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sCoITYOFTIFARD RD MECHANICAL
COMMUNITY DEVELOPMENT DEPARTMENT MOON / PERMIT
13125 SW Hall Blvd. P.O.Bm 23397,Told d,Om 97223(503)639-4175PERMIT #. . . . . . . : IYIEC92-10241
639-4171 DATE ISSUED: 09/22/92
SITE ADDRESS. . . 12133 SW 125TH AV PARCEL: ES103BB-03800
SUBDIVISION. . . . : BROOKWAY ZPNING: R-4. 5
BLOCK. . . . . . . . . . : L01 . . . . . . . . . . . . . ..38
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CLASS OF WORK. . tADD FLOOR TURN. . . . : EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VEN1' FANS. . . :
OCCUPANCY GRP. . :R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES. . . . . . . . : 1 BOILERS/COMPRESSORS HOODS. . . . . . . :
FULL TYPES-------------- 0-3 HP. . . . - I -JIvIES. I14CIN:
: /GAS/ELE./ .3-15 HP. . . . : COMIYIL. INCINi
MAX INPUT: BTU 1;.i-30 HP. . . . : REPAIR UNITS:
FIRE DAMPERS?. . - 30-50 HR. . . . : W'JODSTOVES. . .-
GAS PRESSURE. . . : 50+ lip. . . . : CLO DRYERS. . s
NO. OF UNITS-------------- AIR HANDLING UNITS OTHER UNITS. .,
FURN ( 100K BTU-. 1 10000 cfmi, GNC OUTLETG. : 1
FURN )=100K BTU: > 10000 cfml
Remar!(s: AIR CUNDITIUNER AND GAS FURNACE
Owner: ------------------------------------ FEES __—_---__---__
CORRINE LABARRE t: . pe amount by date r0cpt
12133 SW 125TH PRMT $ 25. 00 JH 09/22/92 —
5PCT $ 1. 25 JH 09/22/92 —
TICARD OR 97,'R,23
Phone 4-
Lontractort
UNIVERSAL HEATING & AIR COND.
4435 SL 251(H
PORTLAND OR 97202 -------------------- ------------------
Phone #: 232-1944 $ 26. 25 TOTAL
Reg #. . 3 12031
REQUIRED INSPECTIONS
This perpit is issued subject to the regulations contained in the Final Inspection
Tigard Municipal L-,6v, ak..te of Uri, Specialty Codes and all other
applicable laws. All work wil! be done in accordance with
approved plane. this perait will expire if work is not started
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within 180 days of issuance, or if work is suspended for more
than Je@ days.
Permittee Signature
Issi-ted By:
Call for inspection 639-4175
INSPECTION NOTICE
City of Tigard Building eepartirvent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection : lne (Rec-o-.Phone): 639-4175 Business Phone: 639-x1171
Inspections" _
Footing Plbg. Underalab i` Mech.1 Rough-in Appr/Sdwlk
Found. Plbg. Top Out Gas tine FINALr
Post/B nm Struct San. Sewer Framing -Bldg.
Poet/Beam Mech. Rnin Drain Innul.ation -Plumb.
Plbq. Unciti c lour Water lLiifne //-- Gyp. Bd. y
Date Requested: ( V W Timet �Am
171 c o
Address:�i /r""_�n t :-7 — Pe/rmmi #i �Z Z/'�
Builder: (.�/' �TRI/ Z -2-` r
THE FOLLOWING CORRECTIONS ARE REQUIREDs
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Inspectors Dater
I "PROM DISAPPROVED APPROVED SUBJECT TO ABOVE
_—Call For Reinsp.
CITY OF' TIGARD RF"(.,.'F-'IPI OF PAYMENT PFCEIPT NO.
CHECK AMOUNT a 26. 2113
NAMP. a UNIVERSAL HEATING CASH AMOUNT 0. 00
ADDRE-�,PS) e A435 SE PSTH PAYMENT DnTF 09 -.'2 9,'
SURD I V 113 1 ON
f7,0PTLIAND, OR 9720'—,-
PURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PPYMENT AMOUNT Prim
MF.1,HAN'XAL. Pl..' 25. 00 ST. BUILD PIER 1. 25
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, . 133 SW Jr.:5TH AVE
7Cj-(AL WOUNT PAID 26. 25
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SIN Hall Blvd. APPLICATION Permit #
PO Box 23397
Tigard, OR 97223
(503) 639-4171
""' '•" �"" escnption
Table 3A Mechanical Code OTY PRICE AMT
job
� �
1) Permit Fee -0- -0- 10.0C
Address CAtY6m40 hp 2) Supplemental^ermit 3.00Q. n-7a
I
" " mourn ce to 1-.u,b0STU —
�� 1) incl. ducts&vents 600 (0.00
"'n""••• '"" Furnace 100,000 +
Owner ( 1 CJ 21 incl. ducts 8 vents 7.50
"Y"°'• Zp o-or Furnance
3) incl. vent 6.00
"""° """° -q Suspenaed heater,wall eater
ss o-A 1� 4) or floor mounted heater 6.00
Occupant
ent not inci. in �
5) appliance permit 3.00
Repair of heating,re ng_.-
_ _ G) cooling,absorption unit 6.00
o
Boiler or comp, seat pump,air cona.
CC li q 7) to 3 HP absorp unit to 100K BTU 6.00
'""'""` oder or comp, eat pump,airy cond.
Contractor
O�5 8) 3.15 HP absorp unit to 500K BTU 11.00
--
Boiler er or comp, oat pump,air con
(� t D1-LQ- 9) 15.30 HP absorp unit.5 1 mil BTU 15.00
'"'•q•9"'°°"N. un lk. T..N. Boiler or comp,heat pump, air Gond.
10) 30.50 HP absorp unit 1-1.75 mil BTU 2250
are y acknowice-dg-e-tTiat I have read this application, that the Boiler or comp,heat pump,air cond.
information given is correct,that I am the owner or authorized agent 1 1) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner,that plans submitted are in compliance with State Air Randling unit to
laws,that I am registered with the Construction Contractor's Board, 12) 10,00n CFM 4.50 ,50
that the number given is correct. (If exempt from State registration, Air an Ing i7m
please give reason below.) 13) 10,000:TM♦ 7.50
on—portable —
14) evaporate cooler 4.50
Vent fan connected
15) to a single duct 3.00
Ventilation system not
16) included in appliance permit I 4.50
59u6w•--.,02-1 "'• Hood served y
01 17) mechanical exhaust 4.50
Describe work new addition alteration&I repair Commercial or inclustrial
to be done residential O non-residential Q 18) type incinerator 30.00
Existing use of Other i.e.,woo stove,water
building or property � 19) heater, solar, clothes dryers,etc. 450
Proposed use of 20) Gas piping one to lour outlets 2 00 a,b0
building or property —
� 21) More than 4 per outlet
Type of fuel•oil Q natural gas Q LPG Q electric. (� -
v
NOTICE
Minimum Fee$25.00 SUBTOTAL 5.00
PERMITS BECOME VOID IF WORK OR CONSTRUC(ION -
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE
IF CONSTRUCTION OR WORK IS SUSPENDED OR —
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PIAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL �dlJ
Special Conditions L��- - -
Date Issued _by
AMMECHPMi
MPdYAI"d�.