Permit CIT OF TIGARD MECHANICAL PERMIT
. , i► DEVELOPMENT SERVICES PERMIT #: MEC2002 -00104
�
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/18/02
PARCEL: 2S 103AC -04100
SITE ADDRESS: 12612 SW 114TH TERR
SUBDIVISION: WALNUT GROVE ZONING: R -4.5
BLOCK: LOT: 010 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Installation of gas furnace.
Owner: FEES
DURFEE, MICHAEL D AND Type By Date Amount Receipt
BUTTERFIELD, MELISSA PRMT CTR 3/18/02 $72.50 2720020000
12612 SW 114TH TERR 5PCT CTR 3/18/02 $5.80 2720020000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
AAA HEATING + COOLING
2915 NE MARTIN LUTHER KING BLV
PORTLAND, OR 97212 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 284 -2173 Heating Unt Insp
Reg #: LIC 222 Final Inspection
EXPIRED
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 OAR 952 - 001 -0080.
You may obtai copies of these rules or direct questions to OUNC by calling (503)246 -9189.
Issue By: ,E�` - Permittee Signature: "h
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next busi ess day
11/11/2001 12:00 FAX 5035981980 CITY OF TIGARD 16002
. • •
A I. Mechanical Permit Application
r,!1 , i City 4f • j, Date received_ 5 K 01- Permit no.: ..- ., o , - r %z/.4 i
- 04- J7gamt Address: Pro j ec t / wino.: �Puedate:
Phone: (503) 6394 '�1'iifr /� issued: �' Receipt no.:
Fax: (503) 598 -1960 // Case file no.: Payment type:
Land use approval _ tinR 1 : Z ��^
Building permit no.:
x I'( : Pr.it NIIT
a 1 2 family dwelling C 1 to a,) ' • -
Y etling or accessory ... • • -, ; 'ndusttial ❑ Muhi -family 0 Tenant improvement
0 New construction 0 Adddition/alter Torn/ epiacement to Other
.1(213 �1TF iN I NI 1114" (uli1II \t Y11 l 11 in\ ti4 ifiThi t t
Job address: , , , _ 4) 41 errGfGG Indicate equipment quantities in boxes below. Indicate the dollar
Bid:. no.: Suite no.: value of all meche»ical materials, equipment, labor, overhead.
Tax map/tax lot/account no.: • profit. Value $ _
Lot: Block: Subdivision: 'See checklist for important application information and
Pro . name: _ ��� jurisdiction's fee schedule for realdential • -. it the.
C i t y / c o u n t y : - ZIP: � G _ I r r ► I s _ 1 \ \ t r I l r 4 ∎ 1 ; - r l r Ni, / I 1 0 ) 1 1 f i 1: s i 11 i_► 4 i
Description and atio on premises: - 1�1)i 1)∎1\iL10( \1 :1\u►' li_LQI )1 '17r 1 se If , or_ 1_1
i i
Est. date of .;... _ _
T
NSF/ ISR
enant improvement or eh • , ' of use:
Is existing space heated or conditioned? C I Yes 0 No Air handling Wait Ci l
Aircosdidoniny( W
AB space insulated? 0 Yes 0 No
ocrationoftatistln VIVA )
Is existing
11 \1( \f \I1t11IOU in'irrrcompressors
�����!� State boiler permit no.:
Address: S lk / i V�: �� r Tons BTU/FI
State A ZIP: �i� MER ... , sttep� -.. -
Phone'- . - _ �� E-mail: 011 . I act ■ • .. . - t
CC$ no : incl •' • ductwotk/veatdam O Yes atwa
City/metro lie. no — na • . tepl' - • to eaten - suspended, tb
wall, t floor mounted
Name (please print):
/ Veer .,. : race ... er I. an . ., 6.
Name:
Chillers t tlonunite BTU/H _
Address: ..., aura — 1P
City: State: DP:
Appliance vent
Phone:
Fax: E-mail: Dryttexhaust
(►I\\11. ith ... .a, i ,7"7,:
..�1
hood Swsuppression :le duct
...
Name: 4, /! / � Exhaust Pin with stn n _>e duct (bath fans)
11Q ailin ,�. / «.. aPartSam • --, : or
City: �/ State./ ' ZIP': l � NI "" PPM : , , . , upto • .
Phone: / Fax: E -mail: LPG NG Oil
. , • : n • : a .nrel over outlets
I_ \ (;1 \ I I at lrturt'a 7 (s • , berequired)
Name: Number of outlets
Otherlidegapidimase Address:
Decorative $ � ■
City! State: ZIP: Insert - .
Fax: F.-mail: '^.' vv
= ape
r _r t'S
Nil= �,
t): /%/ � J _�,f gate: —
.
' Nat ell 3wt•4buoao a coot - -- .. , pi te n lm edicuu, Eve awe intaaoaben.` minimum Permit fee $ .—
ovi.it ❑ MosoetCerd Notice: This permit application fee s 7, _
Credit cord , on,yc, / expire a if a permit is not obatinod pan review ( at %) $
within 180 days after it has been State am Cacdhddx ao aed.e at S Amount accepted as complete. TOT (8°h) $ ,..5-_-..e0
4'
s 7e.
440.4617 (6nWCQM)
.. EXPIRED