Permit MECHANICAL PERMIT _ ,, . , p
:E:1 .. :: . ME8 :: 1 . CITY OF TINA R D rrYVI ARD . 8 ' ' ,
COMMUNITY DEVELOPMENT DEPARTMENT OQE OON
13125 S.W. Hall Blvd., P.O. Box 23397, Tigard, Oregon 97223, (503) 639 -4175 I ?(� M • I"`M T ' NO ' s 3t3.1.3.30
JOB ADDRESS:, 14650 SW 97TH AVE .
TAX MAP /LOT SUB: LT: 13K: .
LAND USE: • . ., .
LOT SIZE: . .,.. , _ _ „ . .
ITEM: ,Na: NO
.WORI< CLASS.:..,ALTERA1 ION . FURNACE. C100K _AIR', HANDLR <10 .
USE TYI ::IE.: EDUCATIONAL. FURNACE 100K+ AIR HANDLR .10K _ .
CONST . TYPE: VN FLOOR FURNACE, , E.VAP ..COOLER
OCCUP . GRP .:, El. , • 'HEATER , . . . . VENT FAN , .
VENT . , VENT. SYSTEM
. BLR /COMP <3HP •. HOOD .
NO . STORIT„ S : 1 BLR /COMP 3- ••13HP' . , . INCINERATOR(DOM (IOM ,
DWELL . UNITS :., - BLR / i5•- i0HP . . INCINERATOR (COM. ,.
FUEL 'TYPE .- BLP /COMP 30 - -50HP REPAIR UNITS
MAX .INPUT BLP /COMP 50. HP .OTHER , . 7
FIRE DMPI;S7 • .GAS PIPING OUTLETS. 7 .
HIGH PRESS? .
I...OW PPE::CSS
1 :WMAI: KS :
Twa.1.I t y Jr . High School. Science Rms
Move & add gas burner connections
_ , . . FEES:, . , .
Tigard School. - District 23J PERMIT $0.00
w 13137 ,sw pacific. hwy . . , PLAN REVIEW . $11,.25.
N E FIXTURES $35.00
R STATE. TAX $2..25 .
OTHER ,
C ., ;, • . . CI••IAUD ,
NORTHWESTERN MECHANICAL.
T • 7333 SE 302ND .
R Gresham OR. 97080 . •
C PHONE: (503) 663 -2643
T REGISTRATION NO,. Norwest TOTAL:, $58.50
p
R pi RECEIPT NO
This permit is issued subjectto the regulations contained in Title 14 _
of the TMC, State of Oregon Specialty Codes, zoning regulations °(>ZI�7 C) INSPI:C:'T' IONS t , .
and all other applicable codes and ordinances, and it is hereby GAS I._INE. , . . .
agreed that the work will be done in accordance with the plans and MECI -IANCL . SYSTE:M • .
specifications and in compliance with all applicable codes and F INAL. ,
ordinances. The issuance of this permit does not waive restrictive -
covenants. Contractor and subcontractors shall have current city
business tax permits. This permit will expire and become null and
void if work is not started within 180 days, or if work is suspended or . ,
abandoned for a period of 180 days any time after work has
commenced. It shall be the responsibility • permittee to assure
all required inspections are requ -sted a d alp. oved.
/ , i
Permittee gnatu7\ ID /�f ) C ALL.. FOR INSPECTION 639-4175
By: ' -_" "-� rr
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
I ..
CITY OF TIGARD MECHANICAL PERMIT Receipt #
Permit # c98/37/
Description
Table 3A Mechanical Code QTY PRICE AMT
City of Tigard
•
13125 S.W. Hall Blvd. 1) Permit Fee -0- -o- moo
P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
639-4175 , 1 , Furnace to 100,000 BTU
i ducts & vents 6.00
Furnace 100,000 BTU +
2) incl. ducts & vents 7.50
Name of Development Floor Furnace
7- -/0//-11y „ � � 3) incl. vent 6.00
Job Address 4 Suspended heater, wall heater
Address /46,50 SC�t] 97.7 4t/P ) or floor mounted heater 6.00
Tax Lot Map No. Vent not incl. in
Lot Block Subdivision
5) appliance permit 3.00
Name (or name of business) /, / 1 Repair of heating, refr ig.,
77 a,#t Sa 6 �D � _ i C / , J 6) cooling, absorption unit 6.00
Mailing Address' Phone 7 Boiler or comp to 3 HP
•
Owner 7) absorp. unit to 100,000 BTU 6.00
City /State Zip Boiler or comp to 3 HP -15 HP
8) absorp. unit to 500,000 BTU 11.00
Name 9 Boiler comp 15-30 HP
/' 7 „ ,� / �� � � / � absorp. . unit' /2 -1 1 million 15.00
Mailing Address Phone 10) Boiler or comp to 30 -50 HP 22.50
