8090 SW CHURCHILL COURT I
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8090 SW CHURCHILL COURT � 1
CITY OF TIGARD BUILDING INSFCTION DIVISION
24 Hour Inspec•ion Line: 639-4175 Business Line: 633.4171 MST
BUP
Date Requested! Z&1 – AM PM BLD
Location D q U 5 c,J iy�� ,!(ct_ Suite MEC
Contact Person Ph PLM A
Contractor S I3 y F� ��G , _ Ph 791.37_ SWR
BUILDING Tenant Owner ELC
Retaining Walt ELR
Footing - - -
pCCeSS:
Foundation
FPS
Ftg Drain --
C,JWI Drain Inspection Notes: SGfJ —
Slab _- SIT
Post&Beam -- -�
Ext Sheath/Shear
Int Sheath/Shear -
Framing
Insulation ( /
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarr- _
Susp'd Ck Ing _._---__--
Roof
Misc:
Final
PASS PART FAIL.
PLUMBING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer -
Rain Drains
Final -
PASS PART_ FAIL
MECHANICAL
Post& Beam
Rough In
Gas Line
Smoke Dampers
Final
PA S ARXFAIL
1 RICA r— --
e
Rcagh In
UG/Slab
Low Voltage
Fire Alarm
Fi �
A'P SS -SART FAIL _
SIE - -
Backfill/Grading - ---- —
Sanitary Sewer
Sturm Drain [ )Reinspection fee of$ required before next Inspection. Pay at City Hall. 13125 SW Hal;Blvd
Catch Basin
Fisc Sun„ty Line [ J Please(all for reinspection RE: �-
___ __ [ )Unable to inspect-no access
ADA
Approach/Sidewalk /
Other Date Ir.Srector - Fx!
Final
PASS PART FAIL DO NOT REMOVE this 'mspectiont record from the job site.
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Bus;ness Line: 639-4171 --�� ---�-
BUP
Date Requested 1-1 Jil�' AM_ _PM — BLD —
Location �( D C t.(,r� -I I Cif - Suite MEC
Contact Person __ (� ((� b '(G1 ab-Cf4 Ph PLM
U
Contractor Ph SWR
BUILDING Tenant/Owner ELC ----- ----— —
Retaining Wall ELR
Footing --------- - ---- --
Access: FPS
Foundatic,t _— --------__ .-.-
Fig Drain
Crawl Drain Inspection Notes:j� „ AGN
SI.'; - I UC �i — SIT - — — -
Post&Beam r -- --- - -
Ext Sheath/Shear
Int Sheath/Shear
Framing /VG%[J Z-Z,c.XieWe--
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm T
jusp'd Ceiling - -
Roof
Misc.
Final
PASS PART FAIL ----- -- --
PLUMBING
Post&Beam - -- - ---- -
Under Slab
Top Out
Water Service
Sanitary Sewcr
Rain Drains
Final
PASS PART FAIL
Post& Beam
Rough In
Gas Line
Smoke Dampers
PA5 PART FAIL
ELECTRICAL
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL-
SITE
Backfill/Grading -
Sanitary Sewer
Storm Drain [ J Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fl,e Supply Line ( J Please call for reinspection RE: [ j Unable to inspect no access
AP'
ApFroach/Sidewalk Q�te 7 Inspector Ext
Othor --�— - -
Final
PASS eART FAIL DO NOT REMOVE this inspection rovcord from the job site.
CITY OF TELECTRICAL PERMIT 1
DEVELOPMENT SERVICES PERMIT #: ELC98-0051
DATE ISSUED: 05/1 :/98
1312 £W Hall Blvd., Tigard,OR 97223 (503)639-4111
PARCEL..- 2S 1 12CC-03000
SITE ADDRESS. . . :08090 SW CHURCHILL. C;T
SUBDIVISION. . . . :BOND PARK NO. 3 ZONING:R-12
BLOCK. . . . . . . . . . . LOf. . . . . . . . . . . . . :058 JURISDICTION: TIG
Pro.j ect De seri pt i on: Add a first branch circuit to an existing residence.
