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15765 SW HIGHLAND COURT-2 f, W' 4 r ,"u �� � V ftiy�lB'l""t�,, r:,.4.�;' .,ITp,Xr-•-.. a_ � Y• A ft.�A:r1��1 i�S}' ylerj. to ADDRESS: k , k t i i:\records\mice Oflmltargetstu ddingAoc L � CITY OF TIGARD BUILD114G INSPECTION NOTICE Inspection Line: 639.417E Business Phone: 639-4171 Footing Rain Drain Cover/Service , FIN Foundation Water Line Ceiling -Plumb. Post/Beam Mach. Shear/Sheath Framing -Mem chi Pibg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. Post/Beam Struct. Mech. Rough-in Gyp. Bd. -Bldg. San. Sewer Gas Line�f�j� Appr/Sdwlk Reins. Other G Date: '7 M._� Entry. Address: CAJ -- Tenant: Ste:_—_. MST: _ BLIP:\n: �/-� +t c A41 I ---hF�G� LM: LC: THE LLOWING CORRECTION E REQUIRED ( LR: i 3 Inspector: _.._ __._.. Date: _APPROVED —DISAPPROVED/CALL FOR REINSP. CF CO i i_. m j 3 t 4 r. CITY OF TIGARD BUILDING INSPECTION NOTICE k , E, Inspection Line: 639-4175 Business Phone: 639-4171 xr Footing Rain Drain Cover/Service FINAL: t ' Foundation Water Line Ceiling Post/Beam Mach. Shear/Sheath Framingc f t, 1". + s� .:'rryfGni6 R ,IhaJi�i a� Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. ,+ � r .a Post/Beam Struct• Mech. Rough-in Gyp. Bd. -Bldg. t San. Sewer Gas Line Appr/Sdwik Reins. s!+x u 1 r {fir. Other: Date: `76 .M. _P.M. Entry: -- Address: Tenant: _ Ste: MST: re ' BUP: Con/Own:_ MEC' PLM: �I ° ,r �D y �/��ELC: � �$y THE FOLLOWING CORRECTIONS ARE REQUIREL7: ELR: _-__ ;, �x�r • ON ot � 14 d7y e- i1 �H i QI- _ d ,r� .. { �'��1�4�l��y, � - I •,ty 1St w�}.�}�f' l r St:- Zjy 1 t A 10, r F. Inspector: —_ — Date: _-APPRO __ APPROVED/CALL FOR REINSP. CF CO j i MIR j, r , 1 CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line: 639-4175 Business Phone: 639-4171 Footing Rain Drain Cover/Service FINAL: Foundation Water Line Ceiling -Plumb, • Post/Beam Mach. Shear/Sheath Framing ec Plbg.Und/Flr/Slab Plhg.Top Out Igsulation -Elect. Post/Beam Struct. ech. Rough f Gyp. Bd. Bldg. • San Sewer Line �� Appr/Sdwlk Reins. Other: Date: _ A.M._,X�713.M. Entry: Address: - Pd� c �_q4, Tenant: —__ Ste. MST: _ BUP: . Con/Own: --____-__- MEG PLM: EI_C: E FO OWING CORRECTIONS ARli REQUIRED: ELR: G In ctor: Date: APPROVED _.- DISAPPROVED/CALL FOR REINSP. CF CO I P - --J 'Q10� r^ ! r0111 �Py+l �'ys7f �'���t'R"1�R�+� �{•�� A Rni� If j1A 1R 1 CITY OF TIGARD BUILDING INSPECTION NOTICE � Inspection Line: 639-4175 Business Phone: 639-4i71 Footing Rain Drain Cover/Service FINAL: d Founation Water Line Ceiling -Plumb. �s t Post/Beam Mech. Shear/Sheath Framing -Mech. Plbg.Und/Flr/Slab Plbg. Top Out Insulation -Elect. Post/Beam Struct. ec , Rough-in Gyp. Bd. -Bldg. ?, San. Sewer as Line Appr/Sdwlk Reins. Other: �_ k Date: Z _ A.M. P.M. � Entry:_ o Address: Tenant: 5te:._--- MST: _ e LIP. I � Con/Own: l� ME! PLM: ELC: „ s THE FOLLOWING CORRECTIONS ARE REOUIRED: