Permit MECHAN I CAL
CITY OFTIRD u l PERMIT
CIT
`COMMUNITY DEVELOPMENT DEPARTMENT Y iNCARD PERMIT # • MEC91 -0179
13125 SW Hall Blvd. P.O. Box 23397, 7ipeid, Oregon 97223 (603) 839.4176
AAA - 41 71 nt.ITE ISSUED: 09/25/91
SITE ADDRESS...: 16485 SW ROYALTY Parkwa/ / PARCEL: 2S115BB -02700
SUBDIVISION C 0 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:
: /WOD/ / / 3 -15 HP • COMML. INCIN:
MAX INPUT: BTU 15 -30 HP • REPAIR UNITS:
FIRE DAMPERS ?..: 30 -50 HP • WOODSTOVES..:1
GAS PRESSURE...: 50+ HP • CLO DRYERS..:
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.:
FURN < 1O0K BTU: <= 10000 cfm: GAS OUTLETS.:
FURN > =1O0K BTU: > 10000 cfm:
Remarks: EXISTING WOODSTOVE
Owner: FEES
NORMA MARSH type amount by date recpt
16485 SW ROYALTY PARKWAY PRMT $ 25.00 JLH 09/25/91 —
SPCT $ 1.25 JLH 09/25/91 —
KING CITY OR 97224
Phone #: 639-8089
Contractor: - --
CONTRACTOR NOT ON FILE
Phone #: $ 26.25 TOTAL
Reg #.. .
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.
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2J
Permittee Signature: .(
Issued By: _
• Call for inspection — 639-4175
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City of Tigard MECHANICAL PERMIT Planck/Rec. #
13425 SW Hall Blvd. APPLICATION Permit # •
PO Box 23397 1/ '—
Tigard, OR 97223 C),'"2 &i
(503) 639 -4171
Name of Dovolopoons Description
/ c� Table 3A Mechanical Code OTY PRICE AMT
Address
Address 1�.,.5� 5ig,`-- ` , / 4. 1) Permit Fee -0- -0- 1 0.00
/� 7 ,.0-7 2) Supplemental Permit 3.00
■ip r �� � Furnace to 100,000 BTU
� � �� ;L 1) Incl. duds &vents 6.00
Phone Furnace 100,000 BTU +
Owner
1039— .109.7' ) y 2) incl. duds 8 vents 7.50
Floor Fumance
A ^ 3) ind. vent 6.00
Nom N. (. n .n. far Suspended heater, wall heater
4) or floor mounted heater 6.00
flaky Areoso. Phone Vent not incl. in
Occupant 5) appliance permit 3.00
CaopStato Lo Repair of heating, refrig.
6) cooling, absorption unit 6.00
Nano Boiler or comp, heat pump, air cond.
7) to 3 HP absorp unit to 1001( BTU 6.00
Mary Addrees Phone Boiler or comp, heat pump, air cond.
Contractor ) 3 -15 HP absorp unit to 500K BTU 11.00
C O O zo Boiler or comp, heat pump, air cond.
9) 15-30 HP absorp unit .5-1 mil BTU 15.00
Soso n.pw.00n No. Coy a.. Tax No Boiler or comp, heat pump, air cond.
10) 30 -50 HP absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond.
information given is correct, that I am the owner or authorized agent 11) > 50 HP absorp unit 1.75 mil BTU 31.50
of the owner, that plans submitted are in compliance with State Air handling unit to
laws, that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4.50
that the number given is correct (If exempt from State registration, Air handling unit
please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
15) to a single duct 3.00
Ventilation system not
16) included in appliance permit 4.50
Swear. (manor «.6«W O Hood served by
17) mechanical exhaust 4.50
Describe work new 0 addition 0 alteration 0 repair 0 Commercial or industrial •
to be done residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water
building or property 19) heater, solar, dothes dryers, etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00 .
