. .__..__. Ua"issued _
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