ELR: I�F ' ,�YsAfl f1r] II 1. ip a Inspector: Date /mm _�� _APPROVED '`"'� moVED/CALL FOR REINSP. CF CO q-, v � ,- R� f �4+y`frr'Y i l ' it � ✓,� �.Il�y+�l r y?7v t ELECTR CAL CITY OF TIGARD PERMITI#. ELC9t6I0416 COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/26/96 13125 SW Hall Blvd.Tigard,Oregon 97223.8199 (503)839-4171 " PARCEL: LS 1 1 NDD_-0970V_I SITE ADDRLSS. . . : 15765 SW HIGHLAND CT SUBDIVISION. . . . : SUMMERFIEL.D 1,40. 6 ZONINCi: R-I BLOCK. . . . . . . . . . . LOT. . . . . . 31. . . . . . . t FtraJect Description : Installing one branch circuit. ---RESIDENTIAL UNIT---- __- TEMP SRVC/FEEDERS---- -----MISCELLANEOUS------ 1.000 SF OR LESS. . . . : 0 0 - ; '00 ainp. . . . . . . : 0 F'UMPI/IRRIGATION. . . . 0 EACH ADD' L 500SF. . . : 0 20i - 400 amp. . . . . . . : 0 SIGN/OUT LINE LTG. . : 0 � I_IMI'T'E:D ENERGY. . . . . : 0 401 - 600 amp. . . . . . . : 0 SIGNAL/F,ANEL. . . . . . . : 0 MANF. HM/ SVC/FDR. . : 0 601+amps- 1000 volts. : QI MINOR LABEL ( 10) . . . : 0 .._._-_-SERVICE/FEE.DER---•_•-- ---_-BRANCH CIRCUM-S--- _.__-_ -_---ADD' L INSPECTIONS.-- 0 _ 200 amp. . . . . . : 0 W/SERVICE OR FEEDER: 0 PIER INc_;F'ECTION. . . . . : 0 r'01 - 400 amp. . . . . . : 0 1st W/O SRVC OR FDR. : 1 PER HOUR. . . . . . . . . . . : 0 401 600 amp. . . . . . : 0 EA ADD' L. BRNCH CIRC: 0 IN F,LANT. . . . . . . . . . . : 0 601 - 1000 amp. . . . . : 0 ____--------•--._......__.PLAN REVIEW SECTION--------- 10004. amp/volt. . . . . : 0 ) =4 RES UNITS. . . . . . . . : ) 600 VOLT' NOMINAL. . : Reconnect only. . . . . : 0 SVC/FUR ) = 2"25 AMPS. . : CLAviS AREA/SPEC OCC. Own er: __-_..__ __.-_•__ yp__-_--amo�_Int_ - by yEEda1 eF,pC� _._._ DON WICK t e 15765 SW HIGHLAND l;f F'RMT $ :35. 00 CJS 06/26/96 96-280999 5F'CT $ 1_1GARD OR 97224 1. 75 CJS 06/26/96 96-280999 Phone #: 598-967 Contractor: ---___.__---____.___._____---_-_- -------•---------..______.____---_.__.__ WES TS I DE ELECTRIC $ 36. 75 TOTAL. ---� -`-- - 7518 SW MACADAM AVE u` _ FIURE EUI RED I NSPECT I ONS F1T1_AND OR 97219 Wall Cover Elect' 1 Final Fihone #: 503-245--3385 EIoct1 Service Reg #. . : 13306 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Coder, am al l other Ferm i t t ee Signature �� -� applicable laws, all work will be done in accordance with approved plans. This permit will expire if work i! not started ' within 180 days of issuance, or if work is suspended for morp , than l80 days, ----- -- isst.led By INSTALLATION Fhe installation is being made on property I own which is not intended for sale, lease, or rent. OWNER' S SIGNATURE: � � 1)AT F. TOR INSTALLATION ONLY---------------- �- �. S I GNA T"URE OF SUP,R. ELEC' N: �_1@ra - - 17 LICENSE 1\10: Call for inspection - 639--4175 •:r ..,;.,.... ,.... ,���!{{$ 1�rr y 1tlr F�j� ty{ i` s gr$,'I�.