Permit r
CITY OF T MECHAN I CAL
P ERMIT
, ?w D EVw LOPMEN DEVELOPMENT SERVICES PERM SUED: Q�3 /iME -0096
PARCEL: 2511OAB -00200
SITE ADDRESS...: 14411 SW PACIFIC HWY
SUBDIVISION • CANTERBURY PLACE ZONING: C —G
BLOCK LOT •1 -3 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN ° 0 EVAP COOLERS: 0
TYPE OF USE •COM UNIT HEATERS..: 0 VENT FANS...: 2
OCCUPANCY GRP..:B VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
•
. 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 < 1O0K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Install 2 exhaust fans.
Owner: FEES
SUPERPLAY type amount by date recpt
14411 SW. PACIFIC HWY PRMT $ 25.00 DLH 03/12/98 98- 304061
TIGARD OR 97223 5PCT $ 1.25 DLH 03/12/98 98- 304061
Phone #:
Contractor:
WHITES MECHANICAL SERVICES INC
5340 NW CROENI ROAD
$ 26.25 TOTAL
HILLSBORO OR 97124 -8514
Phone #: 690 -3489
Reg #..: 64455
REQUIRED 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 Misc. Inspection
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 - 01-0010 through OAR 952 -001 -0880. You lay
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
i . _
Issue By: Permittee Signatur= '�___- •.ilt. ' .
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + ++
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By 1_4
13125 SW HALL BLVD. Commercial and Residential Date Recd - /iz /9P
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # A1E 1 9d - 9096
Called
Incomplete or illegible applications will not be accepted
of De pme P�iect Description
t. L t "� Table 1A Mechanical Code QTY PRICE AMT
Job Street d s ea ` A) Permit Fee -0- -0- 10.00
Address 10411
. "Qire
Bidg# City/State Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner �v ipfr pi.. including ducts & vents
Mailing /I A 1 d 1 d � is �' ?tic., C +' i 3.) Floor Furnace 6.00
I `'1' 1 including vent
City/State // �� zip �Ph ne 4.) Suspended heater, wall heater 6.00
l < 1 i► S(�t- or floor mounted heater
Marne (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Ma ng .44.1 S i p � /w �� - 6.) Boiler or comp, heat pump, air cond. 6.00
' (� to 3 HP; absorb unit to 100K BUT
City/State /� y- Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
I A..) GSG 1t- 3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
t ` ti eCot . , �C , 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Addr ess � / �),,,,_.- r� ( 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy � 105.� IL-+) , 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses City /State • n,,, Zip Poe / ��� 10 Boiler or comp, heat pump, air cond. 37.50
are required if a1 L ib leo > 50 HP; absorb unit 1.75 mil BTU"
expired in COT O on Cont. Cont. Board Li .# Exp. D e 11.) Air handling unit to 10,000 CFM 4.50
database { ; �,,Z A o
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
C ity /State Zip Phone 1....... �� 0
Engineer P 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition iltf Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential gt
Additional Description of work 17.) Domestic incinerators 7.50
lk)c - At.L1Vb F4AuS� cod.) 012
2- E 1 t 1 : b m 18.) Commercial or industrial type 30.00
Incinerator
Existing use of (( /'� -y� 19.) Repair units 4.50
building or property 1..... U IVci 1 �V YV . � - �-'�. `.
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 o 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 iven is correct, that I am the owner or authorized agent of
the own , that ans subrm, . are in compliance with Oregon State QTY. SUBTOTAL
laws.
Sign ure of Ow gr /Agent Date *SUBTOTAL
x " 1 / 3 48 5% SURCHARGE / S
Contact Person ��Name Pho a PLAN REVIEW 25% OF SUBTOTAL
A ✓ b)41 1 (.., Q 43 TOTAL / .A__5 G.
i:Unechpmt.doc (rev 9 'Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
Page No. 1 CASE HISTORY FOR CASE NO.: MEC98 -0096
SUPERPLAY
14411 SW PACIFIC HWY
06/12/98
Action Description Reg/ Schd/ End/ Action Notes Disp By Update Upd
Code Sent Done Done Date By
MECC007 Application received / / / / 03/12/98 RECD DLH 03/12/98 DST
MECC008 Permit created / / / / 03/12/98 DONE DLH 03/12/98 DST
MECC090 (F) Issue permit / / / / 03/12/98 DONE DLH 03/12/98 DST
MECC706 Mechanical Insp 03/12/98 / / 03/20/98 PASS GS 03/20/98 J *H
MECC799 Final Inspection / / / / 03/20/98 PASS GS 03/20/98 J*H
MECC800 Case Finaled / / / / 03/20/98 PASS GS 03/20/98 J *H
•