--RESIDENTIAL UNIT----- ---TEMP SRVC/FEEDERS---- -----MISCELLANEOUS-------
1000 SF OR LESS. . . . : 0 0 - 200 amp. . . . . . . : 0 PUMP/IRRIGATION. . . . : 0
EACH ADD' L 500SF. . . : 111 201 - 400 ramp. . . . . . . : 0 SIGN/OUT LINE LTG.. . : 0
LIMITED ENERGY. . . . . : 0 401. - 600 amp. . . . . . . : 0 S I61,AL., ,-1ANEL. . . . . . . : 0
MANE. HM/ SVC/FDR. . : 0 601+amps-1000 volts. : 0 MINOR LABEL ( 14'x) . . . : 0
----SERVICE/FEEDER---- ----- BRANCH CIRCUITS----- ---•ADD' L INSPECTIONS----
0 - 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PER INSPECTION. . . . . : 0
201 - 400 amp. . . . . . . 0 I st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . . 0
401 - 600 amp. . . . . . : 0 EA ADD' L BRNCH CIRC: 0 IN PLANT. . . . . . . . . . : N
601 - 1000 ,amp. . . . . : 0 ------------------PLAN REVIEW SECT ION--- --- -- -- __--.__
1000+ amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT NOMINAL. . :
Reconnect only. . . . . : 0 SVC/FDR ) = 225 AMPS. . : CLASS AREA/SPEC OCC. :
0-Wrier: ----------------------------------------------------------- FEES --------
FAUL WILDEROURG, CALLA WILDERBURG type amount by date recpt
8090 SW CHURCHILL CT PRMT $ 35. 00 3EO 05/12/98 98-30568
T I CARD OR 97224 5PCT t 1. 75 GFO 05/12/98 98-05685
Phone #- 684--7081
Contractor: ---------- -- ---.-.------------
SHARPE ELECTRIC INC: $ 36. 75 TOTAL
2605 SW RIGGS
- ----- REQUIRED INSPECTIONS -
BEAVER-ION OR 97007 Elect' 1 Service
Phone #: 6t2-7937 E l e ct' l Final
Reg #. . : QD0815
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes anu all other
applicable laws. All work will be done in accordance with approved plans. This permit Mill expire if work is not started within IN
days of issuance, or if work is suspended for more th.1 180 days. ATTENTION: Oregon law requires you to follow the ruled adopted by
the Oregon Utility Notification Center. Those rules are set forth in OAR 952-881-0010 through OAR 952-081-1987. You may obtain a copv
of these rules or direct questions to OlX by calling (503)246-1987. d4�
'
Permittee Signature: _ ,Q�___...._.. IsIssued By -�t„�_-_--
--.------------------------.-__OWNER INSTALLATION ONLY-
The installation .s being made on property I own which is not ilitended for
sale, lease, or r 'rnt.
OWNER' S SIGNATURE 1 ..___ . _—_ DATE: ---
---------------------------CONTRACTOR INSTALLATION ONLY---------------------------
SIGNATURE= OF SUF'R. ELEC' N: �� c''�� � — DATE:
LICENSE NO:
+4++++++++ti ........ ....i•........•F+...A '-•h++4...4� .....++t•F+t+•f•+t+......h+t+•1-...
Call 639-4175 by 7:00 p. m. for an inspection n,-eded the next business day
................................................. r+++.+++++++++.+++++++++++•f+44
CITY OF TIGARD Electrical Permit Application Plan Check ti
13125 SW HALL BLVD. Rec'd By _
TIGARD OR 97223 Date Rec'd
Date to P E.
