Permit CITY OF T MECHAN I CAL
DEVELOPMENT SERVICES PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 DATE I ISSUED: 02 / 02/98 -003
!
PARCEL: 2S1O4AD -02400
SITE ADDRESS...: 12925 SW WALNUT ST
SUBDIVISION ZONING: R -4.5
BLOCK • LOT • 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: 1 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 < 1O0K BTU: 1 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : New gas outlets, gas furnace, and electrical to gas water heater
Owner: FEES
NI CLAUS DURDEL type amount by date recpt
12925 SW WALNUT ST PRMT $ 25.00 B 02/02/98 98- 302945
TIGARD OR 97223 5PCT $ 1.25 B 02/02/98 98- 302945
Phone #:
Contractor:
HARDY PLUMBING & HEATING
14689 NE COUNTRYSIDE
$ 26.25 TOTAL
AURORA OR 97002
Phone #: 222 -9654
Reg #..: 000609
REQUIRED INSPECT IONS
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 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 952-001-0880. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246 -9187.
Issue By: l �
: � � 1' Vut����� Per mittee Si nature
Y 9
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Check i
CITY OF TIGARD Mechanical Permit Application Recd By
131 25 SW HALL BLVD. Commercial and Residential Date Recd Z -
., OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST �
Print or Type Permit # I t re
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
Table 1A Mechanical Code QTY PRICE AMT
Job Street Address Sutter* A) Permit Fee -0- -0- 10.00
Address l ,Zc`fS b-JAL.,..)v
Bldg# City /State Zip 1.) Furnace to 100,000 BTU 6.00
�7/,, /4/2(/f including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner D U� tv ( 1 including ducts & vents i <-0 Mailing Address 3.) Floor Fumace 6.00
C '3.g)" • , S •/ G.J' ZUT including vent
,J
Ay/State Zip P hone 4.) Suspended heater, wall heater 6.00
Z AR S9D -9 $Yt( or floor mounted heater
Name (or name of busm�) 5.) Vent not included in appliance permit ) 3.00
Mailing Address 1
Occupant s 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU"
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
ilati \ 1 le (� / ,�-6 15-30 HP; absorb units -1 mil BTU"
Prior to permit Mailing Addre 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy J 7 /vs- ,.,/, [Qv,--; pa v S / G/, 30-50 HP; absorb unit 1- 1.75mi1 BTU"
of all licenses City /State Zip Phorfa 10.) Boiler or comp, heat pump, air cond. 37.50
are required if �}j/2Q2,9_ � `arl". - '//o S L: > 50 HP: absorb unit 1.75 mil BTU"
expired in COT Oregon C on�t %� rd Li.# Exp. p. Date 11.) Air handling unit to 10,000 CFM 4.50
database o
Architect Name 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 0 Addition 0 Alteration Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional Description of work: A,A-L,,, 6 p J 3 e J 7T, 17.) Domestic incinerators 7.50
1/ , 5 FUR- -1 / f file re 6 Of 18.) Commercial or industrial type 30.00
kips -T ) E ' Incinerator
Existing use of ���f 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 J) Mc
22.) Other units 4.50
Type of fuel - oil 0 natural gas 'FL, LPG 0 electric 0 23.) Gas piping one to four outlets 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 m the owner or authorized agent of
the owner, th planst s , mitt a in compliance with Oregon State QTY. SUBTOTAL
laws. 'i - a / .-1,-- `i_- `)- --9(?
Signature of Owner /Agent Date *SUBTOTAL ZC r(,L
(Re)(-1 1) i n ��� - 9 S �
5% (
Contact Person Name 'J � Phone PLAN REVIEW 25% OF SUBTOTAL t '
TOTAL 2to-1,5
i:\rnechpmt.doc (rev 9 'Minimum permit fee is $25 + 5% surcharge
**Residential NC requires site plan showing placement of unit.