building or property
21) More than 4 -per outlet
Type of fuel - oil 0 natural gas 0 LPG 0 electric 0
NOTICE •
Minimum Fee $25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE
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
Special Conditions
Date issued by
WMECNPMT
wo, oo, dd.v
)1iiiir KING CITY
■110 15300 S.W. 116th Avenue, King City, Oregon 97224 Phone: 639.4082
COMMUNITY DEVELOPMENT
APPLICATION FOR BUILDING PERMIT
(Instructions on reverse)
DATE 9/. 0
1. NAME OF APPLI • : ���: l i Phone No. 6 3 ?- .R 9
ADDRESS: -
ADDRESS OF PR• •SID 1 •
2. TYPE OF CHANGE, IMPROVEMENT OR CONSTRUCTION FOR WHICH PERMIT IS REQUESTED.
DESCRIBE BRIEFLY - ATTACH 'IWO CQPIEL PLANS OR DRAWINGS OF
PROPOSED PROJECT:
3. NAME AND ADDRESS OF CONTRACTOR / io —G
PHONE NO. LICENSE NO.
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 meetin )
SIGNATURE
*************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
APPLICATION RECEIVED BY DATE 9 - 9 /
APPLICABLE FEE RECEIVED $ %A S L'D TOTAL --L. c�-•
PLANNING COMMISSION DECISION: Approved Denied
CONDITIONS
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Approved applications are valid for six months
- Signature s i.�C / - e — '`"r 1 � { ,/ Date 7�
ROTE: Oregon Bonebuilders Law re es that all persons who contract for work on their residence be
registered with the Builde s 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 Ball Ph: 639 -4082.
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NOTE: A permit must also be obtained from the City of Tigard Department of
Ccamnaiity Development Yes ` No
*************************************************** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
CITY OF TIGARD INSPECTION REPORT
The above listed project has been inspected and Approved Denied
Date Comments •
Signature
( RwitcUng .i,n4pec to'r. ptea e. 4.e un . one. (1) copy to King City)
CD 2-87
5/24/00 Activities for Case #: MEC91 -00179 V
3:20:37 PM ® 1 D .
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes .
MECA007 Application received JLH 9/25/91
MECA010 Plan check by 9/25/91 JLH 9/25/91
MECA799 Final Inspection 9/30/91 GS NOTE TLP 9/30/91
MECA060 (F) Issue permit 9/25/91 JLH PASS JLH 9/25/91
MECA720 Woodstove Insp 10/9/91 GS DIS GES 10/9/91
MECA080 Void Permit 10/7/92 GES 10/7/92
MECA007 Application received JLH 9/25/91
MECA010 Plan check by 9/25/91 JLH 9/25/91
MECA799 Final Inspection 9/30/91 GS NOTE TLP 9/30/91 no one home , unable to insp
no one home , unable to insp
MECA060 (F) Issue permit . 9/25/91 JLH PASS JLH 9/25/91
MECA720 Woodstove Insp 10/9/91 GS DIS GES 10/9/91 see list see list
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Page 1 of 1
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171
Inspection: /- 'J 2 z
Footing Plbg. Underelab Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post /Beam Struct. San. Sewer Framing -Bldg.
Poet /Beam Mech. Rain Drain Insulation - Plumb.
Plbg. Underfloor Water Line Gyp. Bd. - Mech. EFo'c 6--
Date Requested: , r 4 7/ Time: AM PM
Address: / / /L ezmit
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
9 - .cam- Y 1
Inspector: ,,/ Date: 9- 3c)-?/
APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
4/ Call For Reinap.
I
INSPECTION NOTICE
G, City of Tigard Building Department
13125 SW Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639 -4175 Business / Phones: 639-4171
Inspection: / ( ' - " 0 $ 9
Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet /Beam Struct. San. Sewer Framing -Bldg.
Post /Beam Mech. Rain Drain Insulation - Plumb.
Plbg. Underfloor Water Line Gyp. Bd. -Mech.
Date Requested: /0-9'-? I Time: AM " '''''''' PM
Address: 6 8 -- • 1-- t • %M., P4 ' it t "`- Fl- 0 /7?
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Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: ■.4 Date: /
APPROVED 3/DISAPPROVED APPROVED SUBJECT TO ABOVE
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