Permit CITY OF TIGARD MECHAN I CAL
PERMIT
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DEVELOPMENT � SERVICES PERMI ISSUED: 07 • ME 97 7 -0`64
PARCEL: 1S135DD -00600
SITE ADDRESS...: 11831 SW PACIFIC HWY
SUBDIVISION • HOFFARBER TRACTS NO.2 ZONING: C —G
BLOCK..........: LOT •40 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 2 DOMES. INCIN: 0
:ELC 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 walk -in cooler Young's Funeral Home
Owner: FEES
YOUNG'S FUNERAL HOME type amount by date recpt
11831 SW PACIFIC HIGHWAY PRMT $ 25.00 JSD 07/16/97 97- 297196
TIGARD OR 97223 PLCK $ 6.25 JSD 07/16/97 97-297196
5PCT $ 1.25 JSD 07/16/97 97- 297196
Phone #:
Contract or:
SHEPLER REFRIGERATION
PD BOX 12146
$ 32.50 TOTAL
PORTLAND OR 97212
Phone #: 282 -7255
Reg #..: 000923
REG?UIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Cooling Unt Insp
applicable laws. All work will be done in accordance with Final Inspection
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 001 -0010 through OAR 952 -001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
‘
Issue By: Permittee Signature:
++- i-+++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ ++
Plan Check # 7- - P C
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential d ' Date Recd ° 11 (' /
TIGARD, OR 97223 l� 7 oats to P.E.
(503) J 539 -4171, x304 I i Date to DST
Print or T e I Permit* Ater q:? oZcy
YP Cali$' 7 2 2 7'7 `303
Incomplete or illegible applications will not be accepted /,,.-) Ger
Name yf Development/Pro Description
od+i � Table 1A Mechanical Code OTY PRICE AMT
Job s Aaareas pJ Suited
A) Permit Fee -0- -0- 10.00
Address I) R 3 /5 W / J ,lc f1
gorge if rsrate 7 1.) Furnace to 100,000 BTU 6.00
� q � 1 / including ducts & vents
N (or name bus, 2.) Furnace 100,000 BTU+ 7.50
}- � including ducts & vents
Mea
Owner e a .. r � r e r 6, / 14, fry N.
// 8 U ss Floor Furnace 6.00
Add 3.) 3 / S /� . �r ' w y including vent
--c sacs
Zip Phone 4.) Suspended heater, wall heater 6.00
4 , D^ c S v - - or floor mounted heater
N (or name of bus n ) / 5.) Vent not included in appliance permit 3.00
Q F` b• , e ✓st I
Occupant M " " 9 Address' 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT" (Z.
City/State ZIP Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to `j eP , - /117e r 5 _I ' , 15-30 HP; absorb unit5-1 mil BTU"
issuance g Addr 7 9.) Boiler or comp, heat pump, air cond. 22.50
applicant 1 0 , )d x J / &/ 6 30-50 HP; absorb unit 1- 1.75mi1 BTU
must provide all state zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor TO �--T /n . 92,A /e, .1 g ' , j, > 50 HP; absorb unit 1.75 mil BTU"
license O� Const Cont. Board Lice Exp. Date 11.) Air handling unit to 10,000 CFM • 4.50
information 7 3 If
for COT COT Business Tax or Metro 0 Exp. Date 12.) Air handling unit 10,000 CFM 7.50
database).
Architect Na ' n ° 13.) Non - portable evaporate cooler 4.50
or Mailing Address . 14.) Vent fan connected to a single duct 3.00
Engineer CayIState Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition 0 Alteration's Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work 17.) Domestic incinerators 7.50
18.) Commercial or industrial type 30.00
Incinerator
Existing use of 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of .. 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas 0 LPG 0 electric 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4-per outlets (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.
Signature of OwnedAgent Date 'SUBTOTAL �
-I ----- 7///9 _ 5% SURCHARGE / Zr
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL G 1
A/D t-^ r A e c A e.. 6,i_ 7J2,-r TOTAL -� /
i:ldstvmechpmtdoc (rev 9 'Minimum permit fee is $25 + 5% surcharge
**Residential A/C requires site plan showing placement of unit
OVER - THE - COUNTER (OTC)
COMMERCIAL MECHANICAL PERMIT CHECK LIST
Permit #:
AA C G ' '� � Z � { Date: /7?
Project Name: Y 174 „ e ha I
Site Address: // S'3 ,S; 47. per, 4
T 's di 0 e . ,d•■
Description of Project: .LA o'k / / j , / , / g 1 k , `y, G ® o A-
Class of Work: Floor Furnace: Evap Coolers: Or
Type of Use: Unit Heaters: Vent Fans:
Occupancy Grp: Vents w/o Appl: Vent Systems:
Stories: Boilers /Comprsrs: Hoods:
Fuel Types - 0 - 3 HP. Repair Units:
/ / / / 3 - 15 HP. Wood Stoves:
Max Input: Btu: Air Handling Units Clo Dryer:
Fire Dampers: < = 10000 cfm: - Oth Units:
Gas Pressure: H / M / L > 10000 cfm: Gas Outlets:
No. Of Units:
Furn < 100k Btu:
Furn > =100k Btu:
NOTES: .4 r•Jriir.7 r.► )* 1 ".lrii,) 7� /J r �.� �uy
R' i ,t J / - t. 1 -A 417,
OMMERCWC::::INSPECTtON: °ACTIONS :<:: >:::.: <:.
Permit Extension i Permit Fee
Gas Line Inspection G 2 Plan Review
Mechanical Inspection �" 5% State Surcharge
Heating Unit Inspection Supplemental Permit
Cooling Unit Inspection Additional Permit Fee
Shaft Inspection Additional Plan Review Fee
Hood Inspection Inspection Fee
Fire Suppr Inspection Miscellaneous Fee
Duct Inspection
Fire Alarm Inspection
Fire Damper Inspection REMARKS:
Miscellaneous Inspection
Fire Alarm Inspection
Final Inspection
OF USE OPTIONS : CAM =.commercial-: CMS` =: commerciat.
:.;PASS OF WORK OPTIONS.EOR ALL: PERM ITS rtewr ADD= additiOni aeration.
=:foundation? '.0TH. = :,OEM = ;demolition:: REP. =. repair,. FPS = fire protection system.:,NOTE= USE.0TH FOR FENCE ; < > >< > < '
RETAINING WALL, DETACHED :DECKS SIGNS. ..AWNINGS. CANOPIES'
i:\ovrcntr.doc (dst) 2/97
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