Permit A CITY OF TIGARD MECHANICAL PERMIT
I�
DEVELOPMENT SERVICES PERMIT #: MEC2000 -00163
c - ' — • 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 05/04/2000
PARCEL: 2S 112CC -04600
SITE ADDRESS: 15830 SW 80TH AVE
SUBDIVISION: BOND PARK NO. 3 ZONING: R -12
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
•
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installing exterior A/C unit. Unit must not encroach into 5' side or rear yard setbacks.
Owner: FEES
ZIELINSKI, AARON D Type By Date Amount Receipt
15830 SW 80TH AVE PRMT BON 05/04/20( $50.00 0001916
TIGARD, OR 97223 5PCT BON 05/04/20C $4.00 0001916
Total $54.00
Phone:
Contractor:
ENERGY MASTERS HEATING + NC
7470 SW 76TH
PORTLAND, OR 97224 REQUIRED INSPECTIONS
Misc. Inspection
Phone: 244 -8880 Final Inspection
Reg #: LIC 000585
PLM 26 -476PB
ORIGINAL
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. All work will be done in accordance with approved
plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through O; - .152 -001 -0080.
You may obe copies •f these rules or direct questions to by calling '503 46 -9 ; •.
. i � Issue By: / Permittee Signatur , i , , I ���� . � l
• Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
I CITY-OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd 5 -
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
. Print or Type Permit # rnl 'C2A ,- 10((11
Incomplete or illegible applications will not be accepted Called
Name of Development/Project Description
Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee , rc 16.00
Address i 9 3c slio qe''''' 1) Furnace to 100,000 BTU
including ducts & vents see footnote 1,2 9.65
Bldg# City /State Zip 2) Furnace 100,000 BTU+
11 041-.1.2C. 0 `r - r 2 •7 if including ducts & vents see footnote 1,2 12.00
Name (or name of business) 3) Floor Furnace
•
Owner
V0 lk 4 Ca 7-lei OAS/! -1 including vent see footnote 1,2 9.65 •
Mailing Address 4) Suspended heater, wall heater
19 3 O SvJ y 1 or floor mounted heater see footnote 1,2 9.65
�O 5) Vent not included in appliance permit 4.75
City /State Zip Phone. Check all that apply: *Boiler Heat Air
`1 ( 172-z ( S9 -1347 For items 6 -10, see or Pump Cond Qty Price Amt
Name r name of business) footnotes 1,2 Comp
6) <3HP;absorb unit to
100K BTU L• 1 9.65 a. (IS
Occupant _ Mailing Address 7) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
City /State Zip Phone 8) 15 -30 HP; absorb
unit .5 -1 mil BTU 24.15
9) 30 -50 HP; absorb
Contractor Name -L
I unit 1 -1.75 mil BTU 36.00
' ^ . _ -'/�, ���` t& keVS I nc , 10) >50HP; absorb unit
Prior to permit Mailing Addpb4s ' >1.75 mil BTU 60.15
issuance, a copy 74 - 70 ^� J 7 r'o 1 11 Air handling unit to 10,000 CFM
of all licenses c Zip Phone h 7.00
are required if t 6 4- 77 213 �444�go 12) Air handling unit 10,000 CFM+
expired in COT re on Const. Cont. Board Lic.# Exp. Date '+ 11.85
database i a ( U 13) Non - portable evaporate cooler
Architect Name 7.00 .
14) Vent fan connected to a single duct
4.75
Or Mailing Address
15) Ventilation system not included in
appliance permit • 7.00
Engineer City /State Zip Phone 16) Hood served by mechanical exhaust
•
7.00 -
Describe work to be done: 17) Domestic incinerators
12.00
New O "e air 0 Replace with like kind: Yes 0 No O 18) Commercial or industrial type incinerator
Residential I Commercial O 48.25
19) Repair units
Additional information or description of work: 8.40
• 20) Wood stove /gas FP /other units /clothe dryer /etc.
7.00
NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets
structural gas calcs. See footnote 1 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electriO 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL „; < �.,DD
I hereby acknowledge that I have read this application, that the information 8% SURCHARGE w (.p.tt)
given is correct, that I am the owner o authorized agent of PLAN REVIEW 25% OF SUBTOTAL
Required for ALL commercial permits only
the ov�ner,�that Ins u ttt f 41i :b ithrggn $t�te�aws. TOTAL
Siiigtature of Owner /Agent Date t! V
n - l -^' n Other Inspections and Fees:
1 C-e-' c - f - OY t " gam 7 i � 1. Inspections outside of normal business hours (mininum charge -two
Contact Person Name Phone hours) $50.00 per hour
� 2. Inspections for which no fee is specifically indicated (minimum .
2 LS �charge -half hour) $50.00 per hour
Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to
1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge- one -half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical
*State Contractor Boiler Certification required
units.
**Residential NC requires site plan showing placement of unit
I: mechperm.doc rev 7/19/99
{ 00- 3501
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JOB NAME 2 j- I Vl S L— t ti TIME ALLOWANCE
FURNACE: 80% 2 STG 80% 1 STG 90% 2 STG 90% 1 STG OTHER
BTU's UPFLOW DOWNFLOW HORIZONTAL
FLUE LINER: 4" 5" 6" 25' or 35'
EXISTING HEAT
AIR CONDITIONER: 2TON 2.5TO 3TON 3.5TON 4TON OTHER
COIL: EGULAR SUMMIT HORIZONTAL illf 15' It
LINE SET: 25' 35' 50'
ELECTRONIC AIR CLEANER: 16x25 20x20 20x25
ELECTROSTATIC FILTER -
WATER HEATER: 40 gal 50 gal STAND
IN PLACE MOVE______FZ
GAS LINE: FIREPLACE FT RANGE FT
DRYER FT BQ FT
WTR HTR FT FURNACE FT
OTHER FT �,,
ADDITIONAL DUCTWORK ..c.� �++ - � ' .4..:-
PLOT PLAN: +fi
.6720______A4 1 r
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