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G ty G r !)0 a rd Mechanical Permit Per rni
w Fee_._-_ s Gb
N,2— Replace ❑ Relocation ❑ Aldi' .n ❑ Alteration ❑ % State
HEATING _ _ �TO�TALL?_..-. i •3� _��
CONTRACTOR (-, .» R/��- rurt�4 C _ 01YNER--Iw�h�-a3��.—D5 UCS I
ADDRESS_��• �1 t��x- --•L�-�_A,�k 5 WORK ADDRESS '^1C) �-(�!._.�.���1t.�lt?.��.
PHONE A?PLICANT— { -:�A�c- i �:ac'
Hi,-t Input Rating (BTU Per Hiur) �c''YY. er'Yr'�'S� — Vent Size`_ C; '' Flue Size_ —
"UEL OIL ❑ GAS ET ELECT ❑ OTHER_
ITEM X10. FEE ITEM N0. FEE
dor Issuance of Permit SEE ABOV Air Condition_Compresyor 15 to 30 HP _ 10,00
Inc.100,000 BTU - _ 4.00 Air Handling 1_0,000 CFM_ _3.00
100,001 BTU & over � 5,00 Air Handiing Over 10,000 CFM 5.00
Noor Furnace _ - 4.00 Evaporative Cooler 3.00
311 Floor Suspended — - _ 4.00 _Range Vent Fan 2.0_0
nsrall Vents Only 2.00 _Ve_nt System _— 3.00
lt,o_rir •Heat Pr Cooling— _ i _ - 4.00_ Hund Commercial 3.0C
air Condition Compf -snr Under 3 HP — _4.00 _ Commercial Duct System 10.C�r
air Condition Compr.ssor 3 to 15 H-PL� 1.50
'ISPECTOR'': COMMENTS_ —•
iTY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS OR SUB CONTRACTORS
=PROVED BY DATE __. ISSUED BY � DATE t
�--CEIPT NO. _ dM
,4 ..
tONP E. RElil!'�PnT Pt','`,181t1;i,);,�BUILGING DEPARTMENT, TIGARD N0.
P 0. V11;5 PLUMBING PERMIT t i
91132 holder of a valid p,urnbing contractors license is hereby
al:chorized to cause plumbing work as herein noted to be installed in accordance with the plumbir9 code of
"i igard. Such installations require inspection by th? City Inspector who shall be notified not less than four
(,!) hours prior to the time the installations are ready for in.;pect.ion. City of Tigard Business License required
for :,il contractors and sub-contractors.
Uwrer t4� c„ m,,+i, _ Address_Lfl
T NUMBER OF TOTAL PERMIT NO.'S
_ TY' PERMIT ITEMS FEE ON EACH AMOUNT (Office Use. Only)
Sin le Family-1 bath-each
Duplex-Poch t i)ath unit _- 25.0)
Additional bathrooms-each _ _ 10.00 -
Mobile Home°Lace-each ^~_ 16.00
INDIV!ZUAL FIXTURE FZ:E8 `
1 to 60 Fixtures In i building-each 3.00 _
51 to 100 Fixtures In 'I building-each
101 to 200 ixtur9%jR i building-each 2.00
_201 a--lore Fixtures in 1 bui;uing-each 1.50
MISCELLANEOUS
Building Sewer-1st 50 ft. 10.00
lew"r-each additional 1W ft. 10.00
Water Servlcu to Wilding _ _ 6.00 t
Private Water Systems-each 100 ft. —� 10.00 �^
Other (Specify).
PERMIT "J, 6)G for Plumbing 1nspe.tlorf Phone 639.4191
10% statelJOY 11,111/0 Plumbing Contractor B
TOTAL RECEIPT NO. Issued By
27
ING PERMIT APPLIC�`I i ION CQF TIGARD DATE �°�
BUILD ' 14101
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONL
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PIANS AND SPECIFICATIONS. OWNERPHONF- — '_---'—
yy�y�. fS t * LOT
" JOB ADDi'4 70 w r tlarw. ;v; OME ADDRESS
OWNER _ ARt:41TECT
r. )() r
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; }.+L'7' r� ENGIN::ER
„a.a C� 4` DESIGNk:R
GUILDER ADDRESS 1.— — �-1
STRUCTURE �CINEW 0 REMf ��11_1DEL ❑ADDITION 1-1REPAIR �C-JRENEWAL LIFIRE DAMAGE _ LIDEMI-O-ILITION
RESIDENCE_❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUSC]PAT10 []CAR LJ
CAR PORT ❑GARAGE _
STORAGE _ FENCE
❑BOND ❑MOVING ❑CONL DITIONAUSE _ ❑DESIGN REVIEW L7 COUNCIL APPROV_D ❑SIGN —
�— HEAT --
OCC_UPANCY _LAND USE ZONE__.___ __.__BLDG. 1YPE --FIRE ZONE__ ._ PLAN CHECK BY _
rll, 509506,---
BUILDING DEPARTMENT SET SACKS FRONT REAR —V — LEFT SIDE_ RIGHT SIDE
Permit "
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check " REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
WOR✓WILL BE DONE IN ACCORDA:;Z_WI1H IHE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub total �" ALL APPLICABLE CODES AND CJRDINANCe.S. THE ISRU.ANCE OF THIS PERMIT DOES NOT WAIVE
RE01ICTIVE CO\ NANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY ROSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total t3•
BY a a APPIJCANT QR ACIf_1vT
--- -- 3 s .
Approved Receipt NQ,, <Wwwwti a+rM+�� +�rr� +rwrwrrwr�wwrrwrr��, .... ....
0�I'. ;
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor _
6'.Zo•�9 o.,. AUMME -t'.wl1, Ow. _
Permit No. 3 _ i
eVt r v• rra.e v
Rough-In
/T Fixture
Final
7 HEATING
-ave �rNA G v Contractor
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Permit No.
---------- --- Oat or Oil V
——�—� Rough-in
Final
-- --- —grWER
-- --� Final -- ---
DRIYEWf Y
Final -^
Storm Drainage
r (Rain Drain)Final
Sidewelk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TltMPORARY CERTIFICATi OCC ANCY Final
CERTIFICATE OCCUPANCY ---
// landscaping
Zoning Final
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