Permit ,CITY OF TIGPRD
/'' DATE ISSUED: 09/�76
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hall Blvd. Tigard, Oregon 97223.8199 (503) 839 -4171 PARCEL: 1 S 135AD -01900
SITE ADDRESS...: 08818 SW SPRUCE ST
SUBDIVISION : GRAHAM ACRES ZONING: R -4.5
BLOCK LOT ° G .
CLASS OF WORK..:ADD FLOOR FURN : 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP.. :R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES -- - -- -- 0-3 HP • 0 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 < 100K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks: Installing furnace and gas piping
Owner: FEES
CAROL ARNSBERG type amount by date recpt
8818 SW SPRUCE PRMT $ 25.00 B 09/25/96 96- 284379
5PCT $ 1.25 B 09/25/96 96- 284379
TIGARD OR 97223
Phone #: 246 -9838
Contractor:
COLUMBIA HEATING
PO BOX 230397
TIGARD OR 97281 - ---------- ____ _
Phone #: 624 -2704 $ 26.25 TOTAL
Reg #..: 76359
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 188 days of issuance, or if work is suspended for more
than 188 days.
P e r m i t t e e Signature: _ L.,.L _ A., _--,-
Issued By :
( :)(.40.-- L OF /_ _____
__ Z)Vell Call for inspection - 639 -4175
Plan Check #
CITY OF TIGARD Mechanical Permit Application Recd By 0 /NulA kt
13 125 -SW HALL BLVD. Commercial and Residential Date Rec'd a l ° 2 - Cr 1 - 1to
TIGARD, OR 97223 Date to P.E.
' (503) 639 -4171, x304 Date to DST
Print or Type Permit# 0Ec - 0 1 Z
Called
Incomplete or illegible applications will not be accepted
mama Description
( ,a1e 77i r� Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Suds! A) Permit Fee -0- 10.00
Address e 3I S 50. 6pru u
BWg# cc rIS z� B) Supplemental Permit 3.00
Name (or name or business I 1.) Furnace to 100,000 BTU 6.00
Owner &J 4 it 5blAj ind. duds & vents / 6 -6D
4 M Adaess 2.) Furnace 100,000 BTU + 7.50
ict 6.0). t e- ind. duds & vents
'I rip I Phone 3.) Floor Furnace 6.00
TI I(. Og q�� o 8% ind. vent
name of ) i 4.) Suspended heater, wall heater 6.00
5/1.491.F' or floor mounted heater
Occupant Mailing Address 5.) Vent not ind. in 3.00
appliance permit
City/State Zip I Phone 6.) Boiler or comp, heat pump, air cond. 6.00
' to 3 HP; absorp unit to 100K BTU
•
i 7.) Boiler or comp, heat pump, air cond. 11.00
I f (��j ') a. -1 '. ,�J� 3-15 HP; absorp unit to 500K BTU
Contractor " 8.) Boiler or corny, heat pump, air cond. 15.00
� , �9 15-30 HP; absorp unit .5-1 mil BTU
Attach copy of /� zip Phone 9.) Boiler or comp. heat pump, air cond. 2250
C urrent Licenses (� `1 ��e J 6[� X77 30-50 HP; absorp unit 1 -1.75 ml BTU
Oregon Const.4:ont Board uc.# Exp. Date 10.) Boiler or comp, heat pump, air cond. 37.50
7(� - Q /b 2 -996 > 50 HP; absorp unit 1.75 ml BTU
COT Tax or Metro a Exp. Date 11.) Air handling unit to 4.50
6 l0 - 9 10,000 CFM
sa nti 12.) A
Architect Na- Air handling unit 7.50 10,000 CTM Of Mailing ✓ Address 13.) Non portable 4.50
evaporate cooler
Engineer CilYiState Zip I Phone 14.) Vent fan connected 3.00
to a single dud
j Describe work New 0 Addition 0 Alteration 0 Repair 0 15.) Ventilation system not 4.50
to be done Residential 0 Non-residential 0 induded in appliance permit
4 Additional Description of work /� 16.) Hood served by
i 2 J 1 1 �3 ` .6t_ - P (ta mechanical exhaust 4.50
1 17) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
building or property • .. type incinerator
•
19.) Clothes dryers, etc. 4.50
Proposed use of 20) Other units 4.50
building or property
Type of fuel - oil 0 natural gas 0 LPG 0 eledric 0 21) Gas piping one to four outlets r 2.00
I 65
I hereby acknowledge that I have read this application, that the 22) More than 4-per outlet (each) .50
information given is coned, that I am the owner or authorized agent of
' the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL
laws. p? ^�r
j .
Signature of Owner/Agent Date *SUBTOTAL _
S;xa: f ; m• ! 2 .6D
5%SURCHARGE '' ,.t 'IA 's ?'t
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL -'`' t ; -
,4,,,T,'_.: ' �`(.
TOTAL -
r.ldst mechpmt.doc 'Minimum permit fee is $25 + 5% surcharge
Rev 7/96
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171 Nj
Footing Rain Drain Cover /Service FINAL \
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mec
PIbg.Und /Flr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer 4112ffel Appr /Sdwlk Reins.
Other: G
Date: ! — 340 � �o A.M. C )
Address: .0 8 t/ 4 S� J •
Tenant: Ste: MS
Con /Own: II ,-(/- 27 D M EC : -
PLM:
ELC:
THE FOLLOWING CORRECTIONS ARE RE UIRED: ELR:
1?/l/15o ,z -
cif
w44
sp- tor: A Date: 30
DISAPPROVED /CALL FOR REINSP. CF CO