Permit J
PERMIT
CITY oF TI GARD DATE I ISSUED: 06/1 /96 -0175
COMMUNITY DEVE YH EPA p R g T �g M 3 ENT PARCEL: 2511 OCD -03100
SI Tth31 F� aI , Blvd Ti g ard. l J e� r t 9,7 2 L" I Y- sulkWY
I SUBDIVISION • ZONING:
BLOCK • LOT
CLASS OF WORK..:ALT FLOOR FURN 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:A1 VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 1 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 < 1O0K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 ) 10000 cfm: 0
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Remarks: Residential alteration of a gas furnace to BTU & one comp. to 3Hp.
Owner:
MARY SCHROEDER type amount by dame recpt
15815 SW ROYALTY PKWY PRMT $ 25.00 CJS 06/12/96 KING CITY
SPCT $ 1.25 CJS 06/12/96 KING CITY
KING CITY OR 97224
Phone #:
Contractor:
PORTLAND METRO —AIRE
10010 SW BEAVERTON HILLSDALE HWY
BEAVERTON OR 97005
Phone #: 626 -7818 $ 26.25 TOTAL
Reg #.. : 61219
REQUI RED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Mechanical Insp
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days.
Permittee Signature: ( ailed
Issued By: 010, C les 4 ni G77
Call for inspection — 639 -4175
JAN -06 –' 00 FR I 01:5 ID: FAX NO: 11017 P01
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City o? Ti MECHANICAL P . E PO5t-it' brand fax transmittal memo 7671 ES otpages
13125 SW Hall Blvd. APP LfCATlO � �' � � m ' f7
Tigard, OR 97223 K in �'
m E c 46-01 75��+. °� �� rx�- P h on e � l
(503) 639 -4171 �% G
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Fax # ✓ _ 7.2 t Fai (/��7 ) 3-7 1
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Job 4� "' �4 ,_ Table 3A Mechanical Code QTY PRICE AMT
Address 7 e4 1) Penult Fee -o- -0- 10.00
2) Supplemental Permit 3.00
`r e� Furnace to 100,000 6TU
4/37 fr 4 P is. - roe 1 1) Incl. duds &vents 6.00 .
Owner 2) incl. ducts & vent$ 7.50
Floor Fumanoe `
3) Ind. vent 6.00
Kam WAN* er daRry
- see •r; . . , w:
4) or Roor mounted Napo 8.00
Occupant """p .o.«. ,,,a .. AO - n
S) appliance permit 3.00
46. a° Repair of heating, retng.
6) cooling, absorpdon unit 6.00
a,,4 1 Boner or comp, heat pump. air Cbnd.
r. M&krD 1"G�, 6 6/84' 7 to 3 HP; absorp unit to 100K BTU % 6 6
Soder or camp, heat pump, air cond.
Contractfr i0 O Sw -t3P, w - Wri e 8) 3 -16 HP; abaorp unit to 500K BTU 11.00
boiler or comp, heat pump, a!r Cont.
aeCr11/- ?"7"2-4" 9) 15-30 MP; absorp unit ,5-1 ml BTU 15.00
moor o•, " p . `w" °"'`',,►" Boiler. or comp, neat pump, air cond. '
6l I ! t g 10) 30.50 HP; absarp unit 1.1.75 mil BTU 2250
i hereby aclmowledge thal l - nave read this application. tha boiler or comp, heat pump, air mind.
intorMatton given is collect, that I am the owner or author12ed agent 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with Stem Air handling unit to .
laws, that I am registered with the Construction Contractors Board. 12) 10,000 CFM 4.50
that the number given Is correct (If exempt from State registration, Air hanging unit
please give reason below.) 13) 10,000 CTM 7.50
Non portable
14) evaporate Cooler 4.50
Vent tan connected • • 15) to a single duct 3.00
Venslaoon system not
16) included In appliance permit 4.50
�iRRrr t ra 4WD "" Hood served try ,
17) mechanical exhaust • 4,50
Describe work new (,) addition () alteration ief repair U commercial or Industnal
to be done residentialg) • non - residential 0 18) type incinerator 30.00
Existing use of Caner i.e., woodstove, water
building or property 19) heater, solar, clothes dryers, etas 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or properly
Type of fuel - oil Q natural gas LPG 0 electric 0 21) More than 4 -per outlet
NOTICE
Minimum Fee $25.00 SUBTOTAL c,24-0
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE / y ''t.,�
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL
AFTER WORK IS COMMENCED.
TOTAL g4 r
Special Conditions __ ,� _..,e ,.. al ..
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- A / s a. A . ? R ate issued by 12,.., / ,e•''
RelRI®grr
3/27/00 Activities for Case #: MEC96 -00175
5:04:27 PM •
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 6/11/96 CJS , RECD CJS 6/12/96
MECA799 Final Inspection • CJS 6/12/96
MECA705 Gas Line Insp 6/12/96 CJS 6/12/96 •
MECA715 Mechanical Insp 6/12/96 CJS 6/12/96 _
MECA725 Misc. Inspection 6/12/96 CJS 6/12/96
MECA060 (F) Issue permit 6/12/96 CJS PASS CJS 6/12/96
MECA075 (F) Reprint Permit 6/12/96 CJS 6/12/96
MECA880 Expired by limitation 3/26/00 HAP DONE No Hold AKJ 3/26/00
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