Permit ',^ zit; MECHANICAL
PERMIT
CITYOF TIRD �m�
PERMIT #.......: MEC90-0062
COMMUNITY DEVELOPMENT DEPARTMENT
�o�usmwm�e*� po��woxuur nn*m o"��"a�p�@�� : PRIM. PERMIT #.: MEC90-0062
' ' ... �r(z DATE ISSUED: 03/29/90
SITE ADDRESS...: 16735 SW QUEEN MARY AV PARCEL: 2S115BC-02900
SUBDIVISION....: ��n ^� {/�-L�/ ZONING:
BLOCK..........; LOT. . . . . . . . .. . . . :
--------------------_--------------------------------(*��----------------------
CLASS OF WORK..:ALT FLOOR FURN....: EVAP COOLERS:
TYPE OF USE....:SF UNIT HEATERS..: VENT FANS...:
OCCUPANCY GRP..:R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES... ^ BOILERS/COMPRESSORS HOODS.......:
FUEL TYPES------------ 0-3 HP....: DOMES. INCIN:
:/GA / / / 3-15 HP....: COMML. INCIH:
MAX INPUT: BTU 15-30 HP....: REPAIR UNITS:
FIRE DAMPERS?..: 30-50 HP....: WOODSTOVES..:
GAS PRESSURE...: 50+ HP....: CLO DRYERS..:
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS.:
FURN < 100K BTU:1 <= 10000 cfm:1 GAS OUTLETS.:2
FURN >=100K BTU: > 10000 cfm:
Remarks:
Owner: ---------------------------------- ---------------- FEES --------------
SIMPSON type amount by date recpt
16735 SW QUEEN MARY AVE PAYM $ 23.63 JLH 03/29/90
PRMT $ 22.50 / /
KING CITY OR 97224 5PCT $ 1.13 /
Phone #:
Contractor: ------------------------
A & B HEATING
DIAL ONE ACE HOLDING
14915 SW 72ND
TIGARD OR 97224 ------------------------------------
Phone #: 503-684-3355 $ 23.63 TOTAL
Reg #..: 31339
' -- REQUIRED 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 180 days.
Permittee Signature:
Issued By _-_—__-_— • -----' —
Call for inspection — 639-4175
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; ._ It z VED MAR 2 2 'ow
4kif KING CITY • Mayor: agett
Council Members:
—r 15300 S.W. 116th Avenue, King City, Oregon 97224 Phone: 639.4082 Maybelle DeMay
Hal Ennor .
APPL I CATION FOR " Herbert Lindner . •
PLANNING COMMISSION PERMIT • Stephen McShane
(Instructions on reverse) Manager•. • •
•
•
Lenore Akerson
~
. DATE ' 2 P6 Chief of Police:
/� • J. Dennis McClain
1. NAME OF APPLICANT: 0M. 9/ fry s o h Phone No. (.c- Ds
7
ADDRESS: f(0 7 DS' 54) Que ■ /71A-F
ADDRESS OF PROPOSED IMPROVEMENT 1073y Lc/ Quee, h1, .,' -e
2. TYPE OF CHANGE. IMPROVEMENT OR CONSTRUCTION FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - ATTACH TWO COPIES OF PLANS OR DRAWINGS OF PROJECT.
PROPOSED: • 1 r LL 11e. - /v ', C-
3. NAME AND ADDRESS OF CONTRACTOR A (3 Hiy cf— A�c / //is -(a 7°- U"0
.77zL�r PHONE NO.( -33SS LICENSE NO. 3/337
4. NEIGHBORS WHO MAY BE AFFECTED BY THIS PROJECT WILL BE NOTIFIED BY THE CITY.
5. APPLICANT OR HER /HIS REPRESENTATIV' - /UST BE PRESENT AT THE PLANNING
COMMISSION MEETING NEXT HELD ON
REPRESENTATIVES NAME PHONE NO.
(The King Ci+ Planning Connission will consider only those applications received at least five (5) days prior to a eeeting.)