� I s�' �,a1 FfiS " �•• �`�t1�. �V'1. n n i o< t . I; 3 Community Development ELECTRICAL PERMIT APPLICATION 13125 SW Hall Blvd. Tigard, OR 97223 Planck/Rec. #,_ ;, J P0g9y Permit # f�C,76 D`fiF • Phone (503) 639 4171 Date Issued 6- 5 - 9C CITY OF TIGARD FAX (503) 684-7297 Issued by TDD No. (503) 684-2772 Inspection (503) 639-4175 ill• 1. Job Address: 4. Complete Fee Schedule Below: Name of Development Number of Inspections per permit allowed � Address / �t�J �,Gt/ /7/ / /�G ( � Service included Items Cost(ea) Sum City/State/-Lip—z/C C /,4c-,/, 'C 4a. Residential-per unit 4 1000 sq It or lase $11000 ', r Name (or nr.me of business) 4/ j 1 f7 Each additional 500 sq it or 11 /� // portion thereof $2600 1 1 Commercial Residential (; (XLimited Energy $2500 L/ )/ 'J Each Manurd Home or Modular 2 Dwelling Service or Feeder $6800 _ 29. Cor Factor installation only: 4b.Services or Feeders J f/ f/p Installation,alteration,or relocation 2 Electrica' Col),tractor / / / I[r L_ 200 amps or lest $8000 _ 2 Address CI« l��r 201 amps to 100 amps $80 00 _ 2 City %i 1r State Zip 401 amps to 100 amps $12000 2 sol amps to oo amps $180W2 Phone No. �' v Over 1000 amps or volts $34000 2 Contractor's License No. ; Reconnect only $5000 Contractor's Board Reg. No. / ) _ 4c.Temporary Services or Feeders Installalion,alteration,or relocation 2 Signature of Supr. Elec'n -- ——"-- 200 amps or less $5000 __ 2 �--nr' 201 amps to 400 amps $7500 2 License No. C�{T r'ione No2yj( 401 amps to 600 amps s:000 Over 800 amps to 1000 vont -------� 2b. For owner installations: see•Y above 4d.Branch Circuits Print Owner's Name_ New alteration or ex,ens on per panel Address a)The lee for branch circuits with City State _ Zip_ purchase or service or feeder Al 2 Phone N0. Each branch circuit $500 h)The fee for branch circuits wllhouf The installation is being made on property I own which is purchase of servke or f d r Are. 2 First brancn circuit $35 00 � 2 not intended for sale, le-.Ove or rent. Each additional branch circuit $500 Owner's Signature _ W 4e. Miscellaneous (Service or feeder not included) 2 3. Plan Review section (if required): Each pump or irrigation circle $4000 2 Each sign or outline lighting $4000 f Signal cnruit(s)or a limited energy 2 Please check appropriate item and enter fee in section 5B. panel alteration or extension $4000 r 4 or more residential units in one structure Minor Labels(10) $10000 -- Service Find feeder 225 amps or more System over 600 volts nominal 41. Each additional inspection over Classified area or structure containing special occupancy the allowable in any of the above as described in N E C Chapter 5 11.r 'rp wimo $3500 i'w lima $5500 i -- Submit 2 sets of plans with application where any nt the above .,r�r,r,i -- $5500 —" apply. Not required for temporary construction se-vices. Jr. Fees: NOTICE 5s. Enter total of above fees $ ' 5%Surcharge(05 X total fees) $ PERMITS BECOME BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR IF 5b. Enter 25%of line A for CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Plan Review if required(Sec 3) $ A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Subtotal $ COMMENCED Trust Account 1Y $ Balance I)ue $ �, e wpm� r 4} p 6 I of IJooHr) rIial11 rr1 ,rrrINI PIAJu,. )Pf NO. e ►r:-r'4�i � WAMF. a WE'STS I ur.. F:F.I:r:l k 1.