12392 SW 133RD AVENUE �i
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MECHANICAL
CITY OF TIGARD PERMIT
PERMIT #. . . . . . . : MEC94-005,5'
COMMUNITY DEVELOPMENT DEPWFNfiN,T DATE ISSUED:
13125 SW Hall 13lvd.Tigard,Oregon 97223.8199,(503)639-4171
PARCEL: 2SI04AB-12700
SITE ADf - -3�3. 12 92 SW 1.---3RD AVE'
SUBDIViSION. . . . !�:iRNING HILL PH 6 ZONING:
BLOCK. . . . . . . . . . LUT. . . . . . . . . . . . . : 155
CLASS OF WCJRK. . :NEW FLOOR FURN. . . . EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS. . . :
OCCUPANCY GRP. . : R-'; VE-NTS W/O APPL.: VENT SYSTEMS:
z3TORIES. . . . . . . . . BOILERS/COMPRESSORS HOODS. . . . . . . :
F'UEL. TYPES-------- 0----3 HP. DOMES. INCIN:
3-15 HP.
COMML. INCIN:
MAX INPUT: BTU 15—;:,171 HP. . . . : REPAIR UNITS:
1-1 RL DOMPERS9. 30-50 HP. . . . : WOODSTOVES. . :
GAG PRESSURE. . . 50+ HP. . . . : CLO DRYERS. . :
1\10. OF AIR HANDLING UN I TS OTHER UNITS. : 1
FURN ( 100K BTU- <== 1001110 c--fm : GAS OUTLETS. :2
TURN ) =100K BTU: > 10000 c,fm :
Remsr-I(s : INSTALLING GAS APPLIANCE NOT A FURNANCE.
owner,: FEES
KURT GOLDSMITH type Amoi-int by date r-erpt
l 39 SW 133RD PRMT $ 25. 00 BLT 02/22/94
5PCT $ 1- 25 BLT 02/22/94
FICARD OR 97223
Phone #: 590-3921
Contractor:
COI ITRACTUR NOT ON FILE.
Phone #: $ 26. 25 TOT(4L
Reg #.
REQUIRED INSPECTIONS
This pernit is issued subject to the regulations ce-itained in the Final, I J TIspection
Tigard Municipal Code, State of Ore. Specialty Codes and all othv
applicable laws, All work will be done in accordance with
approved plans. This pervit will ,xpire if work is not started
within 180 days of issuance, or if work is suspended for more
than 180 days.
Pei�111 I t t re S i gnaAt 1.1v-e 1 114&A
IsFii-ted By : a-1-—I —
for- inspection 639-4175
INSPECTION NOTICE
City of Tigard Building Department
13125 SW Hall Blvd. Tigard, Oregon 97223
Inspection line (Rec-O-Phone): 639-4175 Business Phono: (39-417:1 417f��I
Inspection:___—____-_ y�t A(\' __`'{ Ash t' I� ,H Z- C,[d(l�_l S 0.-
Footing Plbg. Undnraleb Mech. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out Gas Line FINAL:
Poet./Beam Struct. San. Sower Framing --Bldg.
Poet/Beam Mech. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water I.i.ne Gyp. Ed. -Mech.
Date Aequeated:__. �- _ � _ T111Mt X AM PN
Address: I ( .JPermit #,IMCC qy_6U)"
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
I l U6 li
L ,
w a-.,-
CDJ
Inspectors_ �/� Dates Z Z 0
APPP.OVED DISAPPROVED APPROVED SUBJECT TO ABOVE
^__Call For Reinsp.
•
G1 I Y Ulf I lt-441d) -, I&A,JAPI OF [44Mt,N1
AME a W)t,,0t.4MfTHv BONNIE.' CA6H AMI'IUN 1 0. 00
Sw 133141.) Pf4YMI7Nl* DATF (Ae./klc/94
TIGARD, OR SUBD I V U:j I UN
UPPUSF. OF' VlAYMVNI i)11111 IN I P$4 11) PURPOSP OF Pf4YMf-',NI "MI AINT P1411)
a. F:l,'JAAN I CPP- V+- MVC9 ----00!"-" P!5. 00 SiT., BUILD r-11-:-R 1W
P
cs
(yjpt, AMOUNT VIA ID
City of Tigard MECHANICAL PERMIT Planck/Rec. # _
13125 aW Hall Blvd.
APPLICATION Permit #✓r;
Tigard, OR 97223
(503) 639-4171
Tabl,�3A Mechanical Code QTY PRICE AMT
Job .w 1) Permit Fee -0- -0- 10.00
Address .» — 1.00
2) Supplemental Permit
urnace
3C� 1) incl. ducts&vents (1.00
urnace + I
�22 2) incl.ducts&vents 7.50 '—
Owner J 1 or Furnance
1/ 3) incl.vent _ 6.00
„ ' uspcn eater,wa eater
4) or floor mounted heater 6.00
en no � e
Occupant 1 W ) appliance permit - 300 _
S(,2 .� r /�4' ��72-2. 5) aepair o eating,re ng.
6) cooling.absorption unit _ 6.00
_ dr —
nBoiler or comp,heat pump,air co
F J 7) to 3 IAP absorp unit to 100K BTU 6.00
-� �— — i er or comp, eat pump,air-
8) 3.15 HP absorp unit to 500K BTU 11.00
Contractor ,. To i er or comp, a pump,air co .
9) 15.30 HP absorp unit.5-1 mil BTU 15.00
„e,, o .. i er or comp, at pump,air conU.
10) 30-50 HP absorp unit 1.1.75 mil BTU 22.50
re y ac ow a at ave rea3 iFiis app icaUon, a ITinBoiler or comp,neat pump,au con .
information given is correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU
31.50
of the owner,that plans submitted are in compliance with State it an ing unit to 4
x laws,that I am registered with the Construction Contractor's Board, 12) 10,000 CFM .50_
that the number given is correct. (If exempt from State registration, --A an --ng uru 7
please give reason below) 13) 10,000 CTM+
-- .50
on porta
Ve 14) evaporate cooler 4.50
-- en an connect
15) to a single duct -- 3.00 _
-- enh abon system nal
16) included in apphanco peomit 4.50
o sery
17) mechanical exhaust 4.50 _
sen w new a itxma cera n U repair Commercial or tn-X�s�tna
incinerator 30.00
to be done residential Q non 18 residential Q ) type —
xtseng use oT- � -�lfier t.e.,w s eve,water
building or property 19) heater,solar,clothes dryers,etc. 4.50 _
20) Gas piping one to four outlets 2.00
use of —�— — -- --
building or property
21) More than 4-per outlet
F- -
Type of fuel -oil p natural gas Q LPG Q eloctrk-Q
r
—t Minimum II$25.00 SUBTOTAL
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
' AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE 2.
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.
TOTAL :6:7
Special Conditions _
Date issued by_—
WMECl4PMT