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11945 SW PACIFIC HIGHWAY STE 242 J _ ,_ ►� �� t ` IL n.n w. .:� 11945 SW Pacific Hwy Suria 242 103 If this notice appears clearer than flit. 1 J l!L 0 81998 document, the document is of Inartina) y11;11i1y. WCRO1'ILMED I112 4X J { JI IJIJIJI,IJI�) ' IIICI{I�I{ill !"I{1JlJIlI�I{ISI IJIJI{i�IJI{II IJI{Ijlil�i{III IJl{illiJl{I I IJI{iJIIIJIJI i 1{,{ill���lj JI{I{1�1jIJi�l I iJlJl�i{IJI�I IJIJIJI�I�III( ^ 1111 IIMOM MAdE III CN IIIIIIIIIIIIIIIIII IIIII!lUIIIIIJIII!IHll�llil IN1�lllIJ1111lIlI liil�!!I{�!!!I�!i!flllll�llll li!!�lllllllii�IlllilE!!Ilfll 1!lI,IIIIIiifIJllll lIIl�IlilillU{IIIt�lI!I�III!!'t1t�fllfi!llltlll! 1111�Nii 1111Ji{1{ III;J{!;{ llflifll{ !{IIJ{III IIfIJI{1{ !HI�{{IIIII{I�I{Ifllllt�lIIIIIIII�U11�11'. I�F V G. I. iVd,.lA� LtaYl��� T YPE X Gil' Gyp. 04L'�.R I7 IU I I i cc iKIT ► I I V WO T5- UP 20" 4, CAW$, C.0 E=sc I FOR SOUP\vOFtMERcj C>Lt�ilt�" ,pG1M� uMAi/ �vt: �,�OCs► ��`� . ' J`: ��y,AIN�"E TEE L �-.` , y" ( � E `:STA.► '5 TEE L Al.l:�VEL.U� v �- 115V. IG OOWb.TTc, -uP HB" F-LL� �� I NC>r� �xT►-r°1 p I S �- t.,,�-r _..--'--- ----- FOR NOT PL/CITE� INI AIa I �► MI UDC-"• ,1 ! 208V 1HP- 1 J.80x oI�I CEILING, FOR 1NtiULQ'T `V I" MtN.�',K�c�l� +.�- ---- - - ��oG GFIA w►��• � ?.�a wc,•�c __— _ �c =10w +PU LINE NE 32"� 0N%"TI ECT lCOMPReIy�OA. �v&LK-IN COOLER \V/ \V I RF !`,l� F`�l N �-~'/ J car SorFF vaLVE' FOR FIRE fa,YS�TE�S FSR GR I C7D 1.� f3V• 1 NP FoR iHooD EXH4USTF_A6,11NC:a ROOF` FaN- i JECKINC-� t/ 4VITCN. IN K►TI.IEN CpNDTIE INTO INTO HE?Uta FIRE SYSTEM BOX _ ► � 1�3v. jFPOR, 7(1 1 20ev. 1 /2 11 -1 .� X ON CIMILING FOP- 1 i coMPFteySoR (\vo> ►►.i�Reez � .7 �JCDOD DUCTI_l,/IlG► ' '26) • HOc>l� FIPE 5Y5TEM UIQ � �_. N�T 13Y _ EN• CONTR RINK 0i,51P7EN,�-I � w I ! I �YV►JIdK�'i GC�1 G A'�/c'� J � I ! �W . 'CONG LOt_vL �`►� ay W / / � PY E , CvP I� RLJ _ ��. - �.�.•_.�.__...,�....f-..__�___.__. _._._ _.-. f ti.. 4A —_ r_ � .___ -� - 1.1�FZ � rrE�'ti ��� i-1 � D L. up 20" u p `t 0 u ' ICA C nn7_H 4' 0 INK 015F. I v-1► !i§p_UP 20" - 1" IDR01 N TO FLR.SINK, ICE M6C�HINLG � " i ! a •- ,Z.'x�' F I t�E Fjl-t�►�1 NG @ ;- --�' ---- _.__._ � _ � - ----•- .. FLOOR (-iCnEIRWE CIRCUIT CL�FiH R EGK`►'E �z � S ..._ � t LE r 1 I II 1 i I I F. ---- � 5 o. P ! f I ice, I" URL,I rJ 1 I� ExIT LICyH7 PO t_.] CaFZ ' Cl c>H REGI•2TER I i I I EX1�jtiSJC� FLOC,R_�jit�IK _l_j_ 1 • 1 I � � _J I L.J �� i - _ _ -_ 2 N. G.