absorp. unit 1 -1.75 million
Contractor City /State Zip Boiler or comp to 50 HP
11) absorp. unit 1,750,000 BTU 31.50
State Registration No. City Bus. Tax No. 12 Air handling unit to
• 10,000 CFM 4.50 •
•
Air handling unit 7.50
I hereby acknowledge that I have read this application that the information given is 1 10,000 CFM +
correct, that I am the owner or authorized agent of the owner, that plans submitted are in
compliance with State laws, that I am registered with the State Builders' Board, that the Non portable
number given is correct. (If exempt from State registration please give reason below). evaporate c ooler 4.50
14)
Vent fan connected
15) to a single duct 3.00
Ventilation system not •
16) included in appliance permit 4.50
Hood served by
• 17 mechanical exhaust 4.50
Signature (owner or agent) Date Domestic type
18) incinerator 7.50
Describe work ❑ addition ❑ alteration repair ❑
to be done residential ❑ non - residential Commercial or industrial
Existing use of 19) type incinerator 30.00
building or properly Sc foo/ Other i.e., woodstove, water
Proposed use of �� n LL 20) heater, solar, clothes dryers, etc. 4.50 3450
building or property co/ 21) Gas piping one to four outlets 2.00 700
Type of fuel — oil ❑ natural gas LPG ❑ electric ❑
22) More than 4 -per outlet . 3 , ,0 /, 50
NOTICE SUB - TOTAL 4.504
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 . 5C70 41116 SURCHARGE 2
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25% OF SUB - TOTAL 11,25
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER '
WORK IS COMMENCED. TOTAL S8,$0
•
Special Conditions •
Date issued • by
n /u �.b%n�' /i ec�iof nicc, On fY
' / PLAN CHECK APPLICATION
C 1Y OF TIG�4 � l�'!J PLAN CHECK #
COMMUNITY DEVELOPMENT DEPARTMENT C � o�r�iARD PERMIT #
13125 SW Hall Blvd. P.O. Box 23397, Tigard, Oregon 97223 (503)639-4175 / DATE ISSUED —
JOB ADDRESS: /46,,',6 , G(, 9 7144 / TAX MAP /LOT _—
SUB: LOT: LAND USE:
•
OWNER 7791 /� �A 23c REISSUE OF:
ADDRESS: LAST REISSUE: .
FLOOD PLAIN/
SENSITIVE LAND:
PHONE:
APPROVALS REQUIRED
CONTRACTOR / PLANNING:
NAME: .SCter, Ge/1 l P/ � /7 t�Arl „ /j?C ENGINEERING:
ADDRESS: FIRE DEPT
OTHER:
PHONE: ITEMS REQUIRED
LIST /SUBCONTRACTORS: .
ARCH /ENGINEER BUS TAX:
NAME : S e % , f /A de d o t _ CALCULATIONS:
ADDRESS: TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN:
PHONE: OTHER:
COMMENTS: _ 4 S ” • % it 4 .4f.. � /_ iii r . ''._
_
Ca) C4 % I. - [ i e., IS1 , op-r-
-PERMIT # ACCT # DESCRIPTION AMOUNT • AMOUNT PD. BAL. DUE
10 -432 00 Building Permit Fees
c99 /330 10 -431 00 Plumbing Permit Fees j('j�p , /i2
gxec / . 10 -431 01 Mechanical Permit Fees • 4„s 00 45
10 -230 01 State Building Tax (5 %) 3.75 3 .75
Building
Plumbing /. sa
Mech 2.2.5
10-433 00 Plans Check Fee /R.75 1 .7
Building
Plumbing 7.$0
Mech //. 25
30 -443 00 Sewer Connection (20 %) •
30 -202 00 Sewer Connection (80 %)
30 -444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC)
52 -449 01 Parks I System Dev Charge (PDC) _
52 -449 02 Parks II System Dev Charge (PDC)
31 -450 00 Storm Drainage Syst Dev Chrg (SSDC) _____-
10 -230 09 TRFD (95 %) -- —
10 -435 00 TRFD (5 %)
10 -230 06 Washington County Fire #1 (95 %)
—
10 -435 00 Washington County Fire #1 (5 %)
10 -220 00 Amart /Wedgewood •
TOTAL 77. .$Z, 97, 50
- REC #
APPLICANT SIGNATURE
Received By: Date Received:
P LAN CHECK APPLICATION
CI1Y OF TI RD _
CITY OFT16ARD PLAN CHECK ## S' 7
COMMUNITY DEVELOPMENT DEPARTMENT OREGON / PERMIT # _
