Permit • _ f +ItL
PERMIT'
'
. '
CITY OF T I GAR® I T .. �ZIEi; 4 MECS�_iL��'7 / .
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW HaII Blvd. .Tigard „Oregon 97223.8199 (503) 6394171 PARCEL: 191260C-01 107
SITE ADDRESS...: 09500 SW Wr SHINGT,,OIV SQUARE RD #JCPEN,, '
SUBDIVISION....: ZONING: C -•G .
' BLOCK - LOT '
CLASS OF WORK.. : ALT FLOOR FURN....:' ' ' .EVAP COOLERS: '
TYPE OF USE • COM •UNIT HEATERS..: )ENT FANS....:
OCCUPANCY” GRP..: L 2 ' VENTS W/O APPL : . VENT SYSTEMS: : '' ' , •
STORIES -1 B OILERS /COMPRESSORS - HOODS .......e ': '
FUEL TYPES - -; - - -- 0 I-IP DOMES. I NC I N :
3 -15 HP..... ' COML. INCIN:'
MAX' INPUT: BTU 15 -30 HP..:.: ' REPAIR UNITS: '
FIRE DAMPERS ?..: 30 -50 HP . WOODSTOVES..:
bAs PRESSURE...: 50+ HP....: ' CLO DRYERS..,: '
NO. OF UNITS • . AIR HANDLING UNITS - OTHER UNITS. s . , •
FURN < 100K BTU: <= 10000 cf n : 3 - GAS OUTLETS.:
FURN >=100K BTU: . '> 10000 c•fm :
Remarks: JC Penney- Ductwork alteration 3 transfer fans under 10,000 CFM
Owner: - FEES -
WINMAR- CASCADE INC • type" amount by date recpt"
700 5TH AVE #2600 '. PRMT $ 25.00 JDA 08/21/95 95- 269562
PLCK $ 6.25 JDA 08/21/95 95- 269562
- SEATTLE WA 98104 -5026 SPCT $ 1.25 JDA 08/21/95-95-269562 •
Phone. #: .
.Contractor: • •
HVAC INC '
815 SE SHERMAN
' PORTLAND OR 97214 = - . . ' -- . - •- - - - - -- •
Phone # : . - $ 32. 50 TOTAL ,
Reg 4.. : 050897 . •
• . ' REG?U I RED I NSPECT IONS -- •- - - - - --
This pernit is issued subject to the 'regulations contained in the Mechanical Insp ' . . ,
' Tigard :Municipal Code,. State of Ore. Specialty Codes and all other• ' Duct Inspection
applicable laws. All work will be done in accordance with ', . Ili sc. Inspection . .
' approved plans. This - perait will expire if work is not started - ,Final Inspect ion _ . - - '
within 180 days of issuance, or if work is suspended for sore
than 180 days. • - ,. . •
PermitteS_e ,Signat'ur.e: _ • I - r -� (Z 1 -- " -- _..__ —__
' Issued. By _ - -- ___
. -
Call ' for in • - '639 -417 • '
•
City of Tiga. o M ECHANICAL PERMIT , _. .
Planck/Rec. # /P - ' C>
13125.SW Hall Blvd. -', (re f ' APPLICATIO ✓ , / Permit # >��-c gS- -vzP-
Tigard, OR 9722 A50 r „ I
CIA (503) 639 -4171 c rT °
r.... a b..«.pm.nt Des • /(16p)„141
` i S C QFittM4,t - CUU 4+ V I -C ti_�c..� £_, Table 3A Mechanical Code OTY PRICE AMT
Q ���
Job q ,� v J:14 5u) Wa f S 2
1) Permit Fee -0- -0- 10.00
Address gym• zip
--- Ti C' 1412-6 , 02 �, q -2.23 2)' Supplemental Permit 3.00
NoAe (« name w 01An•14) Furnace to 100,000 8 FU
1) incl. ducts & vents 6.00
""i•'0 amrw Phone Furnace 100,000 8 WU +
Owner 2) incl. ducts & vents 7.50
k•"rJe1 'P Floor Fumance
3) incl. vent 6.00
N'"•,« name of bane) Suspended heater, wall heater
J C Vk 4) or floor mounted heater ■ 6.00
Occupant 0 1.1101e Vent not incl. in
5) appliance permit 3.00
0°o TIP Repair of heating, refng.
6) cooling, absorption unit 6.00
Nome 8ouer or comp, heat pump, air cond.
H i fA C -S c__, 2.- Cl = (-1 g a'a 7) to :3 HP; absorp unit to 100K BTU 6.00
Weep Memo • Phone Boiler or comp, heat pump, air cond.
5 5 $-- Ste. rvkain 8) 3 -15 HP; absorp unit to 500K BTU 11.00
U° v n j ractor u ,„ s �,
f 1J � J Boiler or comp, heat pump, air cond.
ci OA 9 T oar 1- 02 E. 97� I y' 9) 15 -30 HP; absorp unit .5 -1 mil BTU 15.00
'jz Shef• °ry Bus. Tax No Boiler or comp, heat pump, air cond.
&{( 50 $ R7 a- I 9 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50
I hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond.
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 .3 4.50 it 5
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
O- r-i (--- al +a_ t L O - y - 14) evaporate cooler 4.50
Vent tan connected
3 ` vvlS- i t S Qilleb t /0 6r6VCF01 15) to a single duct • 3.00
Ventilation system not
16) included in appliance permit 4.50
"gneM• (meow or Kenn U0to Hood served by
17) mechanical exhaust 4.50
Descnbe work new U addition U alteration. J repair U Commercial or industnal
to be done 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 '- �
PERMITS BECOME VOID IF WORK OR CONSTRUCTION ��
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE '
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. t fd
TOTAL •
Special Conditions V"
Date issued by
/
k MECHPMT
wad \ comes re_cA
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 -4171
Inspectiq`
Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk
Foundation Plbg. Underslab Mech. Rough -in Fireplace
Post /Beam Struct. Plbg. Top Out Elec. Rough -in FINAL:
Post /Beam Mech. San. Sewer Gas Line -Bldg.
Plbg. Underfloor Rain Drain - Framing - Plumb.
Alarm Water Line Insulation CePl T)
Underflr. Insul. Shear Wall Gyp. Bd. - Elect.
Date Requested: /0 /S/ 7'5 Time: AM 2:36 PM
Address: �.5?)Q ) Ski
Builder: Permit #: 0 vc)- 7
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I�nspe _Z1 r: � Date: 10- 6 -- 7,5-
' APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE
_Call For Reinsp.