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City ®f Tigard Mechanical Permit
Kew Insttallation � Replace [j Relocation F Addition E] Alteration El (DATE:, -7k,151
HEATING
CONTRACTOR J m Le /d H�'M_I �U`L OWNER-- &-CL � _ yR i PC.ot
ADDRESS �� �`[��'�'�� Lif'r t'�1 icT JOB ADDRESS.
PHONE 1"t APPLICANT d A-
Heat Input Rating(BTU per Hour) Vent Size_. Flue Size
FUEL OIL GAS W ELECT OTHER
ITEM NO, FEE _ �� ITEM NO. FEC
For Issuance of Permit 4SEE BELOW Each Air HandlingUnit ar Duct System _ 7.50 T
New,ur to &incl. 100,000 BTU 6.00 Commercial Hood System 7.50
New 100 000 BUT's & over 7.50 1 Other Eg.,ipment - Each 4.50
Woodburning_Stove _ 4.50 I Trip Inspection 4.50
Wall-Floor- Suspended 6.00 _ Air Condition Compressor -up to°<incl.3 H.P. _ 6.00
Veit S,;tern w/Fa_n _, 4.5_0_ Air Condition Ccrnpri! smr-3.1 to 15.H.P.in"I. 11.00
!ie air_Heat Cooling 6.00 —
CITY BUSINE=:S5 ,LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS !
PERMIT ISSUANCE 10.00 Comments:
FEES
SUB-TOTAL
„ !', STATE Issued Ery
25%PLAN CHECK
BUILDING. PERMIT APPLICATION TIGARD DATE: 5 11__ ,19__31 3741
THE UNDERSIGNED -IEREBY APPLIES FOR A PERMIT FOH ;I IE WORK HEREIN INDICATED BUILDER PHONE 639-0(3b8
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER P ONE _-
LOTNO._ 4 (- .tJ�
OWNER Gary L. Dahrana JOBADDRESS 14875 SW_Haidi Court
ARCHITECT
ENGINEER
BUILDER— Dahrens Constr. ADDRESS 6�, SW_ ESIQNER
STRUCTLIFIE _ _A NNFV � L RkM EL ❑ ADDITION _ ❑ REPAIR _ ❑ RENEWAL ❑ FIRE DAMAGE _ [_' DELAOLITION
!. RESIDENCE [I40MM%1 EDUCATIONALL] OOV'T ❑ RELIGIOUS O PATIO ❑_CARPORT 11 GARAGE ❑ STORAGE ❑ SLAB❑ FENCF
OCCUPANCY _tL_L LANs USE ZONE BL)G.TYPE __..,`7!V FIRE ZONE n PLAN CHECK BY
Construct kin21a family__gwolinj1,_w/a ter.hed :i Bedrooms 2 Ciatt, .
SEE CORRECTION SHCCT AYTACHED.
SEWER PERMIT#23348 - Vb0,00 _ __ araQu 6bD !'I<I7A_t•
OCC.LOAD FLOOR LOAD Aa HEIGHT NO.STORIES— 1 AREA 1260 NO.BEDROOMS 3 VALU8551700.
BUILDING DEPARTMENT SET BACKS FwNT 7 REAR 40 LEFT SIDE 8 RIGHT SIDE
T
Permit $199.OC THIS 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 PAID WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE
- WITH ALL APPLICABLE CODES AND ORDINANCES. THF ILSdANCE OF THIS PERMIT DOES NOT WAIVE
Sub-total 199.00 RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRAC,ORS TO HAVE CURRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING.
State Tax ra 7, 96
SDC— S400,00 ' t
Total $206.96 ____ �L�_c_r•.« ,r..,
__..__.. PDC# I I 10 0.0Q- P—PL ICANT AG 'T
BY ------ P1 ---- t i.c .tt r_
Receipt No. BbI34 .t i. 1 —
ApprovPd cSWh ADDRESS - PHONE
DATE INSP. TYPE INSPECTION PEMARKS PLUMBING _ DATE '—
Contractor >
Permit No. — C _ _ J
Rough-in
Fixture
• Final
+ H TING
Contract
Permit No.
Gas or oil
Rough-In
— -- Final _--
.. ------- �.r.._.-. -- SEWER
Final
p
DRIVEWAY
-- r!nai
�— Storm Urs'.nags
(Reln Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.rINAL TEMPORARY CERTIFICATE OCCI)PANCY Final
CERTIrICATE OCCUPANCY
l.antiscaning
Zr•-•,ig Final