11005 SW 79TH AVENUE {
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MLIE'FIANICAl PE134111"T'
C'R1Y OF TIGA RD (c NO. ME891.A90
ITYOFTWARD
COMMUNITY DEVELOPMENT DEPARTMENT MOON DATL-' 3:155ILlk-i'D: ' '.11.1 /99
13125 SM Hall Blvd.P O.Box 23397,Tigard.Oregon 97223.(503)639-4175 PRIM . PM'T*.NO. f:)`):(-151q
JOB ADI)WkS4ii : 1.1.00,,".-, SW '791"A AVF.:
'TAX MAP'/LO'T' SUE.,. 1-.'T* : Ei'l K
I-ANO USE:
1...(:)T' S11zli-E :
I TEM: NO: NO 1
W(:)Pl( (:'LAS5 : ADDITION FLJr4NA(:,'ki.' (3.00K 3. AIR HANDLP <10
II.115E: 'TYI:)E:: : Ei:1N(.A..E FAMILY FURNACE:: 10OK4- AIR HANDI P 10K
CONST .TYPF.:: FLUOR F'URNA(:,E F::VAP .COOLEP
O(:1C'1tJP .GIPP . HEA'T'ER 4)IL:N'I* FAN
VF.::N*I' VEN I . SYt-il'F-M
BLA/GOMP" (31-11=r HOOD
BI P/(,.*()Ml:) 3-1514) INCINE:1414TOR(DOM
DWEL.I....UNITS : UL P/WMP 1.5--.30W) INCINE:PA*TOR(WM
1-:'UF—1 BL-A/(:'.DMP 30--501-111:'A PE'PA:I'.W IJNI*1'43
MAX. INPUT BL,P/(,'UMI:) 150+14.1 01,14-:141
DMPAS'? PIPINU OU'TLE'TS 1.
HIGH PREKSW?
I Ow PWF.i:ss'?
141z;.MAPK'5 :
0 M . H . LANDF.-AAS PE::RMIT $10 . 00
W
:1.100,,".iN :1.100,,".i 5W *791+1 AVL P1..AN PEWIEW
E OP 9*/Z-�2,3 1--,IX*T*I.JAF.G 11118 . 00
EOW11—i- I*AX $ 90
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NO . "51,00,e1 I T AL : 1111123 . AO
PLICET.P'T NO. ldq'5-?>5—
This permit Is issued subject to thp regulations contained in Title 1.1
of the TMC. State of Oregon Specialty Codes,zoning regulations
and all other applicable codes and ordinances, and it is hereby
agreed that the work will be dome In accordance with the plans and G'Al:i I...INf--
specifications and In compliance with all applicable codes and & BLAM
ordinances The issuance of this permit does not waive restrictive POUGH IN
covenants Contractor and subcontractors shall have current city F'TNAL
business tax permits This permit will expire and become null and
void it work Is not started wit' 1 180 days,or If work Is suspended or
abandoned for a period W 180 days any time after work has
commenced It shall be the responsibility of the permittee to assure
all required inspections are requested and approve I
Permittee Sig Lure
Issued By 6►34A tit r'�
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE
City yr "Tigard Reompt« _
13125 S.W. Hall Blvd. MECHANICAL PERMIT Permit N _ 3-
P.O.
P.O. Bax 23397 _
Tiand o"`^I't'°^
9 r OR 97223 Table a�Mertun{tat Code oTr PRICE AMT
639•4175 —
1) Permit Fee -0- -0- 10.00
Name M Development 2) Supplemental Permit 3-00
Furnace to 100,000 BTU
AddressJob Address / 1) incl.ducts&vents - _ 6.00
) Furnace 100.000 BTU +
Tax Lot
P fro. 2 incl.ducts&vents 7.50
Lot Block SttRl Malon -' -
Name(or nae o(businm) 3) Floor Furnace
m6.00
incl.vent
MfqeTS Suspended heater,wall treater --
Owner Mai VAddwu Ohone r^ �7 r- n 4) orfloormpuntedheater 6.00
C' potato r-) Vent not incl.in
aY+lae� �7��3
appliance perrnit
3.00
--
6) Repairof heating,refrig.,
e - - -- - _cooling,absorption unit 6.00
Boiler or comp to 3 HP
l'rv� peso Phone absorp.unit to 100,000 BTU 6 �^
Occupant Boiler orcomp to3HP-15 HP
P City/State 8) absorp.unit to 500,000 BTU 11.00
-- �—
Narm
9) Boiler or co 15-30 HP
POfi la 1j /�, Q-+_i e'_ ,_e w absorp.unit-1 million t 5.00 --
Ma*V Addna I ` Phone 10) Boiler or comp to 30-50 HP 22.50'Sp
tollISjal't �,�a absorp-unit 1-1.75 million — _
Contractor Clrydsate ZIP 11 Boiler or comp to 50 HP 31.50
�oct..-"'A O 9 n z� ) absorp.unit 1,750,000 BTU -
State iso^ . 1 \ �l Bus Taz No 12) Air handling unit to 4.50
- I hereby acknowledge ghat I have road ews application Btat the kwkwnstion given!s13) Air handling un'1
correct,Out I am live owner or arMrortzed ageM d owner
,Out own ,that pans salmi W are in 10,000;FM i 7.50
oonpliamm wide State tows,that I am registered with tlw State PAAMe!s'board,that the 14) Non portable 4.50
rumor r given a X)MKI,(H ezempt tram State registration,please 0^tl reason twkrw) evaporate cooler
Vont fait oonnec,-tted
15to a single duct 3.00
) Ventilation system not
1 b included in appliance penin 4'SU
Hood served by -
12 Q 17) 4'
mechanical exhaust
- Slpnawra(-14r or aped)-- - _ -DOW t 8) Domestic type 7.50
Describe work p addition ❑ alteration ❑ repair ❑ incinerator
to be done—_ residential f non-residential U_ 19) Commercial or industrial 30.M
Existing use of _ type incinerator
building or properly ___ __._— 20) Other i.e.,woodslove,water 450
Proposed use of heater,sotar,clothes dryers,etc.
building or property-- -- 21i Gas piping one to kmir outlets 2 00 J Sb
Type of fuel-- oil [_] natural gas)) LPG U electric O
22) More than 4-per outlet
NQTICE --- -
SUB-TOTAL
7111S PERMIT BECOMES NULL AND VOID IF WORK OR CON -
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN IAO 5% SURCHARGE
DAYS, OR IF CONSTRUCTION Oq WORK IS SUSPENDED OR PLAN REVIEW 256 OF SUB-TOTAL 5<J
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER — ---- - --
WORK IS COMMENCED. TOTAL
Special Condifinns