Permit -77
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CITY OF TIGARD MECHAN I CAL
/4 ��� DEVELOPMENT SERVICES PERMIT
"�I'I PERMIT # MEC97-0207
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 06/20/97
PARCEL: 1S133DD -02100
SITE ADDRESS...: 12890 SW VILLAGE PARK LN
SUBDIVISION - VILLAGE AT SUMMER LAKE PARK 2 ZONING: R -4.5
BLOCK • LOT °60 JURISDICTION: TIG
CLASS OF WORK..:ALT 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 • 1 DOMES. INCIN: 0
:GAS 3 -15 HP • 0 COMML. INCIN: 0
MAXINPUT: 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: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 ) 10000 cfm: 0
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Remarks : installation of gas heater for residential swimming pool
Owner: FEES
CATHERINE PAUL type amount by date recpt
12890 SW VILLAGE PARK LN PRMT $ 25.00 TAT 06/20/97 97- 296258
TIGARD OR 97223 5PCT $ 1.25 TAT 06/20/97 97- 296258
Phone #: 524 -0710
Contract or:
AMERICAN PACIFIC SPAS LTD
13521 NE WHITAKER WY
$ 26.25 TOTAL
PORTLAND OR 97230
Phone #: 253 -4164
Reg #..: 000987
REG?UIRED 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 Heating U n t Insp
approved plans. This permit will expire if work is not started Final Inspection
within 180 days of issuance, or if work is suspended for more
than 180 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 001 -0010 through OAR 952 - 001080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue B y : , /.l.. , Permittee Signature: 2//74Y67, ✓'S
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check #
C
ITY 'bF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit # /VI gf 1
Called
Incomplete or illegible applications will not be accepted
, me ofoopvelopmenUProject Descnption
i' ' b'�Hke i ►ne -11AV'-t Table 1A Mechanical Code QTY PRICE AMT
Job - Street Address 9 uiten J A) Permit Fee -0- -0- 10.00
Address %�.GQr) 6.fo l'; i l 4 Y LA • 1 /0 -
id e P 1.) Furnace to 100,000 BTU 6.00 •
T i Or 97,?.?-3 including ducts & vents
N (or name of bus 2.) Furnace 100,000 BTU+ 7.50
Owner ( A 4 eV( IA e ` including duds & vents
- Marlin Address y� `` 3.) Floor Furnace 6.00
o
C/ (� (�
Soo. l r l P I Phone 1� Lk, including vent
. 1 _6:4/et r AA Cr. �i Phone 4.) Suspended heater, wall heater 6.00
l I )AY'� v _ l . 07i in or floor mounted heater
(or name of business) 5.) Vent not included in appliance permit 3.00
1 e.Y( r apt
Occupant ling Address
1 ,^ C), (1) (7 6.) Boiler or comp, heat pump, air cond. 6.00
. N ryk- L t o 3 HP; absorb unit to 1 OOK BUT" � O 5 ��� S 4 -0? ) ne 7.) Boiler or comp, heat pump, air cond. 11.00
b ✓ ; ( 3-15 HP; absorb unit to 500K BTU"
Contractor ` /'� `r 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to ./`t C ki- am" l t Cqt tin n 15-30 HP; absorb unit.5 -1 mil BTU"
issuance M. ling Address \ (` i ,1 9 Boiler or comp, heat pump, air cond. 22.50
applicant / 4 5:; I 10 _ (<041z }A. `' e Y 1N Li , 30-50 HP: absorb unit 1- 1.75mi1 BTU" •
must provide all , , e p � rnone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor gild di 1 A. il
∎ 1 - • > 50 HP; absorb unit 1.75 mil BTU"
license O regon Const Cant :�a Lie.# , ; Ex p. Date p 11.) Air handling unit to 10,000 CFM 4.50
information (Sp (i , 0, i i -
for COT - � Business Tax or M a Exp. ate 12.) Air handling unit 10,000 CFM 7.50
database). ( 7 1 9 V
Architect Name
) � 1 A A 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New* Addition 0 Alteration 0 Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional
K dditional De p on of w ® yetks e 17.) Domestic incinerators 7.50
1 544/ld4 1- (0 ✓t i CY Y C w I n IM 18.) Commercial or industrial type 30.00
c� 1 1"' 0 l Incinerator
Existing use of �� 19.) Repair units 4.50
building or property
20.) Wood stove 4.50
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gasX LPG 0 electric 0 23.) Gas piping one to four outlets 1 2.00
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL �,` ^i
laws. O�
Signature of Owner/Agent A Date *SUBTOTAL A � 1 I
�IL77G✓ 1. r/ p)0 ( 7 5%-SURCHARGE I 1/V ` �
:25
Contact Person Name .� Phone J� /` PLAN REVIEW 25% OF SUBTOTAL
K K N 6� l l Ot5 - 2 /! / CPT TOTAL ‘A G v/ J
r
i:4dstlrnechpmtdoc (rev 9 'Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
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Date Requested: 6 ( 97 A.M. V P.M. MST:
q
Location: /--2- $ / Q / 7 /c, e �� X BUP: ? 7 G 2/ 9
. Tenant: Suite: Bldg: MEC: 77-0.207
Contractor: (?121 ,2
-( Spa_ yore ore J 0 Phone: S PLM:
Owner: - 711A. • p Phone: cA-_ H.A.. ELC:
• ELR:
—� SIT:
BUILDING BLDG (con't) PLUMBING 1 Wrial=f21111P ELECTRICAL SITE
Site Post/Beam Post/Beam Po : eam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Ro In Ceiling Water Line
Slab Framing Top Out (Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp - Drywall Storm Furnace . Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Ahn Crawl/Found Dr Heat Pump Low Volt
Approved Approved . prove. Approved Approved •
Appr /Sdwlk Not Approved Not Approved No • .. oved Not Approved Not Approved .
FINAL FINAL &. #i FINAL FINAL
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O Call for reinspection�� _ O Reinspection fee of $ / be ne
required before next inspection O Unable to inspect
Inspector: ..../ /�( Date: ` Z / ' / 7 Page of