10085 SW JOHNSON STREET 10085 SVJ JOHNSON STREET _
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City ®t Tigard Mechanical Permit N° 3 5 7 4
DATE: ___��/�
New Installation Replace ❑ Relocation(,❑ nAdditinn ❑ Alteration
HEATING �1- _ 4 ��% _�.— OWNER . i�H"*SL"%e�`�!-_ _..�._
CONTFAC fOR �t
ADD "�
RESS_��I� r '-��u- { JOB AD0RESS--1Ld/� --Z�
PHONE —._ 244 1 -- APPLICig _-_ ----- -�;- - ---l1 '
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Heat Input. Rating(BTlJ per ,Hour) -- ` �s-�--- Vent Size_ Flue Size--`—
FUEL OIL[] G:+ �; ELECT F-1 _OTHER --- =�
ITEM NO. FEE ITEM — NO. FEE,
For issuance of Permit SEE BELOW Each Air HandlingUnit or Duct System 7.50
N_e_w-into & incl. 100,000 1T_U 6.00 Commercial Hood System 7.50
7.50 Other Equipment Each 4.50
Nevi 100,000 BUT's & over_ _ ---5 — 4.50
Woodburning Stove - _ 4.50 1_Irip Inspection _ _
Wall-Floor Suspended — 6.00 Air Condition Compressor - up to& incl.3 H.P. -- 6.00
Vent System w/Fan —_
±4 U Air Condition Com ressor 3.1 to 15.H.P. incl. 11.OQ
Re aip r 'Heat Cooling —_— 0 ----- -
CITY BU�:AESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PE r1M1T ISSUANCE Comments:
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FEES _ `- ----�..- --------------
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SU TOTAL
% STATE - Issued B�
_25%PLAN CHECK
REC
TOTAL . #
._ L -- igna a of Applicant V
I
Tax Lot 2 SI 2 BB 1000 23-10 North Tigardville Addn
Assessment 927 .48
Lateral 71.83
999. 31-
11-1-61 49.97=-
& SA thereafter
Address_1�'L ,� Permit No. -�- ---
Name of Occupant Permit charge
- ---- - --- Connection fee-2.r,0,4-4-_._
I
-----..--. _ -- Paid by--
----.....-- Date connected
T;pe of Bri'di g inspection fee
Service Rate ,--- - - _ _ Paid by .C_�U�4 Date ,
Contractor- - _ -- Assessment9l
Size of connection -_--