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GRy- of Tigard arch Mechanical Permit 140. .
New Installat'in Replace 0 Relocation E] Addition E-] Alteration p DATE:.a_a
HEATING
CONTRACTORG t —
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~titty�c.L t '"/�- OWNER f&,&&
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ADDRESS : ' l.rv_n"'a�."�,r_ X08 ADDRESS 2BIS S,LU. 161- Wmr�s
PHONE � �-_ APPLICANT , . , f''� C=�:U D>✓
Heat Ir•.put ilatinglBTU per Hour) I ��''r3Vent Site ,'5' 1 Flue Size__ _
FUEL OIL 0 Chis la' ELEC� [D GTHER
ITEM NO. FEE _ITEM � r NO. FEE
For Issuance o1 Permit SEE FIELOW Each Air Handling Unit nr Duc+ System 750
Now-tip to & ind. 100, )0 BTU —�— 6.00 Commercial Hocd S stem 7,60
NMI BUT's & ovor 7.50 Other_E9u jLment - E�.,n 4.60
Woodburning Stove4.50 1 Trip Insro..#on
t sWFloor• Suspended _ 6.00 Air Cordltion Cornpress-r - uw &incl.31'P 6.00
i Vent System w/Fen�— _ 4.50 I Air CondEt'on Gv.^'.^.:ossor 3.a to 15, H.P; incl. 11.00
Repair Heat Cooling _-- x8.00
CITY BUSINESS 1_ICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS! !
PERMIT ISSUANCE 10.00 Com"e"ts!
FEES 111.!�� _ -
'rt rholain _By
E - -
�?A� REC.0 _ r
a!e wun
BUH— ING PERMIT APPLICATION TIGARD DATE _:.. -�-�-�
THE LINtERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED 13UILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER (,t t-r COrintriCEIADDRESS 1 3 S14 Drivr,
ARCHITECT
ENGINEER
BUILDER samIn ADDRESS 12635 .` `' Bernd P'duESIGNER % GOt:t nr
STRUCTURE 12 NEW ❑ REMODEL CJ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION
❑ RESIDENCE ❑ COMM F1 EDUCATIONAL ❑ GOWT L-1 RELIGIOUS 11 PATIO ❑ CARPORT ❑ GARAGE ❑ STORAGE ❑ SLAB❑ FENCE
OCCUPANCY ? '" LAND USE ZONE I i`• BLDG.TYPE —`' FIRE ZONE."".PLAN CHECK B" ''ti�h' HEAT--•—
'rmstr+- r 4iriglp_ fi"AMily dWeI13nr4 w/attF'r, !)�d (TAXa�P. �__...4 Pedro -------
;,"r Xrrm!F.D.
SEWER PERM 11a 71
— _ .�—.'— - --_.._._.__. ._-- ►LSA-_-�+'�_r r�r f�
OCC.LOAD ()r)R LOAD 4 ' HEIGHT 1 NO.STORIES AREA a ''r1'r NO.BEP.'iOOMS VALUF
BUILDItJ.�uflInFair1FrlT___� SETBACKS FRONT REAR S LEFTSIDE RIGHT SIDE
Permit w- to 1.X10 1 HIS 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 234 •' r, WOPK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPEGIFIC'A'fIONS AND !N COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE Of TH'S PERMIT DOES NOlWAIVE
Subtotal ���. ` RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER.PLUMBING AND HEATING.
State Tax . 44
--•– SDC— .,._:,,.U C ,�
Total PDCIFj I f111QrQtt – �*.�" . = ' rw
By APPLICANT OR AGENT
Approved Receipt No. / yr / �upRL88�_ PHONF
DATE 1115P. TYPE INSPECTION REMARKS PLUMBING DATS
Contractor
Permit No. 3olzZD /
D It_ -1 Rough-In
Fixture
final i
HEATING
Contractor
Permit No. ;tj j'(D t!L
Cat or Oil
Rough-in
Final -- —-�
SEWER
-- - - Final i
DRIVEWAY
Storm Drainage
(Rain Drain)final 11 -bv U'rJ
fdewalk
Curb&Street Final
Approach
SLOG.DEPT.FINAL T TEMPORARY CERTIFICATE OCCUPANCY Final
} CF_RTIFICATE OCCUPANCY
Lvidwping
7.oning Final
K.
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