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Permit A ( I C ITY OF TIGARD MECHANICAL PERMIT � �r'\ DEVELOPMENT SERVICES PERMIT #: MEC2 - 00300e L 9•� DATE ISSUED: 7/1 2 13125 SW Hall Blvd., gard, OR 97223 (503) 639 -4171 l„ PARCEL: 2S110CA -01600 SITE ADDRESS: 15245 SW 11 H AVE SUBDIVISION: \ � ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN: 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: Replace NC. Owner: FEES KING CITY CIVIC ASSOCIATION Type By Date Amount Receipt 15245 SW 116TH PRMT BB 7/15/02 $72.50 KING CITY KING CITY, OR 97223 5PCT BB 7/15/02 $5.80 KING CITY Total $78.30 Phone: Contractor: MILWAUKIE HEATING + COOLING 9961 A HIGHWAY 212 CLACKAMAS, OR 97015 REQUIRED INSPECTIONS Mechanical Insp Phone: 557 -5562 Cooling Unt Insp Reg #: LIC 104102 Final Inspection F/XPIR 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 obtain pies of these rules or direct questions to OUNC by calling (503)246 -9189. Issue By: ( G�j Permittee Signature: e>-t a filV( Call (503) 639 -4175 by 7:00 P.M. for inspections needed this next n t business day ( ) Y ex p 07/09/2002 13:38 5036393771 CITY OF KING CITY PAGE 02/02 TRl-C C N `" SERVICE CENTER ER .Mecjianicai Permit Application OFFICE USE ONLY Date received: City of King Cat t 9 _ ©9 Permit no.: LEd .. ...0030O �... l � t , 13125 SW Hall Blvd. Project/appl. no.: Expire date: Clackamas Tigard, OR 97223 !!��-- � n i Date issued: By: Receipt no.: Multnomah Phone: (503) 639 -4171, FAX: (503) 614 -7291 case file no.: Payment type: Washington , C O U N T I E S Land use approval: '. - Building permit no.: TYPE OF PERMIT ❑ 1 & 2 family dwelling or accessory 0 Commercial/industrial 0 Multi - family CI Tenant improvement 0 New construction 0 Addition /alteration/replacement 0 Other: JOR SITE INFORMATION COMMERCIAL VALUATION SCHEDULE Job address: f! _ . Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ . Lot: 'Block: 1 Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City /county: ,� Lam' ZIP: l 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and 1 on of wor ,, on premises: _ _ AND CO:NINIERICAI./INDUSTRIAL EQUIY11 SCHEDULE -- - e440/6- Fee (ea.) Total Est. date of completion/inspection: Description Qty. Res. oily Res. only Tenant improvement or change of use: HVAC: Is existing space heated or conditioned? 0 Yes CI No Air handling unit CFM AZ Air conditioning (si__ re t Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system MECHANICAL CONTRACTOR cot er /compressors Business name:. aa , A. , ,r - _, ifx■ State boiler permit no.: Address: * '. - HP Tons BTU/H i - Fire/smoke dampers/duct smoke eteciors City: � lCi iL�rrl� ZIP: / / . Heat pump (site Ian required) Phone y - Fax: - d t ^t E - mail: Install/replace Iit'm"e7burner BTU/H CCB no.: A) �/ /v ' Including ductwork/vent liner 0 Yes 0 No 3 Install/replace/relocate heaters - suspended, City /metro tic_ no.: wall, or floor mounted ame (please p rint): IA. .s s Vent for appliance other than furnace CONTACT PERSON Refrigeration; Absorption units BTU/H \lame: Chillers HP \ddress: — Compressors HP Environmental exhaust and ventilation: ity: State: I ZIP: Appliance vent hone: Fax: E - mail: Dryer exhaust OWNER Hoods, Type UIUres. kitchen/haxmat // hood fire suppression system fame: - e I G S ,t► r /9 r/ , Exhaust fan with single duct (bath fans) :failing address: ,- % • a , /44 Exhaust system •art from heatin: or A : try - , -.. AM. State: i) ■ _ ZIP: • Q_ Fuel piping and distribution (up to 4 outlets) 'hone: MEMNON Type: . I,PG NG M Oil Email: Fuel . i . ing each additional over 4 outlets r ENGINEER Process piping (schematic required) lame: Number of outlets • .ddress: Other listed appliance or equipment: J Decorative fireplace J 'rty: State: ZIP; Insert — type hone: ! F `- ail: Wood et stove ltcant's signature: ' —'���J Other. pP g ,iL: i Date: Other: ame (print): 0 " Awi E 47 I all jurisdictions , cepl ..- lit cads, please call jurisdiction for morn in forme — Perim fee $ „ 7-7, S - 0 Visa D Ma . d Notice: This permit application Minimum fee $ dit card number: / / expire if permit i not obtaine Plan review (at %) S t� • e° Expire within 180 days after it has been Name of cardholder as shown oil credit card accepted as complete. State surcharge (8%) $ _ s TOTAL $ 7 B • 3 G Cardholder signature Amount 440 -4617 (6/00/COM )