10655 SW 71ST AVENUE ADDRESS:
ST&
.L
J
.-y
Ci]
C9
LL1
J
!Arecords\mirr-i'° ; gets\building.doc
T
CL CL 2
In \
§ \
o a
w d
p § §g
) 2 ±ƒ
Ig g n g g
L2. ) \ \
]
)& \ 3 ƒ 3 3 E W
±
j\
�
�
C) ) % 2
CD 6 � a ƒ
�
�
U CL
j I
2 \
q DO
U) ) \
@
L) m n n n a $
° § % % FQ ]
0 k § a % E a
$
2
� \
3
/
w.
»
J $ § E
e k k £
\ 5 CU
U f\ f $
CL ) k
@ z_ CL
§ 7 ft 11% \ ° I E k >
A z # 2 9 2 2 2 \ \
0 0
J� \ � � \ / /
w
CITY OF T I GARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Mall Blvd.Tigard,Oregon 972234199 (503)539-4171
I TL
APANCA o—"' L
INCIN:
ij REPPIR Ui-41'['G-
14,
Jl'il
U U1 L E I S
.j
MECHANICAL PERMIT Planck/Rec. #
City of Tigard APPLICATION Permit #
13125 SW Hall Blvd.
Tigard, OR 97223 _-
(503) 639-4171 -�-
Do'�jpuO CITY PFrCE AMT
Table 3A Mechanical Code
------ -0- p- 10.00
j F 1) Permit Fee
Job I( T __ �� _ I I
3.00
Address
��,'-�-f� "? 2) Supplemental Permit
I I' �" ) urnaro to 100,000
6.00
(« 1) incl. ducts&vents
,. urnace 106,000 BTU + 7,50 '
2) incl. ducts&van
ownpr li.- �[ c oor urnance 3) 6.00
/ incl. vent I"
Nell Suspended hector,wall heater
o 1 6.00
no"
d) ur floor mounted heater
ant not me.m
300
«• 5) apPliance permit
Occupant Repair of heating refng.
.r. _ 6.01)
6) cooling,absorption unit
uoi er or comp, eat pump,au con G.00
7} to 3 HP absorp unit to 100K BTU
1 Boiler or comp, peat pump,err cond. 11.00
.v —
rr (L 8) 3.15 HP absorp unit to 500K BTU
er or comp, eat pump, air conc�—
Contra:for ti„ 15.00
q ) 9) 15"30 HP absorp unit.5 1 mil BTU
4 )i L 1.1 1[l
Bot or or comp,heat pump, a r cond.
c ry i 22.50
""°�"°'
10) 30"50 HP absorp unit 1-1.75 mil BTU
er or comp, at pump,- a� rr cond•
ere ac ow ge at gave roc is app Icanon,t at t�e 31.50
�, 11) >50 HP absorp unit 1.75 mil BTU
infarrnation given is correct,that I am the owner or authorized agent Au handlrny unit to 4.50
of the owner,that plans submitted are in compliance with State 10,000 CFM
laws,that I am registered with the Construction Contractor's Board, 12) 7.50
that the number given is correct. (Ii exempt from State registration, 13) 10 an ing u
000 CTM +it
please give reason below.) Non portable
4.50 �
14) evaporate cooler
-- ent an connect 3.00
15) to a single duct
Venti aeon system not 4.50
16) included in appliance permit
., c sery y 4.50
17) mechanical exhaust —
Comme(clal or industrial 30.00
ascribe wort new
00 Rio!
alteration repair 18) type incinerator
to be done residential n no O ier t.e.,w stave,water
4.50
xlsting use o 19) heater,solar,clothes dryers,etc.
building or property -----------
2.00
20) Gas piping one to four outlets
Proposed use of ----
building or property_ -`— 21) More than 4-per outlet
~ Type of fuel-of natural gas Q LPG O
V) alae'
1- —F "I(:L Minimum Fee$25.00 SUBTOTAL -
J
c� PERMITS BECOME VOID IF W0nK OR CONSTRUCTION 5%SURCHARGE
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR --
r' IF CONSTRUCTION OR WORK IS SUSPENDED OR
J ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTE;WORK IS COMMENCED. TOTAL
I ! ( (�
Special Conditions i l' )
Data issued by-
r.ura�vur -