►„ A[1X►Rh•.bb a '7516 tat,) NIhi1.::ADNM swv.F VAYMI�N) �)WI r_. F: 6 I'I IRTI.AND OR :il.DD I V 1 (IM y 1� 1'IJFdI'CJSE: I1( 1 14YMi'.N-1 AM( LIN i (.,A 11) 1,1 NI TISE I.IF; PAYMENT 1 14MOUN 1 P44,i I. { �I .,....... ...._ W�._.,_....__. ,;» V�� r+I1:►1J]1.11 1+R_......_.._. w......,�.�. 1» 75 � �DV*.CTR1f.;Al_ FSE"Fti+1J'1' if 1;S74,a SW 1-111.041.(-NO I..:.I s 4 ( 4 sir d.hrs.' 3j Ar 1A11 Zi�ikp� ,s'��g, lVT '. CITY OF TIGARD BUILDING INSPECTION NOTICE w` a rb+9Ra.r�i'r "i Y �f � t r Inspection Line: 639-4175 Business Phone: 639-4171 ^�23 t � , Footing Rain Drain Cover/Service FINAL: rr, p1 t Foundation Water Line Ceiling -Plumb. Post/Beam Mech, Shear/Sheath Frami'ig -Ivlech. tr •. s t1tD,i�itirf(r� ��wgt.`�e'�'�Jart�11�' Plbg.Und/Flr/Slab Plbg.Top Out Insulation -Elect. r,="' Ir6 t ry Post/Bearn Struct. ec Rough-in Gyp. Bd. -Bldg. r San. Sewer s e A r/Sdwlk Reins. i � � t.t'•�p A a� 1r t.. W' � 7, Date: _co r a��—L/ (k' A.M. P.M. Entry: Address: f a4d 4th i, Tenant: _ Ste: MST: BLIP: Con/Own: _ �, _-- MEC: U r w + PLM: E THE FOLLOWING CORHECTIONS ARE REQUIRED: ELR: 4 r 't'i� '��"' ' 777 i/L-_-L_ 7 r 1r!': c r rr r r k e a fit. �t L r rpt l p1jr r��f Inspector: _ _ Date: _. ._ _APPROVED _ PROVED/CALL FOR REINSP. CF CO f 1 S tti.i(t F } 'i w ILI JK. r9 � r,FF"r�. 1�P,sw1E �) r NYr PLUMBING PERMIT CITY OF TIGARD PERMIT ##. . . . . . . : F'I_M96-01 7 • COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/16/96 13125 5W Hail Blvd,Tigard,Oregon 97223.8199 (503)839-4171 PARCEL: 2S 1 1 ODD-097Q0 SITE ADDRESS. . . : 15765 SW HIGHLAND CT SUBDIVISION. . . . : SUMMERFIELD NO. 6 "ZONING: R-7 BLOCK. . . . . . . . . . . LOT. . . . . . . . . . . . . .:� CLASS OF' WORK. . :ALT GARBAGE DISPOSALS. :� 0---�MOBILE HOME _SPACES. :- 0 TYPE OF USE:. . . . :SF WASHING MACH. . . . . . : 0 BACKFLOW PREVNTRS. . : 0 OCCUPANCY GRP. . : k,l FI.._OOR DRAINS. . . . . . . 0 TRAPS. . . . . . . . . . . . . . 0 STORIES. . . . . . . . : 0 WATER HEATE_RS. . . . . : 1 CATCH BASINS. . . . . . . : 0 A FIXTURES------------------- LAUNDRY TRAYS. . . . . 0 SF RAIN DRAINS. . . . . : 0 SINKS. . . . . . . . . . . 0 URINALS. . . . . . . . . . . . 0 GREASE: TRAPS. . . . . . . . 0 LAVATORIES. . . . . : 0 OTHCR F'IXT'URES. . . . : 0 TUB/SHOWERS. . . . : 0 SEWER LINE (ft ) . . . 0 0 WATER CLOSETS. . : 0 WATER LINE (ft ) . . . : 0 DISHWASHERS. . . . : 0 RAIN DRAIN (ft ) . . . 0 Remarks : Installing water heater Owner: _____________._____._.