Permit qec 1cpI 4y
CITY OF TIG4RD M ECHANICAL
PERMIT AI
PERMIT # • MEC94 -0144
COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/07/94 13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 639 -4171
PARCEL: 15135BD-01200
SITE ADDRESS...: 09804 SW SHADY LN
SUBDIVISION ZONING: C —G
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 •2 BOILERS /COMPRESSORS HOODS •
FUEL TYPES 0 -3 HP DOMES. INCIN:
: /GAS/ / / 3 -15 HP •1 COMML. INCIN:
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 t 100K BTU: <= 10000 cfm: GAS OUTLETS.:
FURN > =100K BTU: ) 10000 cfm:
Remarks: REPLACING UNIT
Owner: FEES
VIKING LEASING type amount by date recpt
10260 SW GREENBURG RD PRMT $ 25.00 SW 06/07/94 —
5PCT $ 1.25 SW 06/07/94 -
TIGARD OR 97223
Phone #:
Contractor:
ROBBEN AND SONS HEATING
2300 SE 7TH AVE
P.O. BOX 14867
PORTLAND OR 97214
Phone #: 233 -5841 $ 26.25 TOTAL
Reg #.. : 01884
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 Mechanical Insp
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 susp- 'ed more
than 180 days. ,/ 1
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Permittee Signature: y �
Issued By: -D''1 6
Call for inspection — 639 -4175
4
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SW Hall Blvd.. APPLICATION Permit #
Tigard, OR 97223
(503) 639 -4171
Name a G.•.'epm.nt Descnption -
' Table 3A Mechanical Code QTY PRICE AMT
Address
Job - ,r 1) Permit Fee -0- - 10.00
-____ � `� �' �L -. ` � ,
/ 13s i .
N 2) Supplemental Permit - 3.00
• °' Furnace to 100,000 B I U
J J �� 1) incl. ducts & vents 6.00
Owner 0Z 4 0 n: " ' _ / 2) incl. ducts & vents 7.50
Floor Fumance •
3) incl. vent 6.00
i ab.e4e., ‘17" Suspended heater, wall heater
4) or floor mounted heater 6.00
Occupant
%LI ; "°""' MOM Vent not incl. in
5) appliance permit 3.00
°tfsow LP Repair of heating, refng.
6) cooling, absorption unit 6.00
1.0F" _ Boiler or comp, heat pump, au cord.
4 6 1 t� 7) to 3 HP; absorp unit to 100K BTU 6.00
'` "' � Boiler or comp, heat pump, air cone.
Contractor 3 �r ' i 8) 3-15 HP; absorp unit to 500K BTU 11.00 % D0
Boiler or comp, heat pump, air conc.
( 97�� 9) 15-30 HP; absorp unit .5-1 mil BTU 15.00
coo Coy No. Boiler or comp, heat pump, air cone.
�
/ 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that 1 have read this application, that the Soder or comp, heat pump, air cone.
information given is correct, that I am the owner or authorized agent 11) > 50 HP; absorp unit 1.75 mil BTU 37.50
of the owner, that plans submitted are in compliance with State 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 handling unit
please give reason below.) 13) 10,000 CTM + 7.50
Non portable
14) evaporate cooler 4.50
Vent fan connected
AP - 15) to a single duct 3.00
Ventilation system not
16) included in appliance permit 4.50
• :'c=5-.7'�- ��i Hood served by
/ ii) ‘- 7 o ! 17) mechanical exhaust 4.50
De - we new addition U alteration U re it U Commercial or industrial
to be .one residential 0 non - residential 0 18) type incinerator 30.00
Existing use of Other i.e., woodstove, water •
building or property 19) heater, solar, clothes 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 '2 S . `
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE i.7
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 74 7 ;
Special Conditions -
Date issued by
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