\yaTER-UP► •, 1tvv� ` ! x p�sT 1 _. L__ ..--1 1" r---- -t j p i w[3T�i�-uP 2 ^� I � , C>>�I tV K DI;+F�EN'�Er2 / I' -��. I I I V 1 I I I I � ►C 11 Vw-L -UP�_FCR O RINK D i ------- X.Y1 / 1 - � �2"x�l' PLnT�t-- �Ho7 To , '2c�13v- 2,5K\�-u¢�" 11 V.-121 Nv.u�HT C-4 115v.pnw.LIGII CA fi 001I FLOOR (�_ ICv a/c /�� C_dt=i=�E ML�KERt• ��I�� 1 O\V�ft cc�l_L ►1>�N.i+ LO\VLiZ ! EXIT LIGHT �G lOt�O\v.D�FFtO�sT EXIT LIGHT n -__-- s�' \VpL.K iN COC)�ER EXIyTIN / \ t"1'�C9'SI��C• rQr.�`f fc.cgk �VAt.K—•W F[2 Ft? �'N.AG.�V.•1 /2 URL�,N - � _. . "T"C•\V•TO COFFEE MChKEFZ VY. �'\v✓ rom 2 COMPORTMIcNT y1NIc - IRI;, FM CEILING t W \ 15 �' UP 17' �9u oN� E NR ri - -.. 7 N E�V `' de or- 44�r �, o'� 4yt1 4 //,I/ PE �G r •SANE PEFL . dC �3RF t{ L:: , yt-1 , I ru>a�� 1 a»v r soe.. 3 3 os�e)► 3 31&(a), f i�. Ste. 3 s I Z�b) ; ext ►!-0 1 '�4� - — •/ i `��� ..�. i1 .--. _. _ _ _ P�•OvID1to, $i+�OK.e �K•G� Sent o►� _____._ /1 LJ t f - P -I L I 7 PZNN cLx l°s�. elf_C,(os� J --I z 5 c. � NC• I _ _ r. 1 2" N f,C.W TER I It2 C�RRA.I N �! _1_ ...._.� / I-_ _ ro (t•Q cord iV 6K �it� Q-. FC)R MOP 15IN►� (EXIci?1NG) CR IA,Q�, JwCJ�` t Vbt�� L-t�N N¢.��; \VpTE� 11/2" _2U9y_8K\y-10-UP 20" ....�..-.---- iX�pttV FOR Lov. HOT WNTER HEATER r 1/2"HCFTf#COLD \VL1T'ER-I Y2"DfLQI N L. V. �1NK (�vpLL HUNG OTS • �L�G"rRICQL f� PLuM��Nc� Cc�NTRQCTOR. �. CHe6K WirH OWNCR 1✓Cle D,Pp1_1_1(DNZNL P7 =� '' LIGHTING AND OR E(�1_} IPMENT --- -----------•- __ _.__ ___.______.__.____.-----_--_ _----�-- --- -- --------_ __-_—__---- ------ _ - ---- - --- - .----__ _ - -- C� IRM N a . Fi,L - r _ , • � ti C Nn l` L N CaN W ��s AT Re rRc Ms A Dt=F1 ' - T' � �3E ' TV �_.�-----__�.____ _-- - - --- ------ - c TTI.M CF �x rity -Ntv Ac c r I r la L_ Q �' R eA.{� C1n�A�l N► �J 1q Il �-l:I 1 1 NCS LOC&\TF L� AT -T1 G!NP?P PLAZA , TI�ARC� , OR>E e � CIrIL.INLili IN IZ�_- , rRcCAA5 AND OFFICE AA;D 14AJ_L VvAy F-br r,��z C H R I U L v.RY �� l�r{�e,.• 4o C.Cl . D L 9.2X• Q.3 3aOy �.� �V! LL_O\�./ DR, . Aar Extsr►,vZ, 2 )C(-4 Ac.c����-r1rA>_ PANT:-� �r N 1 L L-C250RQ , C�► C� . X 712�i a- .� . o-�r+,e� . -► cQ,�. i 1 �'�, Leerri u► x �/1V o�ro,y iul�W IG F4 o APPROVED FOR C0Ns*rRi is ,,; ,,\' cover; tff. '� be ''1TY O TIGARD ltqy S� PERMIT M 116&`� :_fE ADDR u;• fA.I�C • Sew- cjos",►t. j eY 7.1-1.! 29' I y D ! XCDN DE 51GN E R.5 1.7.• 2,0\\/E���` /1EW RD. LAKEO5�WEGU,O. 9'7O*j�+ ®CALL: APP"Y20 BY: DRAWN BY DATK• IR[V Ii!