11455 SW BULL MOUNTAIN ROAD-1 p r..,
i
i'
r�
r f
1
`s
CITY OF TIGARD MEC.IIANICAI, 1)BRM11
1'crmit 0 7_
City of 'Tigard
13115 SW iia' l Blvd.
I'.U. Box 23397 TT" s+nlaMCod* QTY FMC[ AMT
Tigard OR 97223
539-4175 1) Permit Fee 0 0 10.00
2) Supplemental Permit 3.00
1) Furnace to 100,000 BTU
_ incl. ducts& vents 6.00
2) Furnace 100,000 BTU +
?am* of Development incl. ducts & vents - _ 7.50
Fred Crang -1) Floor Furnace
incl. vent 6.00
Job AddrT1455 SW bull Mt Rd —__
Address Tax Lot rasp No. 4) Suspended heater, wall heater
or floor mounted heater _6.00
Loi' Block subdivlslon 5) Vent not incl. in
Nem* or name or buetn••eh appliance permit 3.00
red Crane __-- -
Melling Address �— Phone 6) Repair of heating, refrig..
Owner 11455 SW Bul 1 Pit Rd 620 170 cooling, absorption unit 6_v0
c4y1yuls '— zip 7) Boiler or comp to 3HP
Ti ard, Or 97224absorp. unit to 100,000 BTU 6.00
Nana 8) Boiler or comp to 3HP-15HP
McCall/PBS absorp. unit to 500,000 BTU 11_00
Melling Ph" ) Boiler or comp 15-30 HP
1650 N E Lombard 231-3338 'absorp. unit %-1 million 15.00
Contractor ptyne ao 10) Boiler or comp 30-50 HP
Pt rtland, Or 97211 absorp. unit 1-1.75 million 22.50 _
$tvRegistration No. City Bus. Tax No. 11) Boiler or comp 50 HP
0140 00000587 absorp. unit 1,750,000 BTU _ 31.50
i Hereby rcknowt•ep. that I have reed this appflceUon that the information 12.) Air handling unit to —
ow*n U correct, t4►at t am the owner «auth«Ized agent or Me owner, thtl 10,OM CFM 4.50
piano submitted we in compliance with Stale laws, that I am registered with — _—the Slat@ Builders' Board, that the number given is correct. (If oxempt 13) Air handling unit
from State registration piesse yrve reason below). 10,000 CFM + 7.50
Replace existing oil furnace % ' sty 14) Nun portable
oil furnace 112,000 b.t.u . output evap-wate cooler 4.50
15) Vent fan connected
to a single duct _ 3.00
4 ' 16) Ventilation system not
A,"�JAAJII3 r
nature (o ne or agent) Gate included in appliance permit 4.50
17) Hood served by
Describe work [7 addition(-] U] rep6ir ] _ mechanical exhaust x..50 -
to be done residential [� non-residential [_) _ 18) Domestic type
Existing use ofincinerator 1 50
building or properly Residence — 19) Commercial or industrial
Proposed use of type incinerator_ 30.00
building or property-----_--.- 20) Othere., woodstove, water
Type of fuel — oil[A nntuial gas( I i W 1 electric[] heater, solar, Clothes dryers, etc. 4.50
21) Gas piping one to four outlets 200 1
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR 22) More than 4-per outlet _
CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN SUe TOTAL
180 DAYS, OR IF CONSTnUCTION OR WORK IS SUSPENDED
OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY
TIME AFTER WORK IS COMMENCED PLAN REVIEW 25%OF SUB-TOTAL
�- TOTAL
Special Conditions
Dptr o4sond