__.____.___.___..____...._.__.____...._._-_..._._.__._-- FEF_S DON WICK type amount by date recpt 15765 SW HIGHLAND CT PRMT f 25. 00 B 06/18/96 9E+-28071z. 5PCT" s 1. 25 B 06/18/96 96-26,6714 T 1(:itIRD OR 97224 {1hone #: 598-9673 Contractor: COLUMBIA HEATING PO BOX 230397 TIGARD OR 97281--0397 ------•-----.-__.___.__.._._________-_---.____. __... Phone f 26. L5 TOTAL 11 ti::: Reg #. . : 76 359 E'� ----- - REQUIRED INSPECTION5 °,v* This permit is issued subject to the regulations contained in the !op 01_rt lrrsp Tigard Municipal Code, 5+ate of Ore. Gpef.ialty Codes and all other Misr_. Inspection applicable laws. All work will he done in accordance with Final Inspection approved plans. This permit will expire if work is not started ' within 180 days of issuance, or if work is suspended for more than 180 days. Permittee Signatl_rr-e : Cull for-, inspection - 639-•4175 "r L ._ Fc,, PLUMBrty of Tigard ,G PERMIT APPLICATIONPlanck/Rec. # _ 13125 SW Hall Blvd. Permit # tti' y� 1!� n 15 _' Tigard, OR 97223 (503) 639-4171 MINIMUM $25.00 PERMIT FEE + ST. SURCHARGEok ` Nrwv Single Fainilv Residences Only J�1� 1 �/� p 1 BATH HOUSE$140.00 ❑ 2 BATHHOUSE$195.00 Job (,-7(o-'; / ❑ 3 BATH HOUSE 5225.00 ' Address b Fee includes all plumbing fixtures in the dwelling and the first 100 feet 'd of water service, sanitary sewer and storm sewer. See fees below. FIXTURES QTY PRICE NMT 777-77I(i5�n J Sink 9.00 -M�M Ad* --+ Q ,,,.,. Lavatory 9.00 Owner Same _ 590 �p 13 Tub or Tub/Shower Comb. 9.00 cAwSt«. "� all Shower Ony 9.00 Water Closet 9.00 777) Dishwasher 9.00 Z.(" Garbage Disposal 9.00 Occupant •ro A"- A- Wishing Machine 9.00 Floor Drain 9.00 i arae. m Water Heater 9.00 1 f Laundry Room Tea) 9.00 OtherM- 9.00 Other Fixtures (Specify) 9.00 Contractor P 7 9.0000 ora«. �t�I " - 9.00 Seer 5t 00' 30.00d Gk ��t N• �• T""° Sewer-ea. Addit. 100' 25.00 71 (I-K_ 1L' Water Service 1st 100' 30.00 i I hereby acknowledge that I have read this application, that the Water Service ea. Addit. 200' 25.00 information ge4en is correct, that I am the owner or authorized agent of the owner, that plans submitted are in compliance with State laws, that Storm &Rain Drain 1st 100' 30.0-1 ° I am registered with the Construction Contractor's Board, that the 2 e9 Storm 8 Rain Drain Addit. 100' V 5.00 number given is correct. (If exempt from State •gisfration, plea.3 give reason below.) Mobile Home Space 25.00 i _ ) Back Flow Prevention L ! .� vG / - Device or Anti-Pollution Device 9.00 saw• ...