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10865 SW DERRY DELL COURT
City of Tigard Mechanical Permit Perr,it________ ;k,��4t►__ .-____
FeeNew Installation ❑ Replace 11 Relocation U Addition CJ Alteration LJ 3%Vt8te__
TOTAL___ --
CONTRACTOR _ OWNER
ADDRESS- WORK ADDRESS—
PHONE — APPLICANTi _�______— __ —•_ _
Heat Input Rating (BTU Per Hour)_ _ Vent Size _ _ Flue Size____._.
FU:i_ OIL CJ GAS ❑ ELECT ❑ OTHFR
ITEM NO. FEE ITEM NO. FEE
For Issuance of Permit 3.00 Air Condition Compressor 15 to 30 HP _ 10.00
Now- Under 100,000 BTU 4.00 —Air Handling 10,000 CFM i _ F Y.
New 100,000 BTU &over 5.00 Air Handling Over 10,000 CFM~_ y.00
Floor Furnace _ 4.00 Evaporative Cooler M � 3.00
Wall - Floor -Suspended 4.00 Range Vent Fan - 2.00
Install Vents Only _ 2.00 Vent System 3.00
Repair-Heat&Cooling _ 4.00 Hood_Commercial _ _ 3.00
Air Condition Compressor Under 3 HP 4.00 Commercial Duct System _`— _ 10.00_
Atr Condition Compressor 3 to 15 HP 7.5C
INSPECT'OR'S COMMENTS.
CITY BUSIr`1ESS LICCNSE REQUIRED FOR ALL CONTRACTORS OR SUB-CONTRACTORS
APPRGVED BY DATE ISSUED BY---- DATE
RECEIPT NO.
774 Signa!ure of Applicant ^���
CITY 4F >n 7h
BUILDING PERMIT APPLICATION TIGARD DATE- �Mar`.P- 19
NQ 073E
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
OWNER —_ ADDRESS— BUILDS►1 PHONE
ENGINEER
BUILDERARCHITECT DESIGNER
STRUCTURE ONEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEW�-+AL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑C�OMM []EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT OGARAGE ❑STORAGE❑SLAB []FENCE
❑BCU
OND MOVING ❑CONDITIONAL USE C1 DESIGN REVIEW ❑COIINCIL APPROVED ❑SIGNS _
OCCUPANCY LAND USE ZONE. BLDG.TYPE—.F IRE ZONE— PLAN CHECK BY� HEAI
cuct '(.41x321r` rrnn. tr�_I
ratal roof. concrete f;�.�:: ---- ---- - -------
----------- c:pit Com- — ---------— ------_—_ -- u..� l;.t
QCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR 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
- WORK WILL HE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR P.ND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
f%State LICENSE. SEPARATE PERMITS REOUIRED FCR SEWER, PLUMBING AND HE.t,fING.
it,pi AT
Total
B
---+'+? --- nr�Pl I('.ANT OR AGENT ------ ---
----
Approved REceipt No.
PHONE
DAI E INSP. TYPE INSPECTION REMARKS
PLUMBING DATE
Contractor
Permit i4o.
Rou2h-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
_E.92h in -----------
Final
SEWER
Final
----- DRIVEWAY
Final
Storm Drainage
am Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG-DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY
CERTIFICATE OCCUPANCY Final
Landscaping
Zoning Final