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77 MECHANICOL
Err(OF I'OARD APERMIT
COMMUNr,'Y DEVELOPMENT DEPARTMENT CrTYOFTWARD #. . . . . . .
13125 SW Nall blvd. P.O.Box 23397,Tigaid,Oregon 97223 (6W)639417b �ff7
SITE ADDRESS. . . : 11956 SW PL PARCEL: I5133DD-136OV,
SUBDIVISION. . . . : VILL-AGE AT SUMMER LAKE PARK 4 ZONING: R-4. 5
FLOCK. . . . . , . . . . . LOT. . . . . . . . . . . . . : 175
CLAIS'S OF WORK. :ADD FLOOR FURN. . . . EVAP COOLERS:
TYPE OF UwE. . . SF UNIT HEATERS. . : VENT FANS. . . -
OCCUPANCY GRP. . :R3 VENTS W/O APDL: VENT SYSTEMS:
STORIES. . . . . . . . .. I BOIL-ERS/COMPRESSORS HOODS. . . . . . .
FUEL 0-3 HP. . . . - I DOMPS, INCIN-
/ELE/ 3-15 Hr.. . . . . COMML. TNCIN.
.
MAX INPUT: BTU 15-30 HP. . . . : REPAIR UNITS:
FIRE DAMPERS?. . : 30-50 HP. . . . : WOODSTOVF7S. . :
GAS PRESSURE. . . 50+ HP. . . . : CLO DRYERS. . :
NO. OF AIR HANDLING UNITS 0THFR UNITS. -
FURN ( 100K BTU: 10000 cfm : GAS OUTLETS. :
'.1-11?9\1 > =1012)R BTU: 1.0000 (:!fm -
i.<emat-ks : NEW 3 TON AIR CONDITIONER
Owner, FEEc-,'
ART POHLMAN type amol.-tnt by datf, r,ec,rll.
11956 SW 126TH PRMT $ 25. 00 JLH 05/2,6/9L
5PCT $ 1. 25 JL+I
TIGARD OR 97223
Phone #:
Contractor-:
SELL HEA-rING
lbb�'.)CA SE PIAZZA AVE
OR 97015 _— .._______________-»-------_..-------
PI-ione #:: 11 26. 25 TOTAL
Req #. . - 00447
------- REGIU I RE,) INSPECTIONS
This permit is issued subject to the regulations contained in the Final lnsj-�ieution
Tigard Municipal. Code, State of Ort. Specialty Codes and all other
applicable laws. All work will be dope in accordance with
approved plans. Thi permit wiii expire if work is not started
within 180 days of issuance. or if work i; suspended for sort
},iar, 160 days.
(A-
Call for, inspection 639-4175
INSPECTION NOTICE
City of Tigard Building Department
13125 SR Ball Blvd. Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-43.71
Inspection:_
Footing Plbg. Underelab M%�.ch. Rough-in Appr/Sdwlk
Pound. Plbg. Top Out) Gas Line FINAL:
Poet/Beam Struct. San. Sewer Framing -Bldg.
Poet/Beam Mach. Rain Drain Insulation -Plumb.
Plbq. Underfloor Water Line Gyp. Bd. -Hech.
I)ate Requester,!: 9< _ / Tlmev?u�__Zam _PH
Addreee: —�/J ' '41a � Permit f=�[ �G L 12
Builder:
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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inegector: T Date:-
"PROM � DISAPPROYRD APPROVED SUBJECT TO ADO"
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Call For Reinep.
INSPECTION NOTICE
City of Tigard Building Department
1312S SW Hall Blvd. Tigard, Oregon 97223
Inspection Line kRec-O-Phone): 639-4175 Business Phone: 639-4171
Inspections
Footing Plbg. Undosrlab Mach. Rough-in ApprjSdwlk
Found. Plbg. Top Out Gas Li FINAL:
Poet/Beam Struct. ` ^.an. r Framing -Bldg.
Post/Beam Mach. Rain Drain Insulation -Plumb.
Plbg. Underfloor Water Line Gyp. ad, -Mach.
Date Requested: J L/— Times AM6Zt�{JPM
Address: /l%� Cp �_�'��' 1 _,,,�Permit #:
Builders
THE FOLLOWING CORRECTIONS ARE REQUIRED:
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Inspector: _ Date:
APPROVED D APPROVED APPROVED SUBJECT TO ABOVE
Call For Reinap.
• INSPECTION NOTICE_
City of Tigard Building Departasen%.