«s.... r w• Any Trap or Waste Not Connected to a Fixture 9.00 Describe work new O a ition 0 afteration 10repair L � Catch Basin � �~ 9.00 to be done residential non-residential Q Insp. of Exist. Plumbing 40.00/hr Specialty Requested Inspections 40.00/hr Existing use of building or property _ _ Rain Drain, single family dwelii,ig 30.00 Residential backflow prevention devices 15.00 Prcoosed use of building oi property -- '(Except residential backflow prevention devices) NOTICE 'Minimum Fee $25.00 SUBTOTAL JUi> PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF 5•/. SURCHARGE CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED. PLAN REVIEW.5% OF SUBTOTAL TOTAL Special Conditions Oate issued by I i.a. 9 .lii�4'h• t .,��.. '•4ido;. ., r ^,iCrS P, 1 '. 04 -- V� --� --- MECHANICAL. PERM T CITY OF T PERMIT #. . . . . . . : MEC96-0186 • COMMUNITY DEVELOPMENT DEPARTMENT DATE ISSUED: 06/18/96 13125 3W Hall Blvd.Tigard,Oro,ion 97223.9799 (503)639.4171 PARCEL: 2S1 10DD-09700 SITE ADDRESS. . . : 15765 SW H I GHL-AND Ci- SUBDIVISION. . . . : fSUBDIVISION. . . . : SUMME:. FIELD NO. 6 ZONING: R-7 BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . . 313 CI_.ASS F WORK. . :AI_T I'-'LOOK FURN. . . . : 0 EVAP COOLERS: 0 � TYPE O' JSE:. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0 OCCUPANuY GRP. . : R3 VENTS W/0 APF'L_: 0 VENT SYSTEMS: 0 STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . : 0 FUEL TYPES•—_-----------•- 0-3 HID. . . . 0 DOMES. INCIN: 0 :/GAS/ / / 3_.15 HP. . . . : 0 COMML. INCIN: 0 MAX INPUT. 0 S TU 15—:30 1AP. . . . : 0 REPAIR UNITS: 0 FIRE DAMPERS?. , : 30--50 HP. . . . : 0 WOODSTOVES. . : 0 s GAS PRESSURE. . . : 0.1- HP. . . . : 0 LLL DRYERS. . . 0 IVU. OF UNITS- ---- ---- AIR HANDLING JN I T S OTHER UNITS. : 0 FURN ( 1.00K B I U: 1 <= 10000 cfm: 0 GAS OUTLETS. : 1 FURN )=100K BT'I: 0 > 10000 cfm : 0 Remarks : Installing fi_n•nace and gas piping Owner,: --- ___.---_—..______ ____---_____._.____._..__.._..____._._..__.________._._.. FEES ------------ DON DON WICK type amol.tnt by date recpt 15765 SW HIGHLAND CT PRMT $ 25. 00 B 06/18/96 96-260714 TIC��ARD OR 9-72124SPCT $ 1. 215 B 06/18/96 96-280714 1 ' Phone #: b96-967: Contractor-: C(31_.UMB I A HEATING PO BOX 230397 I TIGARD OR 97281 —_______________.__•_•__--_--.__.___._ __._ _. ... Phone #: C-24-02704 $ 26. 25 TOTAL Reg #. , : -76359 ---- REQUIRED INSPECTION,, This permit is issued subject to the regulations contained in the Gas 1_.ine Insp Tigard Municipal Code, State of Ore. Specialty Codes and al) other Mechanical Insp applicable laws. All work will be done in accordance with Final inspect ion approved plans. This permit will expire if work is not started within 100 days of issuance, or if work is suspended for more than 180 days. I er•mi l:i.ee Si natl-tre : ls6ued By: Call for- inspection 639-•4175 City of Tigard MECHANICAL_ PERMIT Planck/Rec. # 13125 FW Hall Blvd. APPLICATION Permit # 1'`I Tigard, OR 97223 (503) 639-4171 rDescription / Table 3A Mechanical Code QTY PRICE AMT ... { f Job L5 q G 11 Permit Fee 0 0 10.00 Address _.. .