Phone (503)639-4171, x304
Print or Type Dp,3 to DST
Inspection (503)639-4175 Permit li
Fax (503)684-7297 Incomplete or illegible will not be accepted caupd
1. Job Address: 4. Complete Fee Schedule below:
Name of Development � n/e� _ Number of Inspections per permit allowed
Name(or name o'business) Powi Q C'� Service included: Items Cost Sum
^J .rc
Address, R U 50Cti u rf Ail 1 r^f tot d evh,a4a. Residential-per unit
City/State/Zio_ 7� 1000 sq or loss $110.00 1
Each additional
ional 500 sq.ft.or
Commercial Rrlsidential portion thereof _ $25.00 1
Limited Energy $25.00
Each Manuf d Home or Modular
2a. Contractor installation only: Dwelling Service or Feeder a $68.00 2
(Attach copy of at nren1t Ilce 4b.Services or Feeders
Electrical Contractor ` n 111-42 e'c 3 t". � � Installation,alteration,or relocation
Addr s 200 amps or less $60.00 2
7---- 201 amps to 400 amps $80.00 2
Ci Stat �.Ip� 7 Q V 1 �. 401 amps to 600 amps $120.00 2
Phone No. 601 amps to 1000 amps r $180 10 2
Job No. Over 1000 amps or volts $340.00 2
Elec..^.ont.Lice. No Exp.Datu,_ D - Reconnect only $50.00 2
OR State CCB Reg. No. Exp.Date1 - 4c.Temporary Services or Feeders
COT But,iness Tax or Metro N Exp.Date Installation,alteration,or reiocaticn
20b amps or less $50.00 2
Signature of Su p r.Elec'n 201 amps to 400 amps $75.00 _� 2
-- 401 amps to 600 amps $100.00 2
_ Over 600 amps to 1000 volts,
License Nr Exp.Date � see•'b"above.
Phone N - _
'77-
4d.Branch Circuits
Now,alteration or extension per panel
1 2b. For owner installations: a)The fee for branch circuits with
1 purchase of aervice nr
Print Owner's Name _ leader fee.
Addfess Each branch circuit $5.00 2
CI - State Zip b)The fee for brunch circuits
city p without purchase of
Phone Iqo._- _ service or feeder fee. 3 j '-
First branch circuit _, $35.00 2
The installation is being made on property I own which is not Each additional branch circuit^ $5.00 2
intender;for sale,lease or rent. 14e.Miscellaneous
(Service or feeder not included)
Owner's Signature __ Each pump or irrigation circle $40.00 2
Each sign or outline lighting $40.00 2
.3. Plan Review section (if required):' Signal circulus)or a limited energy
panel,alteration or extension $40.00 2
--
Please check appropriate Item and enter fee in section 5B. Minor 1.a1::,ta a 10) $100.00
4 or more residential units in one structure 14f.Each addltioral inspection over
Service and feeder 225 amps of more the allowable in any of the above
System over 600 volts nominal � u inspection $35.00 - -
_Classified area or structure containing special occupancy I Pet hour $55.00
as described in N.E C Chapter 5 n Plant $5500
'Submit 2 sets of plans with application where any of the above apply. S. Fees: r
Not required for temporary construction services. 5a.Enter total of above fees $ -�--
5%Surcharge(.05 X total fees) $ -----
NQ11(,E Subtotal
5b.Enter 25%of line 58 for
PERMITS BECOME VOID IF WORK OR CONSTRUCT ION AUTHORIZED IS Plan Review if reauired(Sec.3) $ --NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK Subtotal $ -�--IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY Trust Account iY_
TIME AFTER WORK IS COMMENCED. S
dal balance Due
IdrSTWLCQ6APP Rev 9998
/ \ CIT T OF T MECHANICAL
t._f DEVELOPMENT SERVICES PEKMIT
PERMIT #. . . . . . . : MEC98-0170
13125 SW Nall Blvd., Tigard,OR 97°,e3 (503)639 4171 DA I E ISSUED: 05/11/98
PARCEL: S 1 1 CC-03000
SITE ADDRESS. . . : 08090 SW CHURCHILL CT
SUBDIVISION. . . . : BOND PARK NO. 3 ZONING: R-12.
BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . :058 ,JURISDICTION: TIG
---------------------------------------------------------------------------------------
CLASS OF WORK. . :ALT FLOOR TURN. . . . : 0 EVAP COOLERS: 0
TYPE OF' USE. . . . :SF* UNIT HEATERS. . : 0 VENT F14N,S. . . : 0
OCCUPANCY GRP. . :R:_, VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0
FUEL TYPES-- __.______.._._ 0-3 HP. . . . : 1. DOMF.S. I NC I N: 0
:GAS 3-15 HP. . . . : 0 COMML.. I Nt,I N: 0
MAX INPUT: 0 BTIJ 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?— : 30-50 HP. . . . : 0 WOODSTOVES. . : 0
GAS PRESSURE. . . : 511+ HP. . „ . : 0 CLQ DRYERS. , : 0
NO. OF UNITS------ ---- A 1 R HANDLING UN I T S OTHER UNITS. : 0
TURN ( '0011, PTU: 1 (= 10000 (--fm : 0 GAS OUTL.E'TS. : 0
FURN > ==100K BTU: 0 > 1: 000 cfm: 0
Remarl-.s : Wildeburg - install furnace and a/c
Owner . ——————————————————————————————————----—————————————— FEES
PALM_ WILDEBURG AND CALLA WILDEBI.IRG type amount by date recpt
8090 SW CHURCHIL.L.. CT PPMT” $ 25. 00 JSD 05/11/98 98--305651
T I GARD OR 97224 5FICT $ 1. c°5 .3SD 05/11/98 98-305651
Phone #: 684•-7081
Contractor: - ------- — ------- __..-----
SPECIALTY HEATING R FABRICATIO
9528 SW T I(YARD ST _.._.... ------------------•..___
$ 26. 25 TOTAL
TIGARL• OR 97223
Phone #: 620-5643
Reg #. . : 005657
REOUIRE.D INSPFCTTnNS
This permit is issued subject to the regulations ccr +ined in the Heating Unt Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Cooling Unt Insp
applicable laws. All work will be done in accordance with Final Inspection
approved pla:is. This permit will expire if work is not started
within 180 days of issuance, or if work is suspended for more
than 188 days. ATTENTION: Oregon law requires yo i to follow rules
ar+opted by the Oregon Utility Notification Center. Those rules are
r,t forth in OAA 952--801-8010 through OAi 952-001--@880. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-9181.
By : _ Permittee Signature :_—IJ �1
+++++++++++++++++. +++-4 ++ .++++++•F+."4"+'+++4-+++++++++++++++++++'++++++++++++.++/-+
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
+++++++f+++++++4•++++++++++++4++++++++++++++++++++++++++++++++++++t+++++++t+t++•h
t
Plan Check# (-
CITY OF TIGARD Mechanical Permit Application Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P E.
(50a) 639-41711, x304 Date to DST
Print or Type Pr.;;rnt# ��17 1 -o I�U
r7 L�i
Ir.complete or illegible applications_will not be acceptedCal!ed_ -
Name of Development/Proie" Description
/ f -T �l
�� L, SW (r ktkr6ul I i arJ Table 1A Mechanical Code OTv PRICE AMT
Job Streot Address sudetl A) Permit Fee
Address
Dldgu GtyrState Zip 1 ) Furnace to 100,000 BTU 600
!T! rd )()K 97a-2 q including duds&vents
Name for name of business) 2) Furnace 100.000 BTU+ V 750
Owner AU I V A 11Q 0Idev,It Ilq including duds s vents
Mailing Address k- 3.) Floor FL:mace —6,00 `
?(19/1 S( ) !'k I�r�k W, I F l 4 � including vent
5r State zip Phone 4) Suspended heater,wall heater 6.00
or floor mounted heater
Nam d(or name of business) 5; Vent not included in appliance permit 3.00
___l
ytt P
Occupant Mailing AdUress 6.) Boiler or romp,heat pump,air Gond -
_600-
—_ _ to 3 HP;absorb unit to 100K BUT** i
CdyfStete zip Phone 7.) Boiler or comp,heat pump,air Gond 11.00
3-15 HP;absorb unit to 500K BTU"
Contractor Name 8) Boiler of comp,heat pump,air cond 15 00
^P 0 t 0_'4 N N eat(t1 15-30 HP;absorb unit.E-1 mit BTU
Prior to permit Mading Address 1 9) Boiler or comp,heat pump,air Gond. 22.50
issuance,a copy 9,"i'a 2 j(A-) -f arc( 1)T 30-50 HP;absorb unit 1-1 15mil BTU"
