Permit MECHANICAL PERMIT
OF TI GA RD 1 :F :I: r NO. MI (3(3:I.09 7
cmoF 6
OGEOON
COMMUNITY DEVELOPMENT DEPARTMENT 1)A IL ISSUED: 6/ 6/88
13125 S.W. Hall Blvd., P.O. Box 23397, Tigard, Oregon 97223, (503) 639 -4175 - ' ft' R I M . PM'r . NO . 881095
JOB ADDRESS: 9806 SW TI(:•:ARD ST
TAX MAP/LOT SUB: TIGARI :) :I :NI)(JSTR :I :A1_. PARK LT: BK :
I...ANI) USE:
LOT SIZ....
:I :TEM: NO: NO:
WORK CLASS: AI...m :RA'r :I :ON FURNACE <:1.001< AIR HANDLP <:1.0
USE TYPE: :I :NoL.JSTRIAL.. FURNACE 100K• +• AIR HANI)LR :1.01<
CONST . TYf:'E : FLOOR FURNACE RNACE: EVAP . 0OOI...EP
OCCI.JI' . ( ;PP . : B2 HEATER VENT FAN
VENT VI_:N'r . SYST'EM
EI...P /CC)MP <3H1-' :I. 1 -1001)
NO . S:iT()f2:1:ES : HI._P / COMP :5--•1 5HP :I :Nc :I :NN :BATOR (I)()M
I)WEL_L... (.JN1 :T5 : 1:31...1'; /COMP 1s- •:30HP :[NC :I :NERATOR (COM
FUEL 1YPE GAS 131_.P /COMP 30••- 501••11=' REPAIR UNITS
MAX. :IINPUT DLR /COMP ;:io- +•I -IP OTHER
FIRE 1)MPPS? GAS PIPING OUTLETS 1
1"1 :L( ;I.1 PRESS;?
LOW PRESS?
REMARKS:
Acid 1 ' n of rooftop +•I V AC`, c);:(. p ta. c k w / '-I0 M r31••I
I•titnc1 & :32 MBI -I cooling
FEES:
O Tigard St. Inv. PERMIT $10.00
N PLAN REVIEW $4.50
FIXTURES $8.00
STATE TAX $.90
OTHER
C
O AS1: HEATING
AS:r. HEATING
R 175 i55W 65TH
C lake (]!i Wr_ ?g() ()rt 97034
T PHONE ( 50:3) 6£34 - ••8583
R REGIS'T•PAT] :ON NO. 29938 TOTAL.: $23.40
RECEIPT NO. -
This permit is issued subject to the regulations contained in Title 14
of the TMC, State of Oregon Specialty Codes, zoning regulations
REQUIRED :I :NS :iPI_( : :T:I :( :)N'. :i
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be done in accordance with the plans and FRAMING
specifications and in compliance with all applicable codes and GAS LINE
ordinances. The issuance of this permit does not waive restrictive ME :( :'HANc1_.. SYSTEM
covenants Contractor and subcontractors shall have current city
FINAL
business tax permits This permit will expire and become null and
void if work is not started within 180 days, or if work is suspended or
abandoned for a period of 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all requ red inspections are requested and approved.
Ar
Permittee Sign:t
_ /�
Issued By (:AI_1... I• "(:)I•: INSPECTION 639••- 4175
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
/CITY OF TIGARD MECHANICAL PERMIT . Receipt #
Permit # VP/07 7
C i V\--t_ Description
U Table 3A Mechanical Code OTY PRICE AMT
City of Tigard 5
13125 S.W. Hall Blvd. 1) Permit Fee -0- -0- 10.00
• P.O. Box 23397
Tigard, OR 97223 2) Supplemental Permit 3.00
6 39 -4 175 Furnace to 100,000 BTU
1) incl. ducts & vents 6.00
Furnace 100,000 BTU +
2) incl. ducts & vents 7.50
Name of Development Floor Furnace
A/R _ T 3) incl. vent 6.00
Job Address Suspended heater, wall heater
Address 9ii r 5 N
C• / ��G.B -Q p Sriz 4) or floor mounted heater 6.00
Tax Lot Map No. 5) Vent not incl. in
Lot Block , Subdivision
appliance permit 3.00
Name (or name of business) 6) Repair of heating,
unit
g, r � 6.00
Mailing Address Phone Boiler or comp to 3 HP • Owner 7 ) absorp. unit to 100,000 BTU / 6.00 6
City/State zp Boiler or comp to 3 HP -15 HP
8) absorp. unit to 500,000 BTU 11.00
Nave Boiler or comp 15-30 HP
57 7A) 4 A—/C.. 9) absorp. unit 1/2 -1 million 15.00
Mailing Address Phone ) Boiler or comp to 30-50 HP
/75 524 av 10 absorp. unit 1 -1.75 million 22.50 Contractor City /state • Zip Boiler or comp to 50 HP
l i A'1v aZ 77 D s'� 11) absorp. unit 1,750,000 BTU 31.50
State Registration No. City Bus. Tax No. 12) Or 000 CFMunft to 4.50
29938
I hereby acknowledge that I have read this application that the information given is 1 Air handling unit
7.50
correct, that I am the owner or authorized agent of the owner, that plans submitted are in 10,000 CFM +
compliance with State laws, that I am registered with the State Builders' Board, that the Non portable
number given is correct. (If exempt from State registration please give reason below). 14) evaporate cooler 4.50
.P�Ceo`ii--"i 9 4 PQ'i 12 4) Zi -act • (4.,..J--(..-4-- 15) Vent fan connected 3.00
-y,� �■ C to a single duct
Ventilation system not
16 included in appliance permit 4 '' 0
17) Hood served by 4.50
mechanical exhaust
Signature (owner or agent) , � IC ":1(42.1,_ s - 19 Date 18) Dome type 7.50
Describe work ❑ add to alteration I>1.. repair ❑ incinerator
to be done residential ❑ non - residential eis 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 2.00
Type of fuel — oil ❑ natural gas sr LPG ❑ electric ❑
22) More than 4 -per outlet
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- SUB -TOTAL /8. QD
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 5 &/0 411. SURCHARGE .90
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25% OF SUB -TOTAL 4.50
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL B.4o
Special Conditions
Date issued by