12086 SW 131ST AVENUE N
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12086 SW 131s' AVF
In:
CITY OF T 1 G A R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-OOo45
13125 SW Hall E;vd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9/5/03
SITE ADDRESS: 12086 Sb1/ 131ST AVE PARCEL: 2S 104AB-06500
SUBDIVISION: MORNING HILL NOA ZONING: R-4.5
BLOCK: LOT: 094 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: - — EVAP COOLERS:
T1 PE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VEN'i S W/O ADPL: VENT SYSTEMS:
STORIES: _ BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 - 3 HP: 1� DOMES. INCIN:
LPC 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP:
FIRE CAMPERS?: 30 - 50 '4P: REPAIR UNITS:
GAS PRESSURE: 50+ hp: WOODSTOVES:
FURN < 100K BTU: 1 _ AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfrn: — OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Rem.-ks. Install furnace. I outlet and AC+
Owner: — --
--- _ FEES
SALMI, ALICE H Description pate Amount
12086 SW 131St -- —
TIGARD, OR 97223 I�I I 'I t I I'crnn� I rr 9/5/03 $7250
I A.\i 4 tii;ur 1,1\ 9/5/0:3 $5.80
Phone: L ~~ Total $78.30
Coritractor:
REX HEATING 8 AC
921 SE 168
PORTLAND, OR 97233 REQUIRED INSPECTIONS _ _
PI:c tie: 503-255-7213 Heating Unt Insp
Coling Lint Insp
Reg#: LtC 66418 Final Inspection
This permit is issued subject to the regulations contained in tite Tigard Municipal Code, State of Ore
Specialty Codes and all other applicable laws All work will be done in accordance with approved
plan,,. This permit will expire if work is not started within 180 days of issuailcg, or if work is suspended
for more than 180 days. ATTENTION: nregon law requires you to follow rules adopted in the nregon
Utility Notification Center. Those rules are sat forth in OAR -352-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699. r.
Issued By: � -� _ r „ - _ I ., 2�,z Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for I istsections needed the next business day
oa/o3/2oo3 12:57 FAX 50n54181960 C1TT GF TIGARD 10001
Mecham:cal Permit
((,A,.. I li`catum kar_rved l;/ i41+CTIwUCf1
\,/L �l L' l', Perm No
City of Tigard �� ?semi;n ,wN, PrrnBwla t �- -
Dawsy; Pct•cnf[2ro: ►
13125 SW Hall Blvd, Plat le � Otherrr P�i
sNo,:Tigard,Orceon 97223 L. � __1 -- — -
Phone: 503-639-4171 Fax: 503.593-1960 Pa•e-P vita CueLAnNNoe
hgomt: ww v-'tiprriox'.us ITY ()F TIGARD Date/B Gee _:
Cpntant• _'- Jyt1s,: Sit 1'eg 2 for
24-hour Inspection Ra.3uest: �5�3-b I NazyeRrSetLod —- 5v semen >,iror�tM,� .
NOW conArl''ionDcnnolitiuu_T :4iecFfanicel.p=v fecoe are 4=4 ou ttie gal vnluc cf[hn w.'rk
OAccus
Addition/altera:t�ao/re Is�cem�t Odicr: peafotuw= 1u�at•:fhe value(rounied io the nearest sonar)of t.11 i
mechs:ucal mate rino equipment,tabor,oven=4 uW iTnfit.
i &2-Family drvelliln Cotnmercial/lnstsduialSer Pagr.2 fo IR.t,R,t,rsvz Build= Multi-Fatnil�_-- Awc,i-t aoo - i cm - r Traces
buster Builder Other
Job site address:
Suite : — Dldg./Apt.lfr`. I' sic
1 pjoject Nellie: - 1.. "Webe?watts sy6tcm_ 14
- Be�dentL�l boiler
(,`toss street/Directions to job site: for reditunr er b dmrt a 14
Unit beaters(fuel,not electric)
ta oval!,ind►ut,tuepead etc. 14 0
Fludveat )tor any of above}. � � 10
Subdivision: Q.
Ret sir univaita � 1 ! 12
a 1 S
Lot iM' _ g-r` F - : �• ., ;,
Tax nlt3/ grcel t�; ---
Hr�tat;,o,ter 10 0
—17 finp
da lett 10
_�{ Plat vent to hath! lace I v
�Ll.rl'Uii Q `l C- U tef I o.
-- WOO&TCllet stout _-- � 0.
- Wood fl laod 0
�^ a /IiLrtlflur/vent _ _�0.
Name- 14I L!
r RaagC OOd�O C1'lGlellcll CQtrlptneftt i 0 O l
Address: Clotlina dryer ettlteult 10. 0
C+*.;+/Stat_ _p__1 �� y 3_._.__.._ Sittpie duct exhaust -- - !
E'ilone. C
t�'� ,j -yl D Fax. (batdteoms,tntictcampa"MatIts,
N.une: (, c lti�j ��. AI n1rJ�zewi:pact bar:- - I0 0
Address: e _ Other._- - 10. o
Ci /St de/7jp: horita, --rzs.au for First 4.%1.00 ,endo
Phone: 5e> 33 Fax:.St x.55-`I L Furnace,etc. ••
Water haater •:
BusiueSs Name: �R c�� L Fireplace •'
_Address:
Cl /ty 9t3te/ � I Clcthaa drfc Uis—
Phonc:-�V:'), Omer) ••
CCS Lic. 0. .�.� To
Siesratute: _.__ Darr! 'I 0 sabtu nit 5
_ P t Fet$72,30 Is
r Plea Review Fee(2 %of amts ee S
(Pleobc pnn gree) State—?archaic(A9�d otperaiit eu S
TOTAL fiR1[1T lLrE J�
Notice: This permit application ervirts it a pettait Is dot oMaided within •Fitenatbodolssl'!ot byTri-Conuty!faddist iodimWy Sarviep Board
140 days atter It has bovAe Accepted as conspletp. —Site plan r.gakea for mom ier AX nalta,
i'IUeuV rt�t pornu''vt,:aPutmaUipN.Jx 01/07
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