Permit MI
• CIi TIRD CAlk PLrMt r
FA� ECHANCAL PERMIT # MEC91 -0116
COMMUNITY DEVELOPMENT DEPARTMENT m!EOON /
13125 S W Mall Blvd. ( 6 0 3 ) , 1 3 . 3 _ 9 i 4 1 7 5 / DATE I S S lJ E D : 07/09/91
SITE ADDRESS...: 16530 SW ROYALTY PKWY ` #KCITY) PARCEL: 2S1 —
SUBDIVISION • MLP9O -0021 ZONING:
BLOCK • LOT - 1
CLASS OF WORK..:ADD FLOOR FURN • EVAP COOLERS:
TYPE OF USE SF UNIT HEATERS..: VENT FANS...:
OCCUPANCY GRP..:R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES •1 BOILERS /COMPRESSORS HOODS •
FUEL TYPES -- 0 -3 HP :1 DOMES. INCIN:
: /GAS/ / / 3 -15 HP : COMML. INCIN:
MAX INPUT:55000 BTU 15 -30 HP REPAIR UNITS:
FIRE DAMPERS ?..:N 30 -50 HP • WOODSTOVES..:
GAS PRESSURE...:L 50+ HP • CLO DRYERS..:
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.:
FURN < 1O0K BTU:1 <= 10000 cfm: GAS OUTLETS.:1
FURN > =1O0K BTU: > 10000 cfm:
Remarks: Replace furnace, add a/c unit.
Owner: - - -- FEES
OWEN AYDELOTT type amount by date recpt
16530 SW ROYALTY PKWY PRMT $ 24.00 JLH 07/09/91 02
SPCT $ 1.20 JLH 07/09/91 02
KING CITY OR 97224
Phone #:
Contractor:
SOUTHWEST SHEET METAL
10415 SW 72ND
PURILAND OR 97223 - -- -- - - --
Ph on e #: 5032466284 $ 25.20 1 TAL
Reg #..: 45089
REQUIRED 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 Final Inspection
approved plans. This permit will expire if work is not started -
within l88 days of issuance, or if work is suspended for more
than IN days. —
Permittee Signature:
issued
B y: -- -- -- — -
Call for inspection — 639 -4175
CITY pF TTGARD MECHANICAL PERMIT Receipt#
13125 SW HALL BLVD. Permit #4J /- (2 / /6
P. O. BOX 23397 Description
TI GARD , OR 97223 Table 3A Mechanical Code OTY PRICE AMT
(503)639 - 4175 1) Permit Fee -0- -0- 10.00
Name of Development 2) Supplemental Permit 3.00
I
Job Address I 1 t Furnace to 100,000 BTU 6.00
Address ((0S 30 5 W (?a a,( , incl. ducts & vents ETU 55,000 6.00
Lot Map No. / ) Furnace 100,000 BTU +
Lot Block Subdivision
2 incl. ducts & vents 7.50
Name (or name of business) 3) Floor Furnac 6.00
mu e Ai A ta e 1 0 '�- incl. vent
.t$2a 4 Suspended heater, wall heater
Mailing Address Plane 6,ro 6.00
Owner 76 s3a � A it/ ? k�y ) or floor mounted heater
I ) Vent not incl. in
City
( k � p
2 Z 2 5) permit 3.00
l /
Name (or name pi business 6) Repair of heating, refr ig., 6.00
sA „ " ^ l cooling, absorption unit
Mailing Address Phone 7) Boiler or comp to 3 HP 24i� 6.00
Occupant absorp. unit to 100,000 BTU 6 00
City/State Zip 8) Boiler or comp to 3 HP -15 HP 11.00
absorp. unit to 500,000 BTU
Name 9 Boiler or com 15 -30 HP • 15.00
6j
- ✓ LA) e ST 5V/ L , (6 Ell/ ) absorp. unit 1/2 -1 million •
Mailing Address Phone 10) Boiler or comp to 30 50 HP 22.50
l /5 7 2-- absorp. unit 1 -1.75 million
Contractor City/State Zip 11 Boiler or comp to 50 HP 31.50
� e) 0 , - F 7 y -z - ) absorp. unit 1,750,000 BTU
State R istration No. `� City Bus. Tax No. 12) Air handling unit to 4.50
_SG' 10,000 CFM .
r Air handling unit
I hereby acknowledge that I have read this application that the information given is 1 3) 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 14 Non portable 4.50 •
number given is correct. (If exempt from State registration please give reason below). ) evaporate cooler .
