Permit ./ °" CITY OF TIGARD MECHANICAL
`)1, DEVELOPMENT SERVICES PERMIT
1 A I PERMIT # : MEC98 -0116
13125 SW Hall Blvd., Tigard, OR 97223 503) 639.4171 DATE ISSUED: 04/02/98
PARCEL: 2S1O3DA -04000
SITE ADDRESS...: 10860 SW PARK ST
SUBDIVISION • ZONING: R -3.5
BLOCK • LOT • 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/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP : 0 DOMES. INCIN: 0
:WOD 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..: 1
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 wood stove in garage
Owner: FEES
FREDERICK EPENETER type amount by date recpt
10860 SW PARK ST PRMT $ 25.00 JSD 04/02/98 98- 304629
TIGARD OR 97223 5PCT $ 1.25 JSD 04/02/98 98- 304629
Phone #: 639 -6468
Contract or:
OWNER
$ 26.25 TOTAL
Phone #:
Reg #..: 999999
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Wo od st o v e Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 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 lay
obtain copies of these rules or direct questions to SIC by calling
(503)246 -9187.
I�
Issue By: . Permittee Signat10„
dr
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Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
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Plan Check #
CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd o00c
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # roc� - Op p
Incomplete or illegible applications will not be accepted Called 07Z-
Name of Developme E C nt/Rrojec ���
t - Description
� eb /{ / e Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suite# A) Permit Fee -0- -0- 10.00
Address /6-4,a ate, /34 2t 5)7
Bldg# City /State 1 Zlp 1.) Furnace to 100,000 BTU 6.00
4}
_ 4- -d 570?../2-3 including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner ri' 1 including ducts & vents
Mailing Address • 3.) Floor Fumace 6.00
including vent
City /State Zip Phone 4.) Suspended heater, wall heater 6.00
o,3 5 6Yi e i or floor mounted heater
Name (or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
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
15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy 30-50 HP; absorb unit 1- 1.75mil BTU"
of all licenses - City /State Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
database
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip Phone 15.) Ventilation system not included in 4.50 •
appliance permit
Describe work New, Addition 0 Alteration 0 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 !• f7 1
20.) Wood stove j 4.50
Proposed use of `C 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas 0 LPG jd ele ' 0 23.) Gas piping one to four outlets 2.00
I hereby acknowledge that I have r�3d this application, that the information 24.) More than 4 -per outlets (each) .50
given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State laws. QTY. SUBTOTAL
Signature of Owner /Agent Date *SUBTOTAL [
G: %'! %`te (, t / ' 4 -> 5% SURCHARGE + -
r `JJ
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
Required for all commercial permits only. /
TOTAL
*Minimum permit fee is $25 + 5% surcharge
(/ �
"Residential NC requires site plan showing placement of unit
l:lmechprmt.doc rev 4/98