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CITY OF TIGARD MECHANICAL. PERMIT Permit#
oe.crlption ` —
Yehlo 3A Mechedt:el Code OTYPRICE AMT
City of Tigard 1) Permit Fee -0 0 10.00
13125 S.W. Hall Blvd.
P.O. Box 23397 2) Supplemental Farmit 3.00
Tigard,OR 972236.00---
639-4175 ) Furnace to 100,000 0Tt1 /
incl.ducts&vents _ 6 _
-�,�- Fumacet00,00r1BTU + �-' --- -
incl.ducts 6 vents 7.50_ i
Floor Fumaog
l wma d DevMopmeN -- --a incl.vent -- -- -s-�
Job Address 4) Suspended heater,wall heater 600
Addressor floor mounted heater
Tax Lot Map No
�� - s`! p � E�- 5) Vent not incl.In 3.00
No.
Lot �/ aloar SubdSvblorr.A�1�G -----appliance permit ---- - -
Name(or name of txrsiness) 6) Repair of heating,tett Ig.,
6.00
cooling,absorption unitt
Mailing Address Phew 7) f3oilor or comp to 3 HP 800
Owner - absorp.unit to 100,000 BT1J
cityi3tate Zip - 6) f3o, ,r or comp to 3 HP-15 HP
absorp.unit to 500,000 BTU
Nene - 91 Boilor or comp 15-30 HP -- - 15.00
ebsar�.ur*'h_1 million - ---
'MEq Aftew --. _ amts 10) Boller or oommtp b 36450 HP 22.53
absorp.unit 1-1.76 mill _
Contractor (Xtyr3fab ZIP --" 11 Boar or comp to 50 HP------- 31.50 --
absomp,unit 1,760,000 BTU _
stole negls6tlkxn No Oty sola Tax No. 12 Air hvMl ng unit to 4.50
10,000 CFM
------------------------------------- --
I hereby aclowwfe.lpe that I have reed thie apf-Aca rhn that tw inY.xme",given is 13) Air handling unit
10,000 CFM + 7.50
convct.int 1 am the owrw or aroxwdzed apcoA of the owrw,MM plow wtomow we In -- -- ------ ____.---- —
oorpaanoe wM Stell Iwvv,kha I am registered with the Stas Buidea'Board,t,ol the 14) Non portable 4.50
number gNen is oorred (M exempt from stare registration oleo"give reason bek)w) evaporate et tiler
_ 1 S Vent fan connected 3.00 c
to a single duct -3
-------- --- - - - — - 1 G) Ventilation system not 4.50
included in appliance permit
-- -- 17 t food served by 4.50
mechanical exhaust / y
etrxa(owes or ageN) Dew 1 A) Domestic type
VA 7.50 -.
Describe WOf* additkm O a atlon C) repair I 1 incinerator -
to be done - residential 231non-residential IJ 1 Q) Commercial or industrial 30,00
Existing use of type Incinerator
building or property ---_--.- --- _. 20) Other I.e..woodstove,water / 450
Proposed oleo of
heater,solar,clothes dryers,etc.
------ -- --- — --
building or Ixoperty 21) Gas piping one to four outlets / 2.00
Type of lusl- oil I_] natural gas LPG L] electric ❑
--- 22) More than 41per outtet
N9-Tj-Q I: -- SUS-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 - _-V-`-_ 5010 446 SURCHARGE T
DAYS, OR IF OONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUS-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER -'`-- '---"------- ----
WORK
---WORK IS COMMENCED. TOTAL
;pedal Conditions
BUILDING PERMIT APPLICATION ;,ATE_
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FORTH EWORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PL ANS AND SPECIFICATIONS. OWNER PHC N2- -
LOT T O. ! `-p
OWNER PAm1 1;4iymirc,jr . JOB ADDRESS 1.0873 SW f>rwc.-i:ct . _ 1, 7oycr- ,unC ng 1'
ARCHITECT
s<-Imo ENGINEER J1.MdeC:,rd 211.1
BUILDER ADDRESS UESIGNER
STRUCTURE 19 NEW _ ❑ REMODEL U ADDITION ❑ REPAIR _ [] RENEWAL _ ❑ FIRE DAMAGE ❑ DEMOLITION
I RESIDENCE ❑ COMM FJ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PATIO 1-1 CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY — L,aNb USE ZONE R�••r'__BLDG.TYPE_FIRE ZONE PLAN CHECK BY CR HEAT
CLUjSL1;x-uct sinal,- ft-unily wn-1 ling w/attached car rage._ all pgrVroycd -plows.
%Lt'.�-ac . tS.L85SS1S1c._-_ REISSUE of 69134
SEWER PERN"T0 34520 (dul baths, 3 — tZaps 14 garr3m area 430 --_
OCC.LOAD FLOOR LOAD 40 HEIGHT 2 NO.STORIES '0 AREA 1855 NO.BEDROOMS � VALUE
BUILDING DEPARTMENT SETBACKS FRONT REAR _1 Q 4 LEFT SIDE 2 4 RIGHT SIDE
Permit 367.00 THIS PERMITIS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, ANC IT IS HEREBY AGREED THAT THE
Plan Check 40.00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPL.CABLE CODES AND ORDINANCES THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Subtotal — _ RESTRICTIVE COVENANTS. CONTRACTOR AND SUP CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARAI E PERMITS NEQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax 1.8.3 5 A'. :?S 0.'Au
SDC.— AGENT 600.
4 i
Total �$ J.0 J 00 � ICP C 4RT OR
A0.00 � PDCN, T 25Q.0�
BY _ ,
Approved 385.35 Recelpt No. �X;/7 DOS--------.-- PHONE
I
i
DATE INSP TYPE INSPECTION — — R
EMARKS PLUMBING DATE
Contractor
4,Pprmit No.
Rough-in
Fixture
Final
--I,,
— HEATING _ 1 rZ
Contractor ( ((47,
Permit No. aJ�Cfe�_—
�/- Gas or OilIL
Rough-in
Final
SEWER
Final
DRIVEWAY
%1liiUL_I�1Z Final
Storm Drainage
(Rain Drain)Final `
Sidewalk
Curb&Street Final
Approach
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final
f