15) Vent fan connected 3.00
to a single duct
16) Ventilation system not 4.50
included in appliance permit
•
1,, Hood served by 4.50
mechanical exhaust
Signature (owner or agent) Date 18) Domestic type 7.50
Describe work . ❑ addition ❑ • alteration ❑ repair ❑ incinerator
to be done residential ❑ non - residential ❑ 19) Commercial or industrial 30.00
Existing use of type incinerator
building or properly 20) Other i.e., woodstove, water 4.50
Proposed use of heater, solar, clothes dryers, etc.
building or property 21) Gas piping one to four outlets • / 2.00 7.0 d •
•
Type of fuel — oil ❑ natural gas ❑ LPG 0 electric ❑
22) More than 4 -per outlet •
NOTICE SUB -TOTAL
ZQ•Do
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 - S %.SURCHARGE / .,Uj
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 TOTAL 2.5
WORK IS COMMENCED.
Special Conditions
• Date issued by
)6iiii KING CITY • ,
15300 SW. 116th Avenue, King City, Oregon 97224 Phone: 639 -4082
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
(Instructions on reverse)
DATE 7/919/
1. NAME OF APPL .• : 4II ) i' ) if Phone • i — e-- Gr
ADDRESS: ') i - / • , • ; / .ARV
ADDRESS OF PROPOSED 1- -,o D it v i - • -
2. TYPE OF CHANGE, IMPROVEMENT OR CONSTRUCTION FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - ATTACH 'IWO COP y- OF PLANS OR DRAWINGS QF -
PROPOSED PROJECT: / _ % el - _ ' /i _ //At. A • .
l
3. . NAME AND ADDRESS OF � C T ONTRACTO - • • / - .- _ ,` .--,. ; / _ � Ar 1 9 /a . 777:ef .( i / '� - V PHONE NO ,74zi -ars / LICE SE O. �So V 5/3
4. NEIGHBORS WHO MAY BE AFFECTED BY THIS PROJECT WILL BE NOTIFIED BY THE CITY.
5. APPLICANT OR HER /HIS REPRESENTATIVE MUST BE PRESENT AT THE PLANNING COMMISSION
MEETING NEXT HELD ON
REPRESENTATIVES NAME PHONE NO.
(The King City Planning Commission will consider only those applications received at least five (5) days
prior to a meeting.)
SIGNATURE ei CCU
* * * * * * * * * * * * * * * * * * * * * * * * * ** ** * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION RECEIVED BY 0 DATE '/9//
APPLICABLE FEE RECEIVED' $' "' TOTAL - .
PLANNING. CCYHMISSI DECISION: Appr.ved ' -- • ed
CONDITIONS �_ _ -Z. ,c,e -.� , -o ��
/ •
Approved applications are slid for six months only
-Signature 11 - - Date
7 9 7/
. IOU: Oregon Homebuilders Law requires t i+' all persons who contract for work on their residence be
registered with the Builders Board - hick means the contractor is bonded and insured on the job site.
For your protection, be certain your contractor is registered by calling City Ball Ph: 639-4082.
NOTE: A permit must also be obtained) the City of Tigard Department of j
Corrrramity Development Yes No f
*************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** (i
CITY OF TIGARD INSPECTION REPORT �1
The above listed project has been inspected and Approved Denied k
Date - • Collments -
t
Signature
(Bu .&ung pec.tot. PL.ea be. Actium. one (1) copy to King city)
CD 2-87
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• 5/24/00 Activities for Case #: MEC91 -00116
3:22:55 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 7/9/91 JLH 7/9/91
MECA799 Final Inspection 7/23/91 KS DIS KBS 7/30/91
MECA715 Mechanical Insp 7/10/91 KS DIS KBS 7/30/91
MECA060 (F) Issue permit 7/9/91 JLH PASS JLH 7/9/91
MECA007 Application received 7/9/91 JLH 7/9/91
MECA799 Final Inspection V 7/23/91 KS DIS KBS 7/30/91
MECA715 Mechanical Insp 7/10/91 KS DIS KBS 7/30/91 H19910730KBS
H19910730KBS
H19910730KBS
MECA060 (F) Issue permit 7/9/91 JLH PASS JLH 7/9/91
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INSPECTION NOTICE
City of Tigard Building Depar.ent
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection:
Footing Plbg. Underslab Mech. Rough -in Appr /Sdwl
Found. Plbg. Top Out Gas Line FINAL:
Post /Beam Struct. San. Sewer Framing -Bldg.
Post /Beam Mech. Rain Drain insulation - Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: 7 '" c 6 — 6 // Time:
Address: / 0 7ZCoY11.., y `[ Perm t: 6 14— C l / Cp
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
Inspector: X:61/
Date: 7 — G? — (�
PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
Call For Reinsp.