Signature -(
*e* *, ** * * * **11 ** * * ** *x* *** * ****.** *** * * * * * *** *** ***** * * ** ** * ** **w*awa * *a* *its * **
APPLICATION RECEIVED BY „ow
APPLICABLE FEE RECEIVED $ / '- /�Z/,, , T " O ' L
PLANNING COMMISSION DECISION: Approved /i Denied
CONDITIONS /� ✓� ! i � ✓_-:4 ! _
Appro '. applications are valid for sir months only
Signature � /. '^��:� - � i % Date , 9a
- Oregon Hosebuilders Law require 0 O all ,;arsons who contract for work on their residence be
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registered with the builders Board which means the contractor is bonded and insured on the job site.
For your protection, be certain your contractor is registered by calling City Hall Ph: 639-4082.
Note: A permit must also be obtained from the City of Tigard Department of
Community Development Yes >< No
* e************+************ a* m**+**** w** ** * * * * * * * * * * * * * * * * ** * * * * * * * ** **
CITY OF TIGARD INSPECTION REPORT
The above listed project has been inspected and Approved Denied
Date Comments
Signature
(Building inspector please return one (1) copy to King City)
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P L A N N I N G C O M M I S S I ON
A PERMIT IS REQUIRED FOR ADDITIONS TO. ALTERATIONS, MODIFICATION OR
RECONSTRUCTION, OF EXISTING BUILDINGS: INSTALLATION /OR REPLACEMENT OF HEATING
AND COOLING DEVICES: CHANGING, ADDING /OR REPLACING PLUMBING OR ELECTRICAL -
WIRING; DRAIN LINES. FENCES NOT IN CONFORMANCE WITH ORDINANCE NO. 0 -89 -5. OR
NEW CONSTRUCTION WHETHER RESIDENTIAL OR COMMERCIAL.
" INSTRUCTIONS
1. FEES IN AMOUNTS SCHEDULED IN RESOLUTION R -89 -8 MUST BE PAID
.AT THE TIME YOUR APPLICATION IS SUBMITTED.
2. TWO (2) COPIES OF A PLAN /OR DRAWING OF THE PROPOSED PROJECT
MUST BE SUBMITTED 'WITH YOUR COMPLETED APPLICATION.
3. THE KING CITY PLANNING COMMISSION CONSISTS OF SEVEN VOTING
MEMBERS APPOINTED BY THE CITY COUNCIL OF THE CITY OF KING
CITY. THE COMMISSION HAS AUTHORITY TO MAKE ADMINISTRATIVE
DECISIONS RELATIVE TO LAND USES AND TO MAKE RECOMMENDATIONS
TO THE CITY COUNCIL REGARDING CONDITIONAL USE PERMITS AND
OTHER LAND USE PROPOSALS.
4. THE RESPONSIBILITY FOR COMPLIANCE WITH REQUIREMENTS TO
APPROVE BUILDING PERMITS LIES WITH THE APPLICANT. AFTER
RECEIVING AN APPROVED PERMIT FROM THE KING CITY PLANNING
COMMISSION. YOU MUST ALSO (when appropriate) APPLY TO THE
CITY OF TIGARD FOR A PERMIT (you will be informed at the
time your application is approved by the King City Planning
Commission whether this is necessary).
5. IN THE INSTANCE WHEN A PERMIT FROM THE CITY OF TIGARD
BUILDING DEPARTMENT IS REQUIRED. THE COMPLETED PROJECT WILL
BE INSPECTED BY A TIGARD BUILDING DEPARTMENT INSPECTOR.
_ OTHERWISE YOU SHOULD PHONE KING CITY (639 -4082) AND THE WORK
WILL BE INSPECTED BY A MEMBER(s) OF THE KING CITY PLANNING
-COMMISSION.
.6. APPLICATION MUST BE RECEIVED AT. LEAST FIVE (5) DAYS IN
- ADVANCE OF THE PLANNING COMMISSION MEETING DATE (0y:a-o a.m.
on the last Wednesday of every month in the Council Chamber
in City Hall). APPLICANT OR HIS /HER REPRESENTATIVE MUST BE
PRESENT AT THE MEETING TO ANSWER QUESTIONS THAT MIGHT ARISE.
SPECIAL MEETINGS MAY BE REQUESTED IN EMERGENCY SITUATIONS.