125 SW Hall Blvd. P.O. Box 23397, Tigard, Oregon 97223 (503)639 -4175 DATE-ISSUED
• JOB ADDRESS: / O 3W 97 rn TAX MAP /LOT
SUB: -- -• - --
_.^ LOT: LAND USE
• VALUATION: OTT)
OWNER •�- .� _.- .._
SPECIAL. NOTES
NAME : _ 7764ice `C _ z?'fnZeer Z 3 J REISSUE OF: __ _ _ _
ADDRESS: /3/3 7 SW iy/�,¢y LAST REISSUE:
' - // � FLOOD PLAIN/
PHONE: SENSITIVE LAND: �-
420 / APPROVALS REQUIRED
CONTRACTOR PLANNING:
NAME: ENGINEERING:
ADDRESS: FIRE DEPT -_ �� -� - - --
- - -� OTHER:
PHONE:: - - -! - - -�� ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH /ENGINEER BUS TAX:
NAME.: s47-Veg.,/ _ -� CALCULATIONS :
ADDRESS: 2/3 Sit/ TRUSS DETAILS: - --
ewrAzwd me?" PARKING PLAN:
LANDSCAPE PLAN:
PHONE: 20 •D/T3 OTHER: -
COMMENTS: APO 6
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10 -432 00 Building Permit Fees
- 10 -431 00 Plumbing Permit Fees -- •- ________
10 -431 01 Mechanical Permit Fees
10 -230 01 State Building Tax (5 %)
Building - -
Plumbing
Mech
10-433 00 Plans Check Fee ! - 0.0g / yO, Q �- $-
Building /clp. oS
Plumbing
Mech
30 -443 00 Sewer Connection (20 %)
30 -202 00 Sewer Connection (80 %)
30 -444 00 Sewer Inspection •
- -- - •___... -_ -__ -._
51 -448 00 Street System Dev Charge (SDC) _ ____
52 -449 01 Parks I System Dev Charge (PDC) - ___.�_ - -' - --
52-449 02 Parks II System Dev Charge (PDC) ________
31-450 00 Storm Drainage Sy Dev Chrg (SSDC)
10 -230 09 TRFD (95 %) $ l . $ - - --
10 -451 00 TRFD (5 %) _ q __ y_._3 # _ _ cam__
10 -230 06 Washington County Fire #1 (95 %)
10-451 00 Washington County Fire #1 (5 %) - - - —
10 -220 00 Amart /Wedgewood -
TOTAL
g�C REC # -- --
A'PLICANT SIGNATURE
•
Received By: _ _ Date Received: S /3�
PLAN CHECK APPL.ICAIION
CITY TI1RD
ALLA
CITY OF TIGARD PLAN CHECK # S 7 C_
COMMUNITY DEVELOPMENT DEPARTMENT \ OREGON / PERMIT #
13125 SW - -
Hall Blvd. P.O. Box 23397, regard, Oregon 97223 � 75 DATE ISSUED
1 ✓�
JOB ADDRESS: � / 97
TAX MAP/LOT
SUB: LOT: LAND USE:
VALUATION 3 thro d -- -- -- - —
OWNER SPECIAL.. NOTES
NAME: 7 s< CL'1L ,(,?' /j r Z 3 J REISSUE OF:
ADDRESS: /3/3 7 $'w .904/ ,(. j/(/¢y LAST REISSUE: — -_ --
-- FLOOD PLAIN/
SENSITIVE LAND:
PHONE: � o2OJ I 2161 _._.
APPROVALS REWIRED
CONTRACTOR PLANNING: eW NAME: SGjc'p (e� �7 <V /7'"--./ /'7c,. ENGINEERING:
ADDRESS: _ FIRE DEPT
OTHER: --
PHONE: *terzi~r %/ ���,� ITEMS REQUIRED
LIST/SUBCONTRACTORS:
ARCH /ENGINEER BUS TAX:
NAME: SEA /6'/ eG /ei CALCULATIONS: — -- ADDRESS: 2/3 Si4/ // _ TRUSS DETAILS:
PARKING PLAN:
LANDSCAPE PLAN:
PHONE: 22c •D 173 OTHER:
•
COMMENTS: 407 6 .;N!! � / • L
PERMIT it ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10 -432 00 Building Permit Fees
10 -431 00 Plumbing Permit Fees
10 -431 01 Mechanical Permit Fees
10 -230 01 State Building Tax (5 %)
-
Building -- Plumbing
Mech
10 - -433 00 Plans Check Fee (y 0.0 $ _ / 4 0.e&— 43-
Building /11O. o8'
Plumbing
Mech
30-443 00 Sewer Connection (20 %) _
30 -202 00 Sewer Connection (80 %) _
30 -444 00 Sewer Inspection
51-448 00 Street System Dev Charge (SDC)
52 -449 01 Parks I System Dev Charge (PDC)
52 -449 02 Parks :L:1 System Dev Charge (PDC) _ —
31 -450 00 Storm Drainage Syst Dev Chrcy (SSDC) __ -- - - -_- -- —
10 -230 09 TRFD (95 %) _g -9 — -
10 -451 00 TRFD (5 %) �6 av 'I -_ 3 1 _ Q
10 -230 06 Washington County Fire #1 (95 %)
10-451 00 Washington County Fire #1 (5 %)
10 -2.20 00 Amart/Wedgewood
TOTAL 2 7 ( 2_8
, 5te9� REC # _ �/ . 7 �
�
� , 26 -925°
• . 28
A'PLICANT SIGN ��/�,� 2
• . Received .By: Date Received: <S /3 /��