11385 SW COTTONWOOD LANE-1 ADDRESS:
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13c'ltt of Tigard sulldlaq Department
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125 Bw Ball Blvd. Tigard, 011900197223
Inspection Lina (Rw-O--Phone)r 639-1175 Business Phonot 639-4171
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Plbg. Dnderalab Mach. Rough-in Appr/8dwlk
!round. Plbg. Top Out
acs Lina FIMAL:
Post/Beam Btruct. Ban. Saw r
Freeing -slag.
Post/Beam Hoch. Rain Drain
Insulatior. _plumb.
Plbg. Onda-floor Nater Lina
yp. Bd, -Mash.
Data RequestedrAddress i
p Timer AM PM
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 BW Hall Blvd.Tigard,Oregon 97223.8109 (1503)034-4171
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-CHANICAL "WiT -11anck/Rec. #
City of Tigard M
13125 SW4-lall Blvd. APPLICATION Permit #
PO B'(JX 23397
Tigard, OR 97223
(503) 639-4171
Table 3A Mechanical Code QTY PRICE AMT
MR..
Job i 1385 SW (Zo TTbnLL)e)-,A. J-ij 1) Parmi,Fee -0- 10.00
Address — X—
'T 'j-72-:?j 2) &ipplemental Permit 3.00
'urnwe fr').Ow BTU -
'-)f2 A tn4c---r 1) inrl.chicle:*vents 6.00
Furnace 100,000 BTU
Owner h2175 '��W C40TKOV 2) Incl.ducts&vents 7.60
7.VS&M Laap.-" Floor ru—m3RC-4 —
'tL U ov-- 3) incl. rant 6.00
jw"^'—W --Tu—spencrA R-a-te—Fw9rheater
4) or floor mounted heater G'ou
Occupant Trz.–V AM Vent not RT.�in
6) appliance permit -3.04L
Repair of hsating,re rig.
6) cooling,absorption unit 6.00
25-7-Avt.in "lar or comp Oil pump,air oW.
7) to 3 HP absorp unit to 100K BTIJ 6.00
Boiler or comp,hert pump,air oond.
-1 2�w 8) 3.15 HP abrorunit to 500K BTU 11.00
q
Contracto., p--BaTle—for Comp.hietpump.Wlf-C-0-n-d.-
"W 9) 16-30 HP absorp unit.5.1 mil BTU 15.00
5M'WVW~NO. CIV rw.Tax BoTi4i�r comi: heat pump,air cond.
5(D('1-� 1 '7�--16 10) 30-60 HP absc rp unit 1-1.76 mil BTU 22.50 _J
I hereby acknowl G-39-i ffidt I"MZ ioad this appIration,that the guiler or comp,heat pump,air coP3.
wformation given is correct that I am tie owner or authorized agent 11) >50 HP absorp unit '..76 mil BTU 31.50
A the owner,that plans submitteL.'are in compliance with Siete Aiilisnifing unit to
;aws,that I am registered with the Construution Cont.-actor's F,)ard, 12) 0,000 CFM 4.50
that the number given is correct (it exempt from State registration, Air handing unir-----
,.,ease give reason below.) 13) 10,000 CTM+ 7.50
Non porta ie
14) evaporatec,)ofor 4.50
Vent far conmei,W
15) to a sIngIV dual 3.00
Ventilation system ncl
lie- IA- 16) Included In applianoo pennit 450
Ho;3 sorvee by
17) machanica;exhaust 4.E;0
Describe work now Q _#dclition 0 sit ration(Uj repair mrnerc a or InFustrial
to be done residentialAD non-residential 0 18) type Incinerator 30.00
Existing use of Other i.e.,woods ova,water
building or property 19) heater,solar,dollies dryers.etc. 4.50
Proposed use of 20) Gas piping one to four outlets 2.00
building or property
Type of fuel-oil() natural gas 0 1-17(�C) efeciric 2 V, Moro than 4-per outlet
NOTICE
Minimum Fee$25,00 SUBTOTAL -X
PERMITS BECOME VOID IF WORK OR COPSTRUCTION . . 01
AUT14ORIZEU IS NOT COMMENCED"THIN 41 DAYS,OR .5%SURCHARGE
IF CONSTRUCTION OR wonK IS SUSPENDED UR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL
AFTER WORK iS COMMENCED. --- j
TOTAL
Sperial Conditions
Date issued by
CITY OF " IGAPD RECEIPT OF PAYMENT RECEIPT NO. 393—.243335
CHECK AMOUNT a 26. 25
AME s THE HEAT iNG qPECIAt-If:-)T CASH AMOUNT s 0. 00
DURESS a 9300 NE HALSEY PAYMENT DATE t 08/17/93
SUBDIVISION
PORTI—AND, nR 97220—
URPOSE OF r'AYMENT 44MOUNT PAID PURPOSE OF PAYMENT AMOUNT PnIr)
ECHANICAL PE 25. 00 ST. BUILL PER 1.
% 1365 SW COTTONWOOD LN
OTAL AMOUNT PAID 26. 25