NOTE: INFORMATION MAY BE OBTAINED BY PHONING 639 -4082.
:. REFERENCES: ORDINANCE NO. 0 -89 -4 and RESOLUTION NO. R -89 -8
CiTY OF TIGARD MECHANICAL PERMIT Receipt #
Permit # e C- o O 2
Description
Table 3A Mechanical Code QTY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. C 1) Permit Fee -0- -0- 10.00
P.O. Box 23397 r
Tigard, OR 97223 I 1 ,J 2) Supplemental Permit 3.00
639 -4175 5 a°1) 1 Furnace to 100,000 BTU
) incl. ducts & vents • ( 6.00 6. 00
Furnace 100,000 BTU +
2) Incl. ducts &vents 7.50
Name of Development Floor Furnace
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3) incl. vent 6.00
Job dress Suspended heater, wall heater
Address ( 733 SW (Q iiy Agy nue 4} or floor mounted heater 6
Tax Lot Map No. 5) Vent not incl. in
Lot Block Subdivision
appliance permit 3.00
• Marne (or name of business) 6) Repair of i eatir g, Ceir iy., 6.00 "
�G �e s / >' S cooling, absorption unit • Mailing Address Phone Boiler or comp to 3 HP
Owner
(�a 23 S �� wi 7 ) absorp. unit to 100,000 BTU 6.00
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estate Zip 8) Boiler or comp to 3 HP -15 HP 11.00 •
f ( , 4, 9 7)-1-- Y _ absorp. unit to 500,000 BTU
Nape 9) Boiler or comp 15-30 HP • 13 / �-T absorp. unit 1/2 - million 15.00
Mailing Address Phone 10) Boiler or comp to 30 50 HP 22.50
r ti g7 54) l9• D
7a q_) 3ss- absorp. unit 1 -1.75 million
Contractor foie z Boiler or comp to 50 HP
F 1) P 1
U d ( ? 7 2 Z y 11 absorp. unit 1 BTU 31.50
State Registration No. City Bus. Tax No. 12 Air handling unit to on
3/ 33 Q ) 10,000 CFM - 'D
/ Air handling unit
• I hereby acknowledge that I have read this application that the information given is 1 10,000 CFM + 7.50
correct, that I am the owner or authorized agent of the owner that plans submitted are in
• compliance with State laws, that I am registered with the State Builders' Board, that the Non portable •
number given is correct. (If exempt from State registration please give reason below). 14) evaporate cooler 4.50
)
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Vent tan connected
15 to a single duct 3.00
Ventilation system not
16 included in appliance permit 4.50 , `
Hood served by 5
17) mec a; pica exhaust ,
4. 0
1 Signature (owner or agent) Date ) Domestic type
Describe work ❑ addition ❑ alteration'- repair D. 18 incinerato 7.50
to be done residential ( K non- residential 0 1 9) Commercial or industrial • 30.00 L.
Existing use of
type incinerator
building or properly RQ 5 Other i.e., woodstove, water
20) heater, solar, clothes dryers, etc. 4.50
Proposed use of
building or property 21) Gas piping one to four outlets 2.00 2 -0 a
Type of fuel - oil ❑ natural gas LPG ❑ electric ❑
' 22) More than 4 -per outlet
NOTI E
SUB-TOTAL .
22 -co
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5% 424 SURCHARGE I. j 3
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25% OF SUB -TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL Z3
Special Conditions
Date issued by
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5/30/00 Activities for Case #: MEC90 -00062
1:35:40 PM
Assigned Hold Updated dip O
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level BY Updated Notes
MECA715 Mechanical Insp 4/2/90 KS DIS KBS 10/1/91
MECA007 Application received JLH 3/29/90 •
MECA010 Plan check by 3/29/90 JLH 3/29/90
MECA799 Final Inspection JLH 3/29/90
MECA060 (F) Issue permit 3/29/90 JLH PASS JLH 3/29/90
MECA715 Mechanical lnsp 4/2/90 KS DIS .KBS 10/1/91
MECA845 Request inspection research 5/19/00 JMT DONE No Hold JMT 5/19/00 status V, but no void activity
MECA880 Expired by limitation 5/22/00 HAP DONE No Hold AKJ 5/22/00
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