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CITY OF TIGARD MLCHAIUIC,AL.
DEVELOPMENT SEUMCES PERMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 PERMIT ##. . . . . . . : ME:C 96--17-1 34
r)ATE ISSUED: 10/07/96
PARCEL: C"S1.03AA-O37OO
SITE ADDRESS. . . : 1.23100 SW 1 O6TV: DR
SUBDIVISION. . . . : CLYDESDALE ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . : 17
CLASS OF WORK. . :ALT FLOOR FURN. . . . : 0 EVAG COOLERS: 0
TYPE OF (.15F_.. . . . :S>~ UNIT HEATERS. . : 0 VENT FANS— : 0
OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES-- _._... ____.____ 0__3 HP. . . . : 0 DOMES. I NC I N: 0
3--15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15--•30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS ). . : 30--50 HP. . . . : 0 WOODSTOVES. . , 0
GAS PRESSURE. . . : 50+ HP. . . . : 0 CLO DRYERS. . : 0
NO. OF UNITS--_•--------- AIR HANDLING UN I TS OTHER U!d I TS. : 0
FURN ( 1O0K STU: 1 (- 10000 r. fm: 0 GAS OUTLETS. : 0
FURN ) -1O0K BTU: 0 > 10000 cfm: 0
Remarks : Install new fi.trnace
Owner: - --- - _.....---._.._..___. _._._._._______.__.____.______._---_.___.._________ FEES -_..__--.•--_--_ .-__.____.
BARBARA SCHOOR type mmol-tnt by date recpt
17755 SW OVERI._.001<. LN PRrIT $ i25. 00 JDA 10/07/96 96-284810
5PCT $ 1. 25 JDA 10/07/96 96--284810
LAKE OSWE'GO OR 9'7034
Phone ##:
Con tt-actor': -------__----------------_-----._-
SUNSET FUEL CO
PO BOX 42:287
PORTLAND OR 9724:
Phone #: 503-234-0611. 'l, 26, 25 TOTAL_
Reg #. . . OO�='374
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Mechanical Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection _
applicable laws. All work will be done in accordance with
approved plans. This permit will expire if work is not started
within 188 days of issuance, or if work is suspended for more
than IN days.
Per-mitten S i g n a t i_t r e :
I s s ij e d B y _.____�___._.__-•- —� ___..
fa1l. for inSPPCti0T-1 - 639-41.75
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639-4175 Business Phone: 639-4171
Footing Rain Drain Cover/Service FINAL:
Foundation Water Line Ceiling -Plumb.
Post/Beam Mach. Shear/Sheath Framingue_cl
Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect.
Post'Beam Struct. F}?'ugh-in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr/Sdwlk Reins.
Other: _
Date: �.� ` SA.MP.f�h Ent
Address:
Tenant: _ Ste: MST:
BUR
Con/Own: -Q ` I _ MEC: �3�
PLM: —
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
c�
Inspector: ,�!�� _ Date:/61/2-r,
�� r --
JVAPPROVED DISAPP OVED/CALL FOR REINSP, CF CO
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 SVV Nall Blvd. APPLICATION Permit # 1� GLK&' 0�1 3
Tigard, OR 97223
(503) 639-4171
Table 3A Mechanical Code CITY PRICE AMT
Job � ��� IC�.O �� 1) Permit Fee -0- -0- 10.00
Address u•, ••
T ,�n 'V 2) Supplemental Permit 3.00
• «^• , M•^••• urnace w 100,000 BTU
1) incl. ducts &vents 1 600
1 • A ••, ^^• — Furnace
Owner ` `G-�✓ �� \�OO�`1 U 2) incl. ducts &vents _ 7 50
•• w oor hurnance
C��F �,3j2_!Z,D 01T ciIQ34 )) incl. vent 6.00
-- — ^• ^ ••^•••
Suspended eater, wall eater
4) or floor mounted heater 6.00
��— � ^• Vent not .nc. -
in-Occupant 5) appliance permit 300
•• Repair of heating, re ng.
6) cooling, absorption unit 6.00
Boiler or Comp, heat pump, air con
7) to 3 HP'. absorp unit to 100K 0TU 600
r,•^u ^^• Boiler or comp, heat pump, air cond.
�� (a(p II 8) 3-1.5 HP. absorp unit to 500K BTU 11 00
Contractor J ` pBoiler or comp, heat pump, air cons.
c �� �� 9) 15-30 HP: absorp unit 5-1 mil BTU 15.00
+• •^^^^1 " Boiler or comp, heat pump, air con
10) 30-50 HP: absorp unit 1-1.75 mil BTU 22.50
ere y a� now edge that have reacttis application, tat t'tom—
Boiler or romp, pump, air con .
information given is correct, that I am the owner cr authorized 11) > 50 HP: absorp unit 1 75 and BTU 37.90
agent of the owner, that plans submitted are in cowipliance with rr an ing u ul to
State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50
Board, that the number given is correct. (If exempt from State Air handling unit
registration, please give reason below.) 13) 10,000 CTM + 7 50
Non portable
14) evaporate cooler 450
— Vent an connecte
15) t,) n single duct 300
---Vntnation system not
16) included in appliance permit 4 50
ro^.,,. ,..,. ^ a.^: ,,,• oo served y
17) mechanical exhaust 4 50
Describe work neiv aaomon �� aiteraUon repair l_r Commercial or rnaustnai
to be done residential Q,.ncrTresidential Q 18) type incinerator 3000
xisting use or ter re, woodstove. water
budding or property i 19) heater, solar, clothes dryers etr. 4`;0
rt.
ti Proposed use of 20) Gas piping one to four )utlets 2 00
building or property _
H 21) More than 4-per outlet (each) 2�0
J Type of fuel -oil Q natural gas O LPG Q electric Q —
co _
NOTICE
LL! Minimum Fee 525 00 SUBTOTAL Cj
-J PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 50,6 SURCHARGE _
IF CONSTRUCTION OR WORK IS SUSPENDED OR —"
ABANDONED FOR A PERkjD OF 180 DAYS AT ANY TIME PLAN REVIEW 251,6 OF SUBTOTAL
AFTER WORK IS COMMENCED PLAN
—
t`5l1� _ C--c,f r TOTAL-
Special Condiben '�� 1
Date issued _ by
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