<D 11345 SW Parifir Hwv __ ��� DRAWINo PI—psro �- Suite 242 2 of 3 ..,. ,�al•I tf.�rM Nn tfN1l1M�r.RAfIpRrN� If this notice appears clearer than the � JUL p 81998 document, the document is of marginal qualify. N11CROFILMED �;u ��� ,. ' a 1�1�ill�l �l�l II!►!i!� iii�l i f�llljl I,III I�II!(Ijl !�I�!�! !�I�l,!i!lI;I ! i�!i!jl' !jl�! ! I�I�ff !�!;I II! �Ijill IIIII I• I �IIIIi IjiI I III�fIi�lllllll I iIIIf` illj!I! i� l�!)l�l•�I•�I�{ INCH1MADIr IN CHINA � I I I � I cm 2 7 4 1 _�— - � � �� o 1!7 � Ly I I ! 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',w'.'�hk'�'f�..:,*sR�.r �.1�� - �_.�t'a " , JltlYt*,,.; n"t �+�. oa+w,.p,�M. ,�rw �'151wrNrtli ,At'C', �'••: � 'R`W►4��Ma^a A rwru�!11Afr inn'vd�1rM►�ki�'++►a�In.M1�MAwY7�� If this notice appears clearer tla:ut (he JUL 0 8 1998 document, the document is of marginal quality. N11CRO)F 1j,MED I)i �i���i �i�i �I lif����rl� � il���li�ililt l�ci+i�li�!I+���i !;I�i�i�c�i�i i .�i1' i�{ �i�i •i i�i�ii�w�i�{ i i�i�;�i���i�i i i�i�i�ijiii,� r i�i�i�i�i�i�iri � I�i;ij{���i�i i� i �i � �j������• 4 T_ 17 I I t! { tt� , II ? � t ,nits u � t t I I' ! •�� 1 I' 1 I (�II�II{ISI{II�{I,{�,lillllllillll�ll!„Illlfll}I biil�}l...11ll�;l,. Il?.?Il, }:,....IlilL, ,fl,tll,l,?II!III!l;NI!{?!?!=Ifiiti!?ILIIIII??il�lll!I}(!!I,iI!li!!ltillltll!!�!II?:!!I?�tl1!III!!! to 34! 61,1111 lilt ADDRESS: 11345 SLO i:\records\microflm\targets\building.doc �ITYOFTIGARD MYOFT1ARD r,—'R ill I T COMMUNITY DEVELOPMENT DEPARTMENT 022"1 13126 SW kW BW P.O.Box 23307,1 ig",0"jgDn 9= (603)&W-4175 NTT ISSUED: 05/18/9E L/ Z. 1 ­1 SITE SW _' AC1i:!1C HWY P-i-4PCEL: ; SUBDIVISION. . . . : HOFFARSER TRACTS NO. 1 ZONING: C—G B L 0 L"K. . . . . . . . . . .. LOT- -. . . . . . . . . -------------------------------------------------- -------------------------------------- E I=S FLOOR ('r`_rAS----------- EXTERIOR WALL C 0 N S'!'k U C7 I Cl N CLASS OF WORN.. :ALT FIRST. . . . :8736 s N: 5: E.- W., "rYP,E Or-- USE. . . :COM SECOND. f PMTECT OPEKING,:')?--------- - TYP,E OF CONST. :5N. THIRD. . . . - of N: F. W: OCCUPIANCY GRP'. :7_1 6726 =f ROOF CONST:S F 1 FRE R ET? :Y OCCUP,ANCY LOAD: BASEMENT. - s AREA SEP,. RATED' STOR. : 1 HT : 14 ft OARAGE. . . . OCCU SEP,. BATE:Da B Lill ':' :N MEZZ?:N READ SETBACKS--------- REQUIRED------------------- FLOORk LOAD. . . . - osf LEFT: ft RGH'*- ft 1:*TR SPIKL.N SM01.1, DET. . ,N DWLLLING UNITS: --RNT: 'It REAR: ft FIR ALRM:N HNDICP, ACC:1y' D R.I I S D i:i T;-!F:, 1(4P, SUR7Pi(*_E- PIRO CORR.N. P H R 1-t 1 Nle -�0 1-2)Q71 VALU;7. Rema* t,s- Re—roof a—ea over Ter-: -------------- FEES ryi_._'rBROWN t v pe amount by date recot t194b sw P,AC11FIC HIGHWAY P FRMT $ 170. 