� 2) Supplemental Permit 3.00 ^•"• urnace o-71TMf15-BT� O / 4 1) incl. ducts &vents 6.00 urnace AT 7 B Owner 7117,-E' 7 2) ncl. ducts &vents 7.50 • -oFloor Furnance s incl. vent 6.00 q"•"�° ISuspended eater, wall heater L 41) or floor mounted heater 6.00 ' "' °°• ent not Inc. in Occupant 5) appliance permit 3.00 • Repair r of heat ng, refrig. 6) (-ooling, absorption unit 6.00 l Boiler or comp. heat pump, air con 7) to 3 HP; absorp unit to 100K BTU 6.00 /I Boiler or comp, eat pump, air cond. C• BOX-2,V391 `7 ,�7CJ�' 8) 3-15 HP; absorp unit to 500K BTU 11.00 ContractofrY �o a acomp,Teat pump, air cond. /C•'1 9 �� 9) 15-30 HP; absorp unit .5-1 mil BTU I 15.00 •r •P'�"°� •• Boiler or comp, heat pump, air cond. 5- ��/4'> 10) 30-50 HP; absoro unit 1-1.75 mil BTU 22.50 hereby ac now a ge that ave readthis app anon, tat tI a Boiler or comp, eat pump, air con r information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 and BTU 3750 agent of the owner, that plars submitted are in compliance with Ir an Ing unit to State laws, that I am registered with the Construction Contractor's 12) 10.000 CFM � 4.50 Board, that the number given is correct. If exempt from State - 9 ( P Ir handling unit registration, please give reason below.) 13) 10,000 CTM + 7.50 on portable 14) evaporate cooler 450 Vent fan connected N 15) to z jingle duct 3.00 Ventilation system not 16) included in appliance permit 4.50 Hood serverTby — 17) mechanical exhaust 4,50 escn a won new a dltlon _ alterati Trepair Commercial or industrial to be done residential U non-residential 18) type Incinerator 30.00 Existing use of Other i.e., woo stove, water building or property _ 19) heater, solar, clothes dryers. etc. 4.50 qq Proposed use of 20) Gas piping one to four outlets 200 X. CSC, building or property Type of fuel -oil Q n2tural gas•Fo LPG (J electric 021, More than 4-per outlet (each) 2.00 NOTICE Minimum Fee $25.00 SUBTOTAL �•(.�- PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS. OR 5% SURCHARGE J IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL AFTER WORK IS COMMENCED. TOTAL'•�:� Special Conditions - — Date issued ov H IL001M09TSMECHPMT i f. !:r .... _.,..;..J-., r �..:.�:�.�v[.:_.- -.,t .....ru•+rh4lldsc;,�.�3 .r..r,..sr :e�ski4z�.rive,::;.....,........_ ., ...... ,.-..._. � ........W.�..� i a. 1 4 j isA t (W I 1 k411140 — NI: (,f .11 f It Pi tYMi NJ I RE(.F.I i'1 !'+u. :96.-i--160/14 CA-WG'I-IS W1001A 1 a J tI. 75 NAME G01.1..11'4111 A i-4-li f If-11j L.r.111L,t N L .Hifi AMIA IN i e 0 1,10 04DIDIRRIBS x 0900 1-441 I3URNHOM1 F i 7 Vr POYMENT 01 i 1 t• a 06 i V;"46 'T'I GARD OR tIAJAD I V 1810N a PUf2l'(l E. OF P44 V ME-:hIT (41VI lUN T PAID PI.I dPUf4L- liF F f•1'Y M!'1+I i' AMCION l V-11111) Mw'C:NI�iN T i;F�ll. f E c�"+. 4ttth f=.'f. )tl.►f 11► E'F E? 1 ,•��.� . M17 H{al'dII AL. 1-k 00 t1 1 , l+till i) PF 1< I. tlMvtINC+ PV' HM "x,. 00 fif. �.t1rr .l lrF I, I ; IN I I t !'�I(.f.:4�'r-'•�' 1 f14't`E-') ("'l'/f+.. 4,i't,:.�% i f r i