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CITE' OF TICARD MECHANICAL PERMIT Recelpt#
Permit # - e z I
Description
Table 3A Mechanical Code QTY PRICE AMT
City of Tigard
13125 S.W. Hall Blvd. 1) Permit Fee .0- 0 100^00
P.O. Box 23397 2) Supplemental Permit 3.00
Tigard, OR 97223 —---- —
639-4175411Furnace to 100,000 BTU V r`
6.00
Incl.ducts&vents
Furnace 100,000 BTU + 7.50
` incl.ducts&vents _ _
I� Name of Development 3 Floor Furnace 6.00
incl.vent
Job Add e.y' 4) Suspended heater,wall heater 6.00
Address 1 ) CL or floor mounted heater
Tax Lot Map rlo 5) Vent not Incl.In 3.00
=
Lot -' - Block Subdivision appliance permit
Name(or name of business) 6) Repair of heating,ref 1g., 6.00
cooling,absorption unit _
Mailing Address phone -,) Boiler or comp to 3 HP 6.00
Owner 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
Nee - )
9 Boiler or comp 15-30 HP 15.00
1 , absorp.unit 1/2-1 million
a Ing Address Phyne 10) Boiler or comp to 30-50 HP 22.50
rt a s�-- absorp.unit 1-1,75 mlll!on
Contractor Boller or comp to 50 HP
Ito, /ate / ?gip 11) absorp.unit 1,750,000 BTU 31.50
tate egistration No. City Bus.Tax No. 12) Air handling unit to 4.50
10,000 CFM
I hereby acknowledge that I have read this applicafion that the Information given Iv 13) Air handling unit 750
correct,that i am the owner or authorized agent of the owner,that plana submitted are In 10,000 CFM +
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
�4 mechanical exhaust
s`4nalme(owner or agent) /101 Date18) Domestic type 7.50
Describe work r] addition ❑ alteration L-1 repair El 18) -
to be done residential"W non-residential C]_ 19) Commercial or Industrial 30.00
Existing use of type Incinerator _
building or properly —_— 20) Other i.e.,woodstove,water 4.50
heater,solar,clothes dryers,etc.
Proposed use of �.:�,/'
building or property_ y.- -- 21) Gas piping one to tour outlets 2.00 �1
Type of tuel- oil ❑ natt.:ral gas LPG C] electric ❑
---- 22) More than 4-per outlet
WWII SUB-TOTAL
THIS PERMIT BECOMES NULL AND VOID IF WORT( OR CON- --'- --'-
STRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 4't6 SURI,HAPQE t
DAYS, OR IF CONS"I nUCT ON OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF SUB-TOTAL .7.,
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER
WORK IS COMMENCED. TOTAL .�7.
Special Conditions _._. _____
Date issued b iA
y-
i
CITY OF TIGARD 639.4171 oermbor „LLd 6 4 4, �3.
BUILDING PEWIT DATE
TAX MAPLAT NO. - 9UBDIVI810141
OWNER. Jay !'7illarJOB ADDRESSZS IC�9& Looe -! i
BUILDER ,_-- _ -- STATE REG NO. -_30109 _ -EAP.DATE
BUILDEP'SPHONE 5fib-7 'i
ARCHITECT PHONE OTHER
STRUCTURE NEW REMODEL L ADDITION f REPAIR L; MOVE OTHER _n[N_°QLITIOrJ
RESIDENCE COMM i 1 EDUCATION P INC ❑ HELIGIOUS I i ACCESSORY I GARAGE OTHEH FENCE
OCGUPANCY ;1 LAND USE ZONE LcT+ Li Dr:.TYPE —FIRE 7nNE—_PLAN CHECK BY l r _ HEAT
()rntruct single family dwell a), w 8'ttaClH-� u*cages 811 per aprdraved plaum.
Subject to r.5 COLIC. RFISSCI-E elf 6335
SEWER PERMIT 0 326'4 (ldltl 71- bath 10 traps farnge 400 _
OCC.LOAD FLOOR LOAD 40 HEIGHT 20 NO.STORIES a AREA l r,5:i NO BEDROOMSIII VALUL
BUILDING DEPARTMENT j SET BACKS FRONT REAR 7 LEFT SIDE 1 RIGHT SIDE ''
PermN _ THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE. ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
Plan Check 40.00 _-- WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
PI.Ck.Fire RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
TAX PERMITS.SEPARATE PERMITS REQUIRED FOIL SEWER,PLUMBING AND HEATING.
State Tax 15.1.6 _ S 1)r 250.(X)
total 43b.1Fi — SDC-fnn.0(l
-- PDCN APPLaQhRT
F,P -
p:-,re,
40,00 17 1.30.00
ue 1% 16-_.. Receipt No �,I i AnDDpt s
Issued By._- Approved By.._ _
....u....v..,.iw.-.2.....,...1.i it:+....ul.r......., ........, ......rti,ulbib4 ..., _., _ ...a.:.wi.w-.y.w•...:.'-.w.�a...+.ea..iwrw.... .._.�... : -'#M... _
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-22 8'4 VO, Contractor sr/
?.fi ti �- p ---- Permit No.
nougo-in
Fixture T
7 � Final
HEATING
7�
Contra
/ A o,, ¢�Y .p Permit No. 11.4
L- --
. //-� ` /Cir,iljnE /�i GasorOil
Roughen
-__ ---- Final _ --
- --- — SEWER —
Final
DRIVEWAY
Final
Storm Drainage
(Rain Drain)Final
Sidewalk
Curb A Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTFICATE OCCUPANCY — — ---- —
Landscaping
Zoning Final