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7472 SW FIR STREET
CITY OF TIGARD MECHANTCAI
DEVELOPMENT SERVICES PERMIT
11W 13125 SW Hall Blvd., Tigard,OR 97223(503)639-4171 PFRMT.T
DPTP I SSUFD: 01 1-/9'I
PPKEI..: 29101 DC-0,3501
rTE ADDRE99. 071472 SW r I R ST
5UBD I V I S I M. . ZONING: R-3. 75
BLOCK. . . . . . . . . . . LOT. . . . . . Jl-IRT!3DTC'T TONI: TTG
CLASS OF WORK!
. . .-OTP FLOOR FLIPN. . . . . 0 EVAP COOLERS: 0
TYPE OF Ur)F. . . .
)F UNIT HEATF RG. . : 0 VENT r-ANc
;. . . : 0
OCCUP'nNICY GRP. . :R3 VENTO W10 APPL: 0 VENT SYSTEMS: 0
r3TORIES. . . . . . . . : 0 SOILERP3/COMPRES!3nRr-. HOODS. . . . . . . : 0
rUFL HP. — . Q, DOME!3. INCINI: 0
:GA1-; 3 15 HP. . . . c'If COMML. INCTN: 0
MAX INr-,(JT- 0 BTU 15- 30 141--l. . . . 0 REPAIR I-INIT5: 0
F I RE DPWIC R5)?. . s 30-50 HP. . . . s 0 WOODEMVEE-3. . . 0
GA,13' F,RErjSIJRE. ., .. 50+ 11P. . . . 0 (-'l-O DPY('."Pr:)' . : I
NO. OF AIR HANDLING UN I TS, OTHER UNITS. : I
FURN ( 100K nTU: 1 1001,0 cfm: 0 (3(13) OUTLETS. : t
FURN ) =100V, BTU: 0 > 1.0000 rfrp - 0
Pe mar,P 9 Installation of gas furnace, gas dryer, gas insert and gas piping,
Owner-: F F F 9
JOHN DRnOntIMTR type amomit by date rprpt
102,20 SW DENNFY RD PRMT t 27- 00 DES 01 /13/99 99 -31,214n
T1r-AV;FRTnNi OR W008 5jP('T 3 1. 35 DFP 01/13/99
!)One #.- EXPIRED
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PI-icnp 14 -
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P170.1.11WD IN',;r'F'C',TTnN R
This persit is issuee subject to the regulations mitainee in the Gas Line In,:,p
Tigard Municipal Code, 641- of Ore. Specialty Codes and all other Mpr!iayiiral Trisp
applicable laws. AH work will be done in accordance with Hp;.�.it4yig Lint Tyisp
approved plans. This ptreit will expire if work is W started 111sppeticill
within 180 days of issuance, or if work is suspended for sore Firial Trispert ic)-,i
than 160 days. ATTENTION: Oregon law requires you to folAt,,- miles
adopted by the Oregon Utility Notification Center. Those rules
set forth in DAR 952-001-0010 through, OAR 95201-00e0, you say
obtain copies of these rules r direct questions to OLNC by calling
Permittee c3igl)atllt tf -
5 S kt
1 :-4 F++4.4,+-t-+++ 1-1-+++4.f4-+-+-4-++-4-+-#-+++-++++4-+++-1.......4-+ 4 F++-1 ++++++ F.+.+++++++ +.+{_4
Cal. 1 629- 417b by 7:00 p. m, far- i vispert i nrj,�, r, ,,t h i mess,
ss; ri
,a y
++++4,4-++-4-+4++++-1-+4........4-4+++-+++-+--++4 +-++++++-4-4 4-+4-++-++,4-+ +4 + r++4++ -++4-+4-+4+
Ul-f OF TIGARD Mechanical Permit Application Plan Chpel-M j
13125 SW HALL BLVD. Commercial and Residential Uatra RecRecd Date
�_.��
d
TIGARD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST
Type #
Print or T r ' 1 'c Permit I- �r
—
!1
Incomplete
or illegible applications will not be accepted Called
Name of pevnbpmenvProlect Description
Table 1A Mechanicil Code _ _ Ut Pri;e Amt
Job Street;G—dress— gunk A Permit Fee V _ ^� 10.00
Address // T1�� ��� S� 1) Furnace to100,000BTU /
Bldg# City/State Zip including ducts&vents 6 00 Ips
2) Furnace 100,000 BTU+
including ducts&vents 7.50
Name(or name of buslne s) 3) Floor Furnace _
Owner W 4) fi ?16 Q/1/r•' including vent - _ 600
Mailing Address �} 4) Suspended heater,wall heater `-
/ or floor mounted heater -� 6.00
5) Vent not included i i appliance 5ermit
Cnyrsrete C7_Ip p /P� _ 3.00
*Boiler Heat Air
Name for name of business) '- THAT APPLY. or Pump Gond Qty Price Amt
Comp _ �•
Occupant Mailing Address
-- 6)<3HP;absorb unit to
100K BTU _ 6.00
-y)3-15 HP;absorb unit -
CRyrStale ��� — Zip Phone'--- 100k to 500k BTU 11.00
8) 15-30 HP;absorb
Name---- unit.5-1 mil BTU
Contractor 15.00
9)30-50 HP;absorb
_ unit 1-1 75 roil BTU
Prior to permit Mng Address -- 10)>50HP;absorb unit 22.50
elii
issuance,a copy X1.75 mil BTU 37.50
of all licenses ritylstate JZrp Phone 11,)Air handling unit to 10,000 CFM `-
are required If 4.50
expired In COT Oregon const Cont Board t.ic k Exp oats
database__ 12)Air handling unit 10,000 CFM+
-
Architect Name 13)Non-portable evaporate cooler �1
_ 4 50
or Moiling Address^` - - 14)Vent fan connected to a single duct i --
___ _ 300
15)Venlilabon system not!ncluded in --
En ineer cnyfstew — zia Pnone
9 a Ilance hermit 4.50
-y_ 16)Hood served by mechanical exhaust --
Describe work to be done: i-- _ 4.50
17)Domestic Incinerators -`
New O Repair O Replace with like kind Yes O No O 7.50
Residential O Commercial O 18)Commercial or Industrial type incinerator
3000
Additional information or description of work ~- — tT)Re{alt units
20)Wood stove -
__` 4450
dry
21)Clothes er,etc __'__"~
4.50
Typeof iuel oil O natural gas O LPG O electric O ^ 22)Other units
_ 450
I hereby acknowledge that I have read this application,that the information 23)Gas piping one to four outlets^
given is correct,that I am the owner or authorized agent of __ __ _2.00
the owner,that plans submitted are in compliance wi;h Oregon State laws 24)More than 4-per outlet(each)
Signatu of t7wr+lir/Agant - Date - .__..-___ ______ ��e _ .� 50 4
1 l Minimum Permit Fee$25.00 SUBTOTAL
5%SURCHARGE
Contact Person Name Phone � PI AN hLVIEW 25%or 4UBTOTAL
�• Re ulred for ALL commercial pt,rmlts onl
` TOTAL
'State Contractor Boiler Certification r squired
�Iuires site plan sh(wing placement of unit
I lmechpenn.doc rev 07120198