Permit 41 _ CITY OFTIGARD
MECHANICAL
AarnF . A DEVELOPMENT SERVICES PERMIT
,il PERMIT # • MEC97 -0022
5+ := 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171
DATE ISSUED: 02/05/97
PARCEL: 1S136DA -01000
SITE ADDRESS...: 11564 SW PACIFIC HWY
1 SUBDIVISION • FRUITLAND ACRES ZONING: C —G
r BLOCK LOT •4
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 1
OCCUPANCY GRP..:SR3 VENTS W /O 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP : 0 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: Installing vent fan
Owner: FEES
MARK LAWRENCE type amount by date recpt
1526 PEACE PORTAL DR PRMT $ 25.00 B 02/05/97 97- 289949
SPCT $ 1.25 B 02/05/97 97- 289949
BLAINE WA 98231 -1720
Phone #:J2 6 -332 -5800
lj■ob
Contractor:
CONTRACTOR NOT ON FILE
Phone #: $ 26.25 TOTAL
Reg #.. .
REGQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the . Final Inspection
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 l80 days.
Permittee Si ature: 4e� = _�
Y
Issued By: ,'
Call for inspection. — 639 -4175
f r
Plan Check 0
��
C1TF TIGARD Mechanical Permit Application Recd By $ - •11 ,- *--
13425 SW HALL BLVD. Commercial and Residential Date Recd 2-
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # Mee..- 472.z_
Incomplete or illegible applications will not be accepted
Called
Name a ph
bU2+2L L'<E 0 Dv . -'Pt s.s6-.I C Table 1A Mechanical Code QTY PRICE AMT
Job Street Mares* A) Permit Fee
Address --- 67 1 --(
ress t I 5-
,.) P(>i -csi I C l" -0- -0• 10.00
ttldg& CdyIState Zip B) Supplemental Permit 3.00
fr...Tc„'� i O z 9 -
Name (or name al °a 1.) Furnace to 100,000131U 6.00
Owner IN QAL (,- Pw•-)7 -el C ind. ducts & vents
Maaing Adeesa PO .6.D2I',gat.; 2.) Furnace 100.000 BTU +
, S-2. f P Cp�� k' p� 0 2 . 7.50
and duds b vents
C 'ie ,b9 Poor* 3.) Floor Furnace 6.00
ll
i t t W Pr 61 `6 2 - ;1 I 3ce0 - S 3 Z - 5 OO ind. vent
. N+me (or name of euansas) 4.) Suspended heater, wall heater 6.00
iDu`Z�'LI:S C.I. bw ■ PPTly 't• - � t\1,C , or floor mounted heater
Occupant M (--1 eu � � C � � 5.) Vent not incl. in
3.00
ape
•
ciiyistaia
, 0 Q. ° 1 1- 111,3 1 2. - Z.e& -i 6.) Boiler or comp, heat pump. air acrid. 6.00
Name to 3 HP absorp un3 to 100K BTU
tO Qe -CLL'5 COS t vv\ Vrd✓i.a k (- nst L
7.) Boiler or comp. heat pump, air cond. 11.00
Contractor Millin Address 8.) HP; ahsorp unit to 500K BTU
\ Ck9t - Sv '' Arc C L 'l 8 15-30 HP comp. heat pump, air Bond 15.00
absorp utd .5-1 mil BTU
Attach CurrentLicensees 0 , 0 O. D I 1 13 VAS Z $S (-1 9.) Boiler or comp, heat pump. air Bona. x,50
Oregon carat cant adore ts.: 30-50 HP absorp unit 1 -1.7s mil BTU
l Z� a, Exp. Date 10.) Boiler or comp, heat pump, air pond. 37.50
t l 17i(71- 11 > 50 HP; absorp unit 1.75 mil BTU
COT Business Tag or Mena a
4 11 - ao u`5 r i l j' l 11 10,000 CFM to 4.50
Architect Nam U 12.) Air handing unit
- \tS &st4C e... - 10.000 CTM + 7.50
or s , /� co k - t - N i '. 13.) Non portable
�L''�' 60 g \-o 1 evaporate Cooler 4.50
,
Engineer Cd1dSrate z+v Phone 14.) Vent fan connected 3.00
S ILL . tJ13 t I5 r+3-wol - 11 ) to a single duct c� /
Describe work New X Addition 0 Alteration 0 Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non - residential 0 induced in options permit
Additional Description of work 16.) Hood served by
uL 1 .01$ p r -P¢h R va n# 0 01- mechanical exhaust 4.50
f_ a IT.p 17) Domestic irhdnerators 7.50
Existing use of �� 18. Commercial or industrial
building or property 30.00
type incinerator
19.) Clothes dryers, etc. 4.50
•
P r i d ing o property 5� sa gpSly T , ..1, (m 20) Other units - 4.50
n9 .
Type of fuel - oil 0 natural gas ik LPG 0 electric 0 21) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 22) More than 4-per outlet (each) .50
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
laws.
Signatu ;/• f Own : g • Date 'SUBTOTAL
SUBTOTAL
, . Z5.c)
l / i c Z 6T 5% SURCHARGE l /
• Contact Person Name Pho PLAN REVIEW 25% OF SUBTOTAL
•
E J t D 0 2t` l_ - 2-ikS -Z 5-I TOTAL _ • 7
cldstlmepmtdoc
dh 'Minimum permit fee is 525 + 5% surcharge
Rev 7/96
2/14/00 Activities for Case #: MEC97 -00022
3:13:38 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECC007 Application received 2/5/97 B RECD DST 2/5/97
MECC008 Permit created 2/5/97 B PEND DST 2/5/97
MECC799 Final Inspection 2/19/97 TLP PASS TLP 2/20/97
MECC090 (F) Issue permit 2/5/97 B PASS DST 2/5/97
MECC800 Case Finaled 2/20/97 TLP PASS TLP 2/20/97
•
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