of all licensesr Estate zip Phone 10) Boiler or comp,heat pump,air Gond 37 50
are required if - l( and 61CQ7ra t �a"51•y >50 HP;absorb unit 1.75 mil BTtJ"
expired in COT orft n Const CInt Board Lie# Exp Date 1 i.) Air handling unit to 10,000 CFM 450 j
database 51-19, 1
,) l
1Sl_
Architect Name 13.) Non-portable evaporate cooler 4.50 --�
or Mailing Ai dress a 14.! Vent fan connected to a single duct 3.00
Engineer C tyfState Zip Phone 15) Ventilation system not included in 450
_appliance permit __
Describe work New O Audition O Alteration Repair O 16) Hood served by mechanical exhaust 450
to be done Residential®' Nan-residential O
Additional Description of work17.) Domestic incinerators — 7.50
18.) Commercial or industrial typt. 3000 —
Incinerator
r
use of 19.) Repair units 4 50
ng or property
20.) Wood stove 4.50 �
Proposed use of r 21 ) Clothes dryer,etc. 450 �
building or property ��°�>
22) Other units 450
Type of fuel-oil O natural gas(9 LPG O electr c O -! 23) Gas piping one to four outlets 2.00
I hereby acknowledge that 1 have read this application,that the information 24) More thin 4-per outlets(each) 50
giver s correct,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance wiih Oregon State laws CITY SUBTOTAL
Signature of Owner/Agent Data •SUnTOTAL
{{ �. /(�tT�L L 4.Q% ,r/� "f F --- ---5'.e SURCI-tARC E G
�r1�icAct
Contact Person Name Phone PLAN REVIEW 25%OF SUBTOTAL
Regi fired for all comrr-cial pennits only. _
kPvi r . ���1her 1� 0 -��Ly3 I _� —Iu AL
'Minimum permit fee is$25+ 5%surcharge
"Residential A/C requires site plan showing placement of unit.
I'anechpnnt.doc rev 4198
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CITY OF TIGARD MECHANICAL
DEVELOPMENT SERVICES PF.-RMIT
13125 SW Hall Blvd., Tigard,OR 97223 (503)639.4171 1-'l'7RMTT -4. . . . . : lylEC97--01ZtL*)
DATE ISG)UED: 02/10/97
PARCEL: 2S112CC--03000
,-iTTF. A!)DRESS. . 08091A SW iHURCHIL.L. CT
SUBDIVISION. . . . : BOND PARK NO. 3 ZONING: R- IL--'
BLOCK. . . . .. . . . . . . LOT. . .. . . . . . . . . . . .58
F.'L.A 91: OF WOW<. , ADD FLOOR TURN. . . . : 0 EVAP COOLERS: tA
TYPE OF USE. . . . :SF UNIT HEATERS. . : I VENT FANS. . . : 0
OCCUrDANC Y GRP. . :H2 VENTS W/O APPL_- I VENT SYSTEMS: 0
..
9Tn P T ES. . . . . . . . : 0 BOTLERo/COM(_-'RE_qSOR6 HOODS. . . . . . . 0
FUEl. 03 HP. . " . : 0 DOMES. INCIN: 0
: /GAS/ 3-15 HP. . . . : 0 COMML. TNCIN: 0
MMX INPUT: 0 BTU 1')-30 HP. . . . : 0 REPAIR, UNITS: 0
FIRE DAMPERS?. . .- 30--50 HP. 0 WOODSTOVES. . : 0
,AS PRFSSURF. 50--f lip,. . . . 0 CLO DRYERS. 0
1\10. OF UNTTS- AIR HANDL_TNG UN I TS OTHER UNITS. : 0
FLIRN < 100V BTU: 0 <= 10000 cfm ! 0 GAS OUT1_.ET1,3. % I
FURN )=100K BTU: 0 ) 10000 cfm : 0
Rpm.;ai-14s : INSTL HFATER, VENTS, GAIS PIDING OUTLETS
Owner- FEES
BOND type amoi.int by date r'er_pt
B090 SW CHLIRCHHILL CT PRMT $ 2_'5. 00 TAT 02/10/97 97-293153
5PCT $ 1. 25 TAT 02/10/97 97 -290155
'TIGARD OR 97224
Photle #:
cont.r.'ar.,tor--- --------------- ----------------
WMESTFAD STOYF CO INC
THE ENERGY SAYERS
C'729 NF PPOADWPY
PORTLAND OR 97=.32
Plione #.- 5032'80' 3G! `5 $ 26. 25 TOTAL
Rey #. . : 000857
REQUIRED INSPECTInh1r,
This perait is issued subject to the regulations contained in the Geis Line 1nrf3
Tigard Muricipal Code, State of Or-@. specialty Codes and all other Merhanical Tnsp
appl;cable laws. All wcrk will be done in accordance with Misc. Inspection
approval p)ans. This pervit will expirt, if work is not started Final Inspection
within !W days of issuance, or if work is suspended for aore
than 18@ days.
