10465 SW 67TH AVENUE w r w Mmff=s-,=--- -
- 104i;5 SW 67th. Av. —
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MU-MANICAL.
CITYOF TIGARD P E 1:',,M I*I
CF1Y0Fn0R0 PERNYT #. . . . . . . : VILC90-019(d
COMMUNITY DEVELOPMENT DEPARTMENT F;IN. P,E R N I'T 0 11 F.C 9 0 0
13 126 SW HWI Blvd. P.O.Box 23337,T4ard,OreW 4782.f03 1171
09/41.8/90
DA'TF. 7SSUED
Sl'y,'E ADDRESS. 3.04(.,5 SW E,7TH AV P A R C E L. .1 13'—.,AD 00900
VILLA RIDGE NO. 2 ZONING: R-4. 5
BLOCK.. . . . . . . . . .
-................-
CI-ASS OF WORK— :ADD FLOOR FURN. EVOP COOLERS:
YY P E OF LJ S E. . . . :SF UNIT HEA'T'ERS,. VENT FANS. . .
OCC"L)1-"ANC'y GRr:,. . -.R3 VENiS W/O PIPPL-- VE111, SYSI'Llis.-
";TORIES. . . . . . . . .. I(OI[-ERS/C'OIIV-'Rl::'.c;(.';ORS KDODS. . . . . . . ..
FUEL (1) 3 HP. . . . . DOMES. 11AC'IN-
/(3 A S 3-15 HP'. . . . .. COMML., INCIN:
111AX IIAPIUT: •30 1AP. . - - -- R'I1'.PAIR t.JNI'T'S-.
1"IRE DAMPERS"t.). 30-50 HP. - - .- ft WOODS*rOVES. . L
UAS r5o+ HP'. . . . .. CLO DRYERS— -
1,10. OF (JNI'Y*S---------- ----' AIR HANDLINQ1 UNITS 9 1Jq E R UNITS. : 1.
I URN < 1.00K BTLJ-. 1 10000 cfni-. GAS OL.":! FTS. -. 1
FURN ):=1001/% DIIJ3 > :10690 c'fnl:
R e ni.A-r 1-�iii
FLES
KINDI EY type &MOLI)lt by d,.':r t P e( p
1046;'-'; SW 67'TH AVE PAY111 $ 23.63 "LH 09/18/90
R 11 T 2R. 50
TIGAPI) OR 9722.3 5 UT 3
['410ile #.-
('01-MIDIA HLAIT1,16
89v3t1'-' qW 14UtMHAP1
SPACE E -410
TiGORD OR 97223
I'*q-1(:)1-)*- 0- 621+..-0704 tG 2:3.03 TOTAL
Req #. . - 3802f, PECTIONS
PEA11JIRED :1 N S
This permit is issued subject to *he- regulations conta,ned ►n the Filial II-Ispecti'll .........
Tigard Municipal Code, State of Ore. specialty Codes anu all other
applicable laws. All work will be done in accordance with ......
approved plans. This permit will expire if work is not StiTted ......
within 180 days of issuilce, or if work is suspended fur more
than 180 days.
P
Clerinitt-ee 5J-917At Lk TL
Isst,ted By. n
-J.1-1 639-4175
CITY OF TIGARD MECHANICAL PERMIT Receipt# _ ---.___-
1312 5 SW HALL B LVD. Permit#
P. 0. BOX 23397 �� /� `� Descr;plion —� ----
TIGARD, OR 97223 j Table3AMechanicalCode - OTY
PRICE AMT
(503)639-4175 610 / 1) Permit Fee - -0- - -0- 10.00
Nasse of Developi wrt 2) Supplemental Permit 3.00
— --- Furnace to 100,000 BTU
Jot' �fel5S 1) 6.00
incl.ducts&vents
t _ -
Address Tax Lot� � a No f �� _ Furnace 100,000 BTU + 7.50
2) incl.ducts&vents
to Mock SIAWr ision
Name for name of hutsiness) 3) Floor Furnace 6.00
1 — --incl vent
Mailing �t _
Aedross lnnrx, 4) Suspendm , dier,.wall heater 6
.00
Owner ( Z ( L.-e J I' 7�f or floor mounted heater
cAyrState ZP 5) Vent not incl.in 300
appliance permit --
Name((w name of business) 6) Repair of heating,refr ig., 600
_cooling,absorption unit _
— Boiler or comp to 3 HP
Occupant Malty Ad'drm Pnon7)e absorp.unit to 100,000 BTU 6 cJ
City;,tate , 81 Boiler or comp to 3 HP-15 HP 11.00
_absorp.unit to 500,000 ETU_ -
---� --
Namq 9) Boiler or comp 15-30 HP 15.00
— absorp.unit 1h-1 million _
Mailing AddAddress. ^"'r" U 10) Boiler or comp to 30-50 HP - _ — 22.50
. „) absorp.unit 1-1.75 million
� 1 ,c-X 3�T b IP !I
ContractorI ) Boiler or comp to 50 HP 31.50
GtyeStaa Z+p 11 absorp.unit 1,750,000 BTU
Zt No. City Utts.Tax No. 12) Air handling unit to 4.50
c�� bc� r-^ '10,000 CFM -- —v-
Y� 13) Air handling t snit 7.50
1 tweby aioawbd Be
dge that I have reats applicaton that vie enbrmatw�-.given is 10,000 CFM +
Coned.that I am to owtxx ix sutlronrnd agent of the owner,Thal plans nutXnitted are in --- --— --
Compkarx**nth State lawn,that I am rNt,.twod with the State nuiklnrs Hoard,that the 14) Non portable 4.550
number given is coned 111 enempl kom State registration phase grvn reason helow) evaporate cooler W —
15) Vent fan connected 3.00
I:a sinole ud
Ventilation system not
16) d.50
included in appliance permit —
Hood sere id by 4.50
I17) mechani(;llexhaust
`,lpnature tow, W or "no — Dale 18) Dom astic type 7.55
Describe work El add(ion FJ alteration U repair F..-1 Incinerator _ T_
to be done residential 1-1 -ne.l-residential O _ 19) Commercial m industrial 30.00
type incinerator
Existing use of
I building or properly '0) Other i.e.,woodstove,water ' 4.50
heotar,solar,clothes dryers,etc. _—
Proposed use of - —
building or property _-- — - 21) Gas piping one to four outlets / 200
Type of fuel— oil 11 natural gas O LPG U electric U
22) More than 4-per outlet
SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 - 5'X SURCHA'AOE —
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25X.OF SUBTOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER —'— — —
WORK IS COMMENCED. 1 TOTAL
1 t'
Special Conditions
Date issued_--_-_ ____ by _-