11149 SW ESCHMAN WAY i
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_ L1149 SW ESQ„IAN WAY
CITY CF TIGARD MECHANIC.
DEVELOPMENT SERVICES PERMIT #t-' RMI? . : ME(
13125 SW Hall Blvd., 'figard,OR 97223 (503)629-4171 DATE ISSUED, 0C3/ti4/'
pnRCEL: lr:;l W:sDE1 4'o7i
1 1 1--Ci P,vi L--'-.3L,6 + 4 N W H Y
lJSDTVT5I0N. . . . : I-nsi—l.E a A-r HRITTANY ZONING: R 1, Pl)
,,_OCK. . . . . . . . . . LOT. . . . . . . . . . . . . . 1. JURISDICTION; TTF
_ASG OF WORK. . :i)l_T f'I.-nnR FURN. . . . . 0 F l'AP COOLERS.t C
Yc'C OF USE.
. . . :Sr" UNIT HEATE"RS. . : 0 VENT FANS. . . : 0
"CLW,PNCY ORP. . :F?I'd VF'NT5 lAtn A►,K'!_.: 0 VENT '3Y`TF.MS: 0
TORIES;. . . . . . . . . 0 BOILERS/COMPRES5OR5 HOODS, . . .. . . . . V,
JEL. TYPE.t=-------- _. ._...__.__ . __ 0 . . HP, . . . : 0 DOW S. T NC I N: 0
3AS 3-15 HP. . . 21 COMML. I NC I N: 0
a); INPUT: 0 nl!..I 15— ;4� lip. . . . w 11 PU',AIR UNITS- V.
IRE DAMPERS?. . : 50-50 Hp. . . . : N WOODSTI VES). . : 0
10 PRC-.SGLJPFE . . : 50+ 1iP. CI-.r1 DRYE=RS. . : W
9. OF UNI 1'S-,------ f1 I R HANDL T NG UN T`f r, OTi-IE R UNITS. : I
JRN ! 100K PTU-. 0 10000 00 ( 1 in . 0 f30!-) X11 1 TI._E7 r3. : 0
JRN ) 1:1001l" BTU: 0 > 10000 (.fm: 0
Fsm-:ar,Ns : Inst;L11 gas stove
uner, FEE=S
TCHAE'L. GFr'KING R C:,h'F.:'f'i ('1ERte,IN(-, <<mui.irlt 1.)y da',e r•ecp1
1145 SW FSC,HMAN WOY vv f'RM'f $ 25. 00 JOD 08/04/'-)7 G7-- "J, �.i. .
TGARD O>9 3'7'i .,XPIRF- 1 . 27 JOT) 1718104 )7 17..-,�
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e7nl;1 ,3c{. nr- :
IT;EMAN' S F T REFI K1 F /rn T i'n rl!rlr
:'675 SW PF.AVE rtI')Flr1 R1
2.,5 TOT(,i_
AVERTnN OR 7712710", i
'Toric-� #: 646- 640')
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W. 000005
is permit is issued sub;ect to the regulations contained in the h1E, _tlanic.al Insp
gard Municipal Code, State of Ore. Specialty Codes and all other F'i )P1 IrTwpect ion
,plicable laws. All work will be done in accordance with
proved +lans, This permit will expire if work is not started
vr.thin 180 days of issuance, ur if work ire suspended for more
'han 180 days. ATTENTIONi Oregon law requires you to follow rules
'opted by the Oregon ",ility Notification Center. Those rules are
t fcrth in OAR 952--801-0010 through OAP. 952-001-0080. You may
Main copies of these rules or direct questions to OX by calling
03)24!-9187.
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Ca11 6339--41.75 tly 6:00 p. m. for- iriapec.tiar s i i e P d e d the riaxy h1.15LTieS.. ,I.a�,
++++•++++ Ii ++i•+++•+4++4+++•1++-1++++++++++4•++++•+•-1 ++++++++...�-+++4++•++++a 4 4+4+ 1-
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CITY OF T!GARD Mechanical Permit Application Recd
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGA.'RD, OR 97223 Date to P E.
503`` 639-4171, x304 DatePermit osT )
f d N/ ' 1 � t .,�•.
Print or Type CallediT—
__ ___Incomplete or illegible applications will not be accepted
Name of DeveropmmvProiact Descnphon
TableIA Mechanical Code CITY PrtCE AMT
Job street Address suns A) Permit Fee ��_-- 0- -0- 1000
Address .
Baga Crtyrstate zip 1.) Fumace to 100,000 BTU 600
rincluding ducts&vents _
— Neme for name of business) 21 Fumace 100.000 BTU+ 7 50
_ including ducts&vents
Owner � (- CI_Mailing Address 3) Floor Fumatx 6 00
r - • t, tv: including vent —
Cityrstata zip Phone a 1 Suspended heater,wall heater 500
or floor mounted heater
Name to nsmie of business) 5) Vent not included in appliance permit 3.00-
Apt- _
Occupant Mailing Address � - 6) Boiler or romp,heat pump,air Gond. 600
to 3 HP;absorb unit to 100K BUT"
cdr%snai: zip Pnone -- 7) Boiler or comp,heat pump,air Gond. 11 00
_3-15 HP;absorb unit to 500K BTU"
Contractor risme , 8) Boder or comp,heat pump,air Gond 1500
,Pnor to �A7-. L I5-30 HP;absorb unR.S 1 and BTU"
issuance Mailmy Address 9) Boiler or comp,heat pump,air Gond 22 50
applicant /5 -S.-W Iml 30-50 HP;absorb unit 1-1.75md BTU"
must provide all rtyrstate zip Phone 10) Boiler or comp,heat pump,air Gond. 3756
r t I� tf >50 HP;absorb unit 1.75 mil BTU"
contractor '- i)�A72;l� C�( Y ILnC.-.� • —
license Oregrin Conn.Com Bora l.io.e Exp.Date 11 ) Air handling unit to 10,000 CFM 450
information -LI" r _
for COT COT Kiss rax w Merin w Dale 12) Air handling unit 10,000 CFM 7 50
ne
If
database)
_ _ �,_ - - - - --
Architect N°'^°� 13) Non-portable evaporate c,jle( 450
or Hiding Address �- 14.) Vent ran connected to a single duct 300
Engineer C�r'18t° -' zipPhone 15) Ventilation system not included in~ 450
-�-�- appliance permit _ _
Describe worts New O Addition U Alteration O Repair O 16) Hood served by mechanical exhaust 450
to be done Residential O Non-residential O _ -_ ---
Additional Description of work —� —� 17) Domestic incinerators 7 50
18) Commercial or industrial type 3000
Incinerator
Existing use of " - -: 19) Repair units -- 450
building or property — ----- - — ------- - --
20stove 4.50
Proposed use of 21 ) Clothes dryer,etc 4 50
building or rroperty -- _ --- -
22) Other units 4 50
Typf fuel-oil O natural g:s O LPG O electric O 23 1 Gas piping one to roar outlets 200
e o
Ihereby-,ckncwl"e that I have read this application that the - 24 1 More than 4-per outlets(each) - 50
n
nfonnat'on given is coecd.that I am the owner or authonzed agent of -
( the,owrer,that plans submitted are in compliance with Oregor,State CITY SUBTOTAL
laws
Slgnatu•e of Owner/Agent Date 'SUBTOTAL
/? 1 � 5%
Contact PPhone PLAN REVIEW 25%OF SUETOTAL
TOTAL- ----- -
udstVnechpmt doc rev 9 - 'Minirnum permit fee is 525+5"'°surcharg? -
-'Residential A/C requires site plan showing placerrent of un,t.