Iflit--tev
By
&11 for in�ipe-tion 639-4175
City of Tigard MECHANICAL PERMIT Planck/Rec. #
13125 sw Hall Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
- -- .,,,. �-- ascription --
0-VL Table 3A Mechanical Godo - - QTY PRICE AMT
JCbc, S ") C L ctirLUl f(j C4I 1) Permit Fee -0- -0- 10.00
Address
CuY It . 2 Z 2) Supplemental Permit 3.00
krb urnace o �6 �
� Jl� 1)
� ` � incl. ducts 8 vents
E3T6.00
«• ( Furnace +
Owner ' 2) incl. ducts 8 vents -_- 7.50
T'►�s�--'- '"�- -Floor -urnance
3) incl. vent 6.00
- uspen- nate,w`aT Tieaier
4) or floor mour,led heater 6.00
Occupant en .-no imp, rn
p 5) appliance parmit 3.00
Zm- -"T�apari�TFieaung,reTng�-
6) coc'i,g,absorption unit 6.00 _-
-96110C or comp,a puT-mp,air coni
b n e� `tom 7) to 3 HP;absorp unit to 100K BTU 6.00
i�`" 60ret or comp,mat pump,arr con .
Contractor �"- ✓�L� 8) 3.15 HP;absorp unit to SOOK BTU 11.00
of or or comp, Fea pump;arr ccn
�- gj 1530 HP;absorp unit .5-1 mil BTU 15.00
•• •• r er or comp,heat pump,it con -
r, 10) 30.50 HP;absorp unit 1-1.75 mil BTU 22.50
hereby ac ow qe a ave(ea is application, a e '-moi or or comp, ea pump,air .con
information given is correct,that I am the owner or authorized agent 11) > 50 HP;absorp unit 1.75 mil BTU 37.50
of the ownur,that plans submitted are in compliancki with State -Au Finn ing unit to
laws, that I am registered with the Construction Contractor's Board, 12) 10,000 CFM 4 50
that the number given is correct. (If exempt from State registration, Air handling un"if
---
please give reason below.) 13) 10,000 CTM, 750
on porta Te . _
14) evaporate cooler 4.50
- - Vent fan connected ----
15) to a single duct 3.00
r, _ -Veno anon system not - - —
16) included in appliance permit 4.50
o sery "y
( 17) mechanical exhaust 4 50
escn a worx newitr t on aeratirepair ,ons imerciaT-6r itna
n r--
td-be de" residential Jfon-residential(D 18) type incinerator _ 30.00
.xis>"ing user- - regi i.e.,woousTo,water
building or properly ��S i �"�'T r rt � _ 1 J) heater, solar, clothes dryers,etc, 4.50
Proposed use of 20) Gas piping one to four outlets 200 Z-
building or property._
21) More than 4-per outlet
Type of fuel -oil Q natural gas®" LPG Q electric Q - -
- - NOTICE- --- -- --- -ry
Minimum Fee$25 00 SUBTOTAL L
PERMITS BECOME VOID IF WORK OR CONSTRUCTION
AUTHORI7ED IS NOI- COMMENCtD WITHIN 180 DAYS,OR 5%SURCHARGE l �-
IF CONSTRUCTION OR WORK IS SUSPENDED OR --� `-
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK IS COMMENCED ------ -�- -
TOTAL
Special Conditions
Date issued by
•MF71CMi
�.x1`.nrWv
RECEIVED
FEB 1 0 199.1
COMMUNITY OEVELOPMEN►