Permit CITY OF TIGARD MECHANICAL
/ /orlh �I' � � DEVELOPMENT SERVICES PERMIT
���' PERM I T # • MEC97 -0237
13125 SW Hall Blvd., Tigard, OR 97223 (503)639.4171 DATE ISSUED: 07/09/97
4 f ° 46 1
I PARCEL: 2S103CD -00400
SITE ADDRESS...: 13615 SW 115TH AVE '!
SUBDIVISION ZONING: R -4.5
BLOCK LOT • JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 1 DOMES. INCIN: 0
:GAS 3 -15 HP • 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP • 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP • 0 WOODSTOVES..: 0
GAS PRESSURE...: 50+ HP • 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Install air conditioner
Owner: FEES
ANDREW BITHER type amount by date recpt
13615 SW 115TH PRMT $ 25.00 JSD 07/09/97 97- 296931
TIGARD OR 97223 5PCT $ 1.25 JSD 07/09/97 97- 296931
Phone #: 624 -8578
Contract or:
SPECIALTY HEATING & FABRICATIO
9528 SW TIGARD ST
$ 26.25 TOTAL
TIGARD OR 97223
Phone #:
Reg #..: 006657
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Cooling Unt 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 persit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than 188 days. ATTENTION: Oregon law requires you to follow rules
'adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 881 -8818 through OAR 9521814488. You lay
obtain copies of these rules or direct questions to DX by calling
(583)245 -9187.
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Issue By: A Permittee Signature:
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd d 6,
TIGARD, OR 97223 Date to P E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # , i C
Called
Incomplete or illegible applications will not be accepted CJ
Name of Development/Project Description
Table 1A Mechanical Code Orr PRICE AMT
Job Street Address l Suites A) Permit Fee -0- -0- 10.00
Address 3415 Sly) i t 5-i -it A ve
Bldg# City/State Zip B) Supplemental Permit 3.00
I tga,rik de- 97,,D,
Name for name of business) 1.) Furnace to 100.000 BTU 6.00
Owner Mt.ctie i) & t t r incl. ducts & vents
Mailing Address 2.) Furnace 100,000 BTU + 7.50
( N., /1-i S j,� ( 5 , a i/e_ incl. ducts & vents
City/State J zip Phone 3.) Floor Furnace 6.00
1 tgax L Ot Q 6241-8.572 incl. vent
N f or name of business) 4.) Suspended heater, wall heater 6.00
a .,bO I/ or floor mounted heater
Occupant Mailing Address 5.) Vent not incl. in 3.00
appliance permit
City/State Zip l Phone 6.) Boiler or comp, heat pump, air cond. �I 6.00 A
to 3 HP: absorp unit to 100K BTU I �l
Contractor Name 7.) Boiler or comp, heat pump, air cond. 11.00 •
tPrior to edaL { 3-15 HP: absorp unit to 500K BTU
issuance teui.tat--1 Addres 8.) Boiler or comp. heat pump, air cond. 15.00
applicant � S LA) / C. QXd Si JI . 15 -30 HP: absorp unit .5-1 mil BTU
must provide all CL7Staie JJ Zip Phone C/ 9.) Boiler or comp, heat pump, air cond. 22.50
contractor 2 r-4 012. `17,334 6...x.) '5643 30-50 HP: absorp unit 1 -1.75 mil BTU
license O Const. Cont. Board Licit Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
information (, /457g ,' j /(t [ Q > 50 HP: absorp unit 1.75 mil BTU
for COT COT Business Tax or Metro x Exp. Date 11.) Air handling unit to 4.50
database). 9 3 3 5 9 7 Cj 10,000 CFM
Architect Name `J 12.) Air handling unit 7.50
10,000 CTM +
Or Mauling Address 13.) Non portable 4.50
evaporate cooler
Engineer City/State Zip - Phone 14.) Vent fan connected 3.00
to a single duct
Describe work New 0 Addition 0 Alteration Ci Repair O 15.) Ventilation system not 4.50
to be done Residential p Non - residential 0 included in appliance permit
Additional Description of work 16.) Hood served by mechanical exhaust 4.50
17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrialtype ' 30.00
building or property incinerator
19.) Repair units ( 4.50
Proposed use of Abe) 20) Woodstove 4.50
building or property
/ 21) Clothes dryer, etc. 4.50
Type of fuel - oil 0 natural gas ( LPG 0 electric 0 22) Other units 4.50
I hereby acknowledge that I have read this application, that the 23) Gas piping one to four outlets 2.00
information given is correct. that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State 24) More than 4 -per outlet (each) .50
laws.
, 8., 1 , 7 /Q /'� 7
Signature of Owner /Agent Date QTY.SUBTOTAL
`SUBTOTAL
6 A Od�L� 14-21)
V
Con ct Person Name Phone 5% SURCHARGE .
r
PLAN REVIEW 25% OF SUBTOTAL
TOTAL O'e.
i Adstlmechpmt.doc (rev 7/96) `Minimum permit fee is $25 + 5% surcharg
t
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A hdrew
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5/30/00 Activities for Case #: MEC97 -00237 t
2:48:09 PM A'?
Assigned Hold Updated
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Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 7/9/97 JSD PASS JD 7/9/97
MECA799 Final Inspection JD 7/9/97
MECA730 Cooling Unt Insp 7/9/97 JD 7/9/97
MECA060 (F) Issue permit 7/9/97 JSD PASS JD 7/9/97
MECA845 Request inspection research 3/27/00 JMT DONE No Hold JMT 3/27/00
MECA880 Expired by limitation 4/18/00 HAP DONE No Hold AKJ 4/18/00
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