Permit MECHANICAL
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� ��� OF � � -�N��� � � PERMIT #......: MEC95-03
COMMUNITY DEVELOPMENT DEVAMME- NT DATE ISSUED: 10/13/95
1o1usSw Hall Blvd. Tigard, Oregon 972230819e (503) 639-4171
PARCEL: 26103DC-00803
SITE ADDRESS...: 13530 SW 115TH AVE
SUBDIVISION....: VIRGINIA ACRES ZONING: R-3.5
BLOCK..'.. ^ LOT :1
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CLASS OF WORK.. :ADD 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:
:/GAS/ / / 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..:
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.
cURN < 100K BTU: <= 10000 cfm: GAS OUTLETS. :1
FURN >=100K BTU: > 10000 cfm:
Remarks: Install gas line
Owner: ------- — — — FEES ----
ROBERT MILLS AND IRENE type amount by date recpt
13530 SW 115TH AVE PRMT $ 25.00 JSD 10/13/95 95-271634
5PCT $ 1.25 JSD 10/13/95 95-271634
TIGARD OR 97223
Phone #:
Contractor: — —
ARTISAN KITCHENS INC
1025 NE ARRINGTON RD
HILLSBORO OR 97124-0000 — --------
Phone #: 503-640-9190 $ 26.25 TOTAL
Reg #..: 102568
— REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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.
Perm ittee Sir ure __
~
I ssued - • ' ���@��N�r~ 111011
Call for inspection — 639-4175
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City of Tigard MECHANICAL PERMIT . Planck/Rec. #
13125 -SW Hall Blvd. APPLICATION Permit # MCc 95' -ol
Tigard, OR 97223 .
(503) 639-4171
Name of Ueveapment it. Description
/ 5 -
3 0 auv I i 6 Table 3A Mechanical Code OTY PRICE AMT
aware..
Job s 0 973 1) Permit Fee -0- -0- 10.00
Address l e '
2) Supplemental Permit 3.00
Name (or name of business) Furnace to 100,000 BTU
1) incl. ducts & vents 6.00
Madng, Address Phone Furnace 100,000 BTU +
Owner y 1 5,4 A €Dt1E- 4m.2`4- �. 2) incl. ducts & vents 7.50
City /State Lp Floor Furnance
504-146-,q- p 4.ipt 6- 3) incl. vent 6.00
Name (or name of business) Suspended heater, wall heater
Rpm r kt j,-Z ( c f � 4) or floor mounted heater 6.00
Madng address one Vent not incl. in
Occupant 54-0'1 1 4-S A ✓E 5) appliance permit 3.00
Cr r5late zoo Repair of heating, refrig.
6) cooling, absorption unit 6.00
Name Boiler or comp, heat pump, air cond.
A-ert 5/41/ /'ri4c-AlS 610--9//0 7) to 3 HP; absorp unit to 100K BTU 6.00
Madmg Address Phone Boiler or comp, heat pump, air cond.
r SE 39, e Win' 8) 3 -15 HP: absorp unit to 500K BTU 11.00
Contractor u ZIP Boiler or comp, heat pump, air cond.
• luS Aoeo OR 47423 ° �{€/ 9) 15 -30 HP; absorp unit .5 -1 mil BTU 15.00
. tale Regcegauon No. City Bus. Tax No. Boiler or comp, heat pump, air cond.
1N COT 10) 30 -50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that 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 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
agent of the owner, that plans submitted are in compliance with Air handling unit to
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from State Air handling unit
. registration, please give reason below.) 13) 10,000 CT + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
15) to a single duct 3.00
f Ventilation system not
1 i /OA? /7s 16) included in appliance permit 4.50
Signature (owner or agent) j „ate Hood served by
17) mechanical exhaust 4.50
Describe work new (} addition 6 alteration O repair O Commercial or industrial
to be done residential ® non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property •
21) More than 4 -per outlet (each) 2.00
Type of fuel .- oil 0 natural gas a LPG 0 electric 0
NOTICE — F 7
" Minimum Fee 525.00 SUBTOTAL CC
PERMITS BECOME VOID IF WORK OR CONSTRUCTION j�� /�
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 PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
OTAL v�
Special Conditions /� f,
Date is; -• / �/
by /
H:LCGIMDSTSIMECHPMT
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CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer <Gas Linj,/ -Bldg.
Plbg. Underfloor Rain Drain Framing - Plumb.
Alarm Water Line Insulation -Mech.
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: // /`Z_/9S Time: AM
Address: / _ / �S //ST W. l T"
�r: lv ){ a-3 (i3 Permit #: MEC-- 5,5" &3(-3
THE FOLLOWING CORRECTIONS ARE REQUIRED:
W L.a_ - ..z •s
Q7f\s 1 e '2-2- -- S\c
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Inspector: _. / j i ti 1/4- Date: /7/ /cJ
PPROVED _DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.
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5/30/00 Activities for Case #: MEC95 -00363
2:01:30 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 10/13/95 JSD PASS JD 10/13/95
MECA060 (F) Issue permit 10/13/95 JSD PASS JD 10/13/95
MECA705 Gas Line lnsp 11/2/95 11/2/95 RB PASS RB 11/2/95 to stove top
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