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a1YOF TIFARD
C"YOFTWA
rOT4 R�D MECHANICAL
COMMUNITY DEVELOPMENT DEPARTMENT 'ERM I1
13125 SW Hell Blvd. P.O.Box 23397,11gaid,Oregon 97223(603)6394176 i:-ERMIT #. . . . . . . : MF.C92--0115
DATE ISGUEDi 06/08/92'.
SITE ADDRESS. . . : 11125 SW 109TH PARCEL: IS134DB04117+1,,
SUBDIVISION. . . . : CARNAHANS nDVITION ZONING: R---4. 'j
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .3
CLASS OF WORF,. . :ADD Ft-OOR FURN. . . , -. EVAP COOLERS:
TYPE OF USE. . . . :SF UNIT HEATERS. . : VENT FANS- -
OCCUfDANCY GRF-,. . -.R3 VENTS W/O APPI-- VENT SYSTEMS;
GTOPIES. . . . . . . . : P1711-LERS/COMPRESSORS3 HOODS. . . . . . .
FUEL TYPES-------------- 0-3 HP. . . . : 1 DOMES. INC IN:
, /ELE/ 3-13 IAP. COMML. INCIN:
MAX INPUT; LA T U 15-30 HP. . REPAIR UNITS:
FIRE DAMPERS?— . 30-.50 HP. . . . . WOODSTOVES. . :
GAS PRESSURE. . . Flo+ HP. . . . : CLO DRYERS. . -
NO. (IF (ITR HANDL.ING UN T.TS OTHER LIN,ITS. -
F-URN < 100K u'ru: 10000 Qfm: GAS OU',LETS.
A
FURN ) =1410K BTU-. > 1.0".00 c-fm -
kemav-ks : PIR CONDITIONER
Owner,: FEEC'
VERN FRY type amount by date t,ec-W
111;:'5 SW 109TH PRMT $ 25. 00 JLH 06/08/92
SPOT $ 1. 2�_J JLH 06/08/91_1
TIGARD OR 97223
Phone #s
Cantv-ac-tor:
BELL HEATING
15`)t.10 SE PIAllA AVE
CLACKAMAS OR 9 /01t)
Phone 0: i:-.%. c:`, TUI AI_
Recd
I—
Rep #. . - 00447
REQUIRED INSPEc,rIONS
This permit it issued subject to the regulations contained in the Firial ITispectiun
Tigard Municipal Code, State of Ore. Specialty Codes and ail other
applicable laws. All work will be done in accordance with
approved Wars, This permit will expire if work is not started
within 16J days of issuance, or if worm is suspended for more
than 180 dans.
Permittee Siqnai ur,a,
LLI
Issued By :
Call for inspection 639-4175
INSPECTION NOTICE
city of Tigard R:silding Department
13125 SH Hall Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-41.75 Rumness Phone: 639-4171
Inspection:
Footing Plbq. Underslah ech. Rough-i: Appr/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Pont/Beam Hoch. Rain Drain Insulation -Plumb. \I
I-lbg. Underfloor Nater Line Gyp. Bd. -Mech. J
Date Requested: Time: AN//J PM
Addreess Permit
Builders
THE FOLLOWING CORRECTIONS ARE PSQVIRED:
v
o�
LL)
All /7
1napector!_..
APPYA)M DISAPPROVED APPROVL+D SUBJ6CI' TO ABOVE
Call For Reinap.
CITY OF TIGARD
Permit
MECHANICAL PERMIT Re #
#
13125 SW HALL BLVD
p. O. BOX 23397 (� Ucsc,phon
��/ ► J ' ' /) Table 3A Mechanical Code QTY PRIG AMT
TIGARD, OF; 97223 Jf/-rt ✓ v
(503)639-4175 ' I QL 1) Permit Fee -0- _0- 10.00
Name of Development3.00
2) Supplemental Prmit
Address i 11 Furnace to 100,000 BTU 6.00
Job incl.ducts&vents
Address ` (✓ /" --
Tax Lot Map No. 2) Furnace 100,000 BTU + 7.50
incl.ducts&vents
Lot Block Subdivisan ---
Name(or name of bus!.iess) 3) Floor Furnace 6.00
incl.vent
Ile
Mailing Address 'f phone 4) Suspended heater,wall heater 6.00
Owner - t4e or floor mounted hearer
Vent not incl.in
City/State zap 5) 3.00
appliance permit
T . c 2 7 Z_
Na (or name of business) 6) Repair of heating,teff i 6.00
_ cooling,absorption unit —
Mailing Address Phone 7) Boiler or comp to 3 HP
absorp-unit to 100,000 BTU 6.00 6,
Occupant
Cdy/state Z,p 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU
Boiler or comp 15-30 HP 15.00
Name 9 absorp.unit'/,-1 million
Mailing Address , phone 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million
--F
Contractor city/Stato Zip 11) Boiler or comp to 50 HP 31.50
absorp.unit 1,750,000 BTU
e/1.1 "� _t '7e�/j
Slate Registration No. City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
Air handling unit
I hereby ackrxwAedge that I have read this application that ttie information given is 13) 10,000 CFM + 7.r�0
ported,that I am the owner o authorized agent of the owner,that plans t ubmitted are in
ocxnpfiance with State laws,that I am registered with the State Buikfers'Board,flat the i 4) Non portable 4.50
number given is c xrw 1.(if exempt from Stale registration please give reason below). evaporate Cooler
Vent fan connected 3.00
-- - 15) to a single duct
�— 16) Ventilation system not 4.50
included in appliance permit
------ Hood served by 4.50
17) mechanical exhaust ---
signature(,*Aur or agent) Date- 18) Domestic type 7.50
---r-— incinerator
Describe work ❑ addition ❑ alteration ❑ repair ❑
to be done residential ❑ non-residential ❑ 19) Commercial or industrial 30.00
type incinerator
Existing use of Other i.e.,woodstove,water
building or properly _ ----- 20) heater,solar,clothes dryers,etc. 4.50
Proposed use of
> building or property -- 21) Gas piping one to four outlets 2.00
__j Type of fuel- oil C7 natural gas ❑ LPG ❑ electric ❑
w - 22) More than 4-per outlet
NOTIC - ��� SUB-TOTAL
A<- _
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- 5%SURCHARGE
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 _ lr
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS Al ANY TIME AFTER --
WORK IS COMMENCED. TOTAL
Special Conditions
Date issued by-- —