50 JLH 05/11/92 22_1705E PILCK $ 110. 83 JLH 05/! 'L/92 2c-:7052 OR 972-23 =IRE t 6 8. .217) JLH 05/ii/92 L7_27075E Pflone 4., 5P,C T $ 8. 53 JLH 05/11/92 `27052 Cant ract or THOMAS DELANEY 7,352& SE DOvLE P,GAD ESTACADA OR 97023 --------------------------------------- Phons #: 64-6-1156 $ TOTAL Reg *L. . : ;.:;6861 ------- REUU1REU INSPIECTIONS This cersit is issued sullect to the regulations contained in the Roof nailng Inso Ticard Municical Code, State of Ore. Specialty Codes and all other Insulation Insp apoli:able !am All work will be Joni it accordance with Final Inspection approyv^ olans, This ve-*it will emvire i; work is not started within The jays of issuance. or if w3rk is suspended for mere thar 180 cays. T-,sued Rv ., Call for instiection 63q--417� SIGN PERMIT PERMIT #: SGN91-0129 DATE ISSUED. . . . : 10/04/91 EXPIRATION DATE: 42 /04/91 PARCEL. . . . . . . . . : 1S135DD-03301 ZONE. . .. .... .. . . C-G BUSINESS NAME. . : RICKSHAW GRILL SIGN LOCATION. . : 11945 SW PACIFIC HWY APPLICANT/AGENT: DAVID WANG BUSINESS TAX NO: SIGN: PERMANENT (X) FREESTANDING ( ) FREEWAY ( ) TEMPORARY { ) WALL (X) ELECTRONIC ( ) OTHER ( ) BILLBC'ARD ( ) BALLOON ( ) SIGN DIMENSIONS. . . . . . : 3' X 14' TOTAL SIGN AREA. . . . . . : 42 sq.ft. WALL AREA. . . . . . . . . . . . . 378 sq.ft. WALL FACE (DIRECTION) : E SIGN HEIGHT. . . . . . . . . . . 3 ft. PROJECTION FROM WALL. : 0 in. ILLUMINATION. . . . . . . . . : INT DESCRIPTION OF SIGN: PERMANENT WALL SIGN. 3' X 14' = 42 SQ.FT MATERIALS. . . . . . . . . . . . : ACRYLIC EXISTING SIGNS. . . . . . . : 0 ELECTRICAL PERMIT REQUIRED: YES BUILDING PERMIT REQUIRED. . : NO ADMINISTRATIVE EXCEPTIONS. : N/A PERMIT FEE: $ 25.00 APPROVED BY: DATE: 10/041193. a.o�e Permit No. ��y CITY OF TIGARD jIGN PFINIT APPLICATION 'the applicant hereby applies for a permit for the work irxiicated or as shown in the aeoartT)anying plans and specifications. SIGN LOCATION ADDRESS: t4j, Pc1C ZONING: C-(i i}H cti, cR, L. NAME OF BLJSIlJE:S.S: ��� C K S APPLICAur/AGENT': D/ D koAf� COMPANY: ot,,,), 4 r PHONE: V/;, 'Me City of. Tigard imposes an annual Business Z'ax which must be kept current on all persons doing business .in the City. Do yr,, presently have a current business tax? Mr, (k ) NO ( ) U.L. Label # -- PROPOSED SIGN: (Check as many as apply) MMANENr FRFMSrANDING ( ) FREEVAY ( ) TEMPORARY ( ) WA',�L ELWIRONIC ( ) OTHER ( ; Br-J130°►RD ( ) BALL()O t ( ) SIGN DIMENSIONS: _.