Permit --
....,.A. CITY OF TIGARD MECHANICAL
/.0 DEVELOPMENT SERVICES PERMIT
~=u~~ m~m~�~" "�"=~"� " ~'~~n u� n.�~~�� PERMIT #. . . . . ... : M��C97-0124
-�� �� 13125 SW Hall B��C���� ����/�
Tigard, ' DATE ISSUED: 05/08/97
PARCELt, 2S103BC-07300
SITE ADDRESS...: 12262 SW LANSDOWNE LN '
SUBDIVISION.. . . : 'FYRESTONE .~ • 'ZONING:`R=4. 5 '-
BLOCK..........: LOT :12 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/O APPL: 0 VENT SYSTEMS: 0
STORIES. . ...... : 0 BOILERS/COMPRES SORS HOODS.......: : 0
FUEL TYPES 0-3 HP • 0 DOMES. INCIN: 0
:GAS ~ ' ' ' . ' ' 3-15 HP. . . . • •�• COWL. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. ...: 0 REPAIR UNITS: 0
FIRE DAMPERS?:1 . :` ` ~ ' • 30-50 HP.. . . u• 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.: 2
FURN >=1690KBTU: 0 > 10000 cfm: 0 • .
.
Remarks : Install gas log fireplace and gas line for dryer
Owner: --- — FEES
BARRY REYNOLDS . ' ' type • amount by date recpt
12262 SW LANSDOWNE LN PRMT $ 25.00 JSD 05/08/97 97-294338
TIGARD OR 97223 ' 5PCT $ 1.25 JSD 05/08/97 97-294338
Phone #: 206-338-7114
Contractor: — —
ABLE MECHANICAL INC
3345 NW GLENCOE RD
HILLSBORO OR 97124 .
Phone #: 640-4141 '/ ' ' ' '^ . $ 26.25 TOTAL .
Reg #..: 000691
. ' ` ------- REQUIRED INSPECTIONS . '. .
This' permit issued subject tn±he:.regolatinns contained in the ^ ' Mechandcal. Insp. ... . � ` • - • _�__ ` .
Tigard Municipal Gode State of' Ore: Codesand*ll other —~' FinaI Inspection'''~- '' ' . _________
applicable laws. All work will be done. in accordance with • ___ ___ ____ ___
approved plans. This permit will expire 'if•work is not ,started' _ _______ .
.
within 18W days of 'issuance, or if work is suspended. for more ' • ___
than 180 days. _ . ___ __
�
_�� _ __������ ������
__ _—
Permittee Signa _ ./.* / . ------ -- _______ ____
� � __� __ �__
Issued B � . --�
______ ____ _____ ____ _____ __
` Or Call for inspection �— 639�_4175
Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 - - Date to P.E.
(503) 639 -4171 x304 Date to DST
Print or Type Permit # Al L C9 - o /0(7
Incomplete or illegible applications will not be accepted Called 0-9-7
Name of Deevelopme Description
e7J C('v� ( i rj)./ � Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- . -0- 10.00
Address 1a2 -6,. i ,An
Bldg# n
c on zip �� aa � B) Supplemental Permit 3.00
Name (or name of business) i L 1.) Furnace to 100,000 BTU • 6.00
•
Owner '� S incl. ducts & vents
M �
g Ad s \ 2.) Furnace 100,000 BTU + 7.50
c�- / 1 S tpA6S own 1-''i . incl. ducts & vents
City /State l n �1 Zi Phone
k 1�CAnd Qt` ��cr .0 Q3sJ� -7 t �4 3) vent
6.00
am o r name of business) 4.) Suspended heater, wall heater 6.00
V A/IcV .Q . or floor mounted heater
Occupant Mailing Address " 5.) Vent not incl. in 3.00
appliance permit
City/State Zip I Phone 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorp unit to 100K BTU _
"1Bj �/y�, ,,,� '� 7.) Boiler or comp, heat pump, air cond. 11.00
1 C' ' i Y l A ca I,� . gi 3-15 HP; absorp unit to 500K BTU
Contractor ( ya ®g Address I i I (0 8.) Boiler or comp, heat pump, air cond. 15.00
Attach CO of /State 1 Zi Phone 15-30 HP; absorp unit .5-1 mil BTU
P i � p 9.) Boiler or comp, heat pump, air cond. 22.50
Current Licenses �C/rC O�(j? (0(-0- t it L k 1 30-50 HP; absorp unit 1 -1.75 mil BTU
Oreegon Cont..Boa1d Lic.# Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
f O«"l (o -1- , 5)----) > 50 HP; absorp unit 1.75 mil BTU
• OT Business Tax or Metro # Exp. Date 11.) Air handling unit to • 4.50
X4 . .. � � t 19-- I -cln 10,000 CFM
Architect Name 12.) Air handling unit 7.50
10,000 CTM + - --
Or Mailing 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's Repair 0 15.) Ventilation system not 4.50
to be done Residential 1, Non - residential 0 included in appliance permit
Additional Description of work - 1 16.) Hood served .by
- s - r`1S . ?L) \ O re_ - ma c p z (t mechanical exhaust ' 4.50
n` c � 1' `' o ff( �k 0 17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
building or property type incinerator
19.) Clothes dryers, etc. 4.50
Proposed use of 20) Other units 4.50
building or property
Type of fuel - oil 0 natural gas/ LPG 0 electric O 21) Gas piping one to four outlets /� 2.00 n
I hereby acknowledge that I have read this application, that the 22) More than 4 -per outlet (each) J � .50 oC
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL 4n s
laws. .M.=
v , y .A~ /, 1tiJ,
Signature of Owner /Agent Date
. `SUBTOTAL �µ�:�. ��..At. � �.
?3y. _.. "=:a =a SA-,
( Q ,, SURCHARGE "` . . J
C R a �KA`� 5% SU \ ��- �l ZUNI. � R HARGE .. 1` ��
Conta t Person Name Phone PLAN REVIEW 25% OF SUBTOTAL . f;„; -;; _ -..
"t' C3b' i .
A ,(-',4, , r\-c. L 3 CCJ- (01,0 TOTAL 07-04:",i71- . _.,:�.�=
i:\dstknechpmt.doc 'Minimum permit fee is $25 + 5% surcharge M dj
Rev 7/96