13125 SR Hall Blvd_ Tigard, Oregon 97223
Inspection Line (Rec-O-Phone): 639-4175 Business Phone: 639-4171
Inspection
Footing Plbg. Underalao �Kech. Rough-in) App:/Sdwlk
Found. Plbg. Top Out Gas Line FINAL:
Post/Beam Struct. San. Sewer Framing -Bldg.
Pest/Beam Hoch. Rain Drain Insulation -Plumb.
1
Plbg. Underfloor hater Line Gyp. Bd. -Koch.
Date Requeeteds � c� _Times AM PM
Address: [ }� _ Permit ( �
Bu i 1 der: �T
THE FOLLONINO CORRECTIONS ARE REQUIRM
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Inspectors ✓ ,L Date: IJ - I 9
Al'' APPROVED DISAPPROVED APPROVED SUEJECT TO ABOVE
--Call For Reinap.
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C Ul'i OF T I GARD _ RE"C[ I(''T OF PAYMPNT RFCE I P T NCI. :92-227694
_227694
(,HE(. I. AMOUNT 26. C25
Ni IME a BE].I... HEATING CASIA (401OUN1 0. 00
ADDRESS 15550 SF PIAllA AVE PAYMENT BATE
CL..AC MMAS, f, R 97015,---
LlSDIV.ESIOIV
PUH1:105E OF PQY�IE:.I41' AMOUNT PA.II, PORPOSE. OF PAYMENT AMOUNT PAID
ME.CHAN I GAL. F'E
25. 00 sill BUILD PF 14 1. 05
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1 1 y5 -;w 1 t:_"hT►I r• L.
TOTAL AMOUNT PO I b - - - - > 216. 125,
CITY 'OF� TIGARD MECHANICAL PERMIT Receipt #
13125 SW HALL BLVD. Permit#_
P. O. BOX 23397 Description
T I GARD, OR 97223 Table 3A Mechanical Code CITY PRICE AMT
(503)639-4175 1) Permit Fee -0- -0- 10.00
Name of Development 2) Supplemental Permit 3.00
i
Job Address I i) Furnace to 100,000 BTU 6.00
Address //Cf rj7c 5, w 12-(- � incl.ducts&vents
Tax Lot Mar No. 2) Furnace 10 BTU + 7.50
incl.ducts&vents
Lot Block Subdivision "
Name(or name of business) 3) Floor Furnace 6.00
incl.vent
^ -1 I A-,-e, t J —
Mailing address Phone 4) SuE pended heater,wall heater 6.00
Owner `�'a7�f or floor mounted heater
i
City/Statezip 5) Vent not incl.in 3.00
appliance permit
Na (or name of business) 6) Repair of heating,refr ig., 6.00
cooling,absorption unit
,��1/�rr c —
Mailing Address Phone 7) Boiler or comp to 3 HP 3 ��L 6.OU
Occupant absorp.unit to 100,000 BTU
City/State Zip 8) Boiler or comp to 3 HP-15 HP 11.00
absorp.unit to 500,000 BTU _v
Boiler or comp 15-30 HP 15.110
Name 9
// ) absorp.unit 1/2-1 million
• zr!/ c-lc�i/�v --
Malling Address Phone 10) Boiler or comp to 30-50 HP 22.50
absorp.unit 1-1.75 million
Contractor Boiler or comp to 50 HP
City/state Zip 11) 31.50
G 9,7e/—f_ absorp.unit 1,750,000 BTU
State Registration No. City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
Air handling unit 7.50
1 hereby acknowledge that I have read this application that the information given is 13) 10,000 CFM +
coned,that I am the owner or authorized agent of the owner,that plans submitted are in
compliance with State laws,that I am registered with the State Builders'Board,that the 14) Non portable 4.50
number given is correct (if exempt from State registration please give reason below). evaporate cooler -
-�_ — — — 15) Vent fan connected 3,00
to a single duct
------ 16) Ventilation system not 4.50
included in appliance permit
17) Hood served by 4.50
mechanical exhaust
Signature(owner or agent) Date 18) Domestic type 7.50
Describe work O addition ❑ alteration ❑ repair ❑ incinerator J _
to be done residential la-- non-residential ❑ 1 g) Commercial or industrial 30.00
Existing use oI type incinerator
building or properly ` } 20) Other i.e.,woodstove,water 4.50
heater,solar,clothes dryers,etc.
Proposed use of —
«= building or property `- _ -- 21) Gas piping one to four outlets 2.00
Ln Type of fuel- oil ❑ natural gas ❑ LPG ❑ electri- Q
r 22) More than 4-per outlet
I— NOTICE f= � SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 596 SURCHARGE �,2r
co —
W DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF 3UB-TOTAL TOTAL
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER —
WORK IS COMMENCED.
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Special Conditions
Cate issued____._ by _