� .. EVIRATION MI'E: TOTAL SIGN AREA (Sq. Ft `: - WALL AREA (Sq. Ft.) : R 7q 0 , ' WALL FACE: --/i HEIGHT (Ft) PRO,JEI ION FRCNJ WAIL: -t�- IL MINATION: YES (')C) NO ( ) TYPE: COPY: (C K s /21 C MAIERIALS: , / -C EXISTING SIGNS: A11IMSI'F2A UVE EXCUTION: N/A ( ) APPROVED ( ) HOW MLXH AREA ( ) HEIGHT ( ) OCN ENTS: PIANNIM DEPARIMENr All sign permits must be aeccupanied by a scale Permit Fee: &C drawing and plot plan. If work authorized under &KMi _ No: 9/ .a2lftb Z a sign permit has not been coMleted within ninety AMpLAa By: _ _ _ days after the issuance of the permit, flie permit. Date__/0-- -4 - ^L/ shall Lveccnne null and void. EU -IMICAL PERMIT I C IMFY MAT I AM THE RFMRDE D OWNER OF THE MQUIRE D: YES ( NO PR7ET OR AN AGENT AUINORIZED BY THE: OWNER. FYM-DING PERM' REQUIRED: YES ( ) NO Applicant's Signa a ---- // c-p/BKMPMM1' Address/) n Telepho ne N:\WbRD\acxMFv\ 2 2- APPROVED ;CI'T'Y OF TIGARD Title `L Date to I CITY OI' T I©AR;1 — Rt OF F -lYMENT RECF J PT NO. 8007 CHE.-CK AMOUNT A 1.03 NAME WANG, FAVID U„ CASH AMOUNT : 0.00 ADDRESS 3915 SF (.3RD PAYMENT DATE. 09/30/9i SUBDIVISION PORTLAND, OR 9720b-- 4'URF'.5F OF PAYMENI fIMGUhl1' PAID PURPOSE OF �'AYMENT AMOUN'C PAID I_ANDyL'3E APPL . ._..... 5.00 NUSINE5S TAX 1Ea.0 E I v ISGN 91-129 TOTAL_ AMOUNT PAID > ��1.03 INSPECTION NOTICE City of Tigard Building Department 12420 S.W. Main St. Tigard,Oregon 97223 Phone: 639-4171 Type of Inspection Date Requested � %� � ` 71 me L A.M. P.M. Address - i �4 r�� ( �. Permit # Owner Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to - _ Approved Inspector ���1 _ [ Disapproved Date �—=7 CALL FOR REINSPECTION ❑ YES I3 NO INSPECTION NOTICE City of Tigard Building Department 12420 S.W. Main St. Tigard,Oregon 97223 Phone: 639-4171 Type of Inspection i Date Requested —71) Time A.M. P.M. Address Peninit #-- .......... Owner Lot Builder The following Building Code deficiencies are required to be corrected: Z, —4-e Presented to FAI Approved Inspector U Disapproved Date CALL FOR REINSPECTION N YES 11 NO •'an7 of 96"4 M I'C U i BUILDING PERMIT APPLICATION TIGARD DATE/ — 1e II