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HomeMy WebLinkAboutPermit Mechanical 2002-8-26 L'.:':' r'.l!l bU1LL11NI; LIJLlt.~ ::-uJ~ rdX:)U.)-.)(o-41Ul HUg ",,0 l;L '.........--..-..-.----- _ _.. '~I/iI!"'\"""""''''; , ,,', "',, " " ,.., "'."'.',.~',""".. ":!IC!'~,,;::., !i-J-i~'r'::'"'''''''' . . ~~~~~~~~: .~i'; ~.)l.;:\:':.~;"(;,:~~~~~'. " ':':~:3 )..:...~,1~;~,1}.,,"" "~~!.~,,;~~,....<.?\..~:~,:.i~,(~:::,):.:,,.,;.... .__u_____...__ ...... _... _ _. ...... .. .. .(t, ., _~. l-'.\11/~1 Permit Application for BoilerlPressure Vessel: _ b Installation 0 Alteration , 0 Repair 0 Welded' 0 Non-Welded '. ) Depsrtm.nl ot COIl$\Imer&: BWliDe1!l Senird Ilhte:8!z.yk1.z...- B'0fF- , Building Codes Division. Boiler Stell on ' i' " 1535 Edgcwll.er NW, Salem, 1'.0. Box 14470, Salem OR 97309-0404 (503) 373-7499, Fax: (503) 378-4101,TIY: (503) 373-135'8 www.orcgoobcd.org' ' , t;.tnl.<. &hw.\,~ ,lv-.(. .....4-~Oi Lv / Its ~ ~k. A .........., ~., t:.\t~.;".M.Q " ,-", 97~02- t9_~ ..... '" Permit no,: flJ.. - 18134 I Cp Accepted . Q Denied INSTRUCTIONS: Complete all ReeDO"! nnd return a!)plic:ation by fax \0 Boiler SectiOD, dtief Inspector, (503) 378-4101. Pt_ read "NOTE" Oi\ the hncJc oC Ihls form. which eonl3ioslmporbmt inrormallollllDd lIie reqlliremenlli r"uiulln O~ 480.630 - Lictoa:og 8ltd oenJnc31ion ~ r ,. _....J iDstll!ling, all.enng, or replliring boiIeM; or .., .,...... ves5Cl8; CXlIlIIlltlIlion; Cu. , " \ I'l'r II '. \, l \ I , H: \.' \11 III \ Boi1ertpreslwe ",.oe! oon~\IOr Conallllction Coatracton Phone: !>usiness liccn,e no,: 13 9'l -/013 Board ltg~lI1tiOll DO.: 1(" 4(, ~ (SW) 6&3 - ~ ?IS- I R ""mp no.: OO!nilicaleno.:.pI- F(JyV4tI1'~":(Q"?.B List the nmc(s) and Oregon H=5e number(,) of aU Oas, J through 0... 6 mechanic> who wUJ perfonn work on !hi. project: (AntCn t4ditiOft1J llbftff it n~r:.~.) Name . 1 LicCT\Se no. ~ ~lAv........~~ E"" 9<- - .~ 6 2.. It if rile applicant's rcspOllslbiliry co obrain IIPprQvol from the Illlthorized inspector prior III comMcRci/lf lIIork. ~PPfl~:.:=.t~~~ ~L Ji7~'__ D.~ Type at boiler/j="urc; YCSSCllO be in3laIlcd/rClpaircdlllltered (ifaJrcred. ~it'<hw~s and calculations): ~ ~' Jk~J- e..>c c ~~ (S~-.J I Size and I...,~h of piping 10 be insmlJcd: - - I i h.:." '> C/o Dc,mbc n= of "",m (>ltld1 odditionaJ sheeu if ne...sory): 1 /.It '?~ {J r;;~ - ~f-.Vx..-U- r-Le4.. + () lL.... .1\ I Or:> D I AutbarizedWpecmr- ~...pee~,ign .' '/ Dc-pUtylSpeCl>1: , ~ -- . ~. I eon;/1~~z "t;.........t 0, S ~/ ..::r""yo, o. S' /,.- , 503 378 4101 .Im ~O:! C7mlOOM'\ OI~IC1-2S-28r:;::.: 1<.1: lS lA, ll.t.:U 0 VI.lu..... , ~...-- .e ./' AuthOrU:ed Inspector: : STATE 'OF OREGON BOB GRAHAM 541-915-4505 Fax: 541.937.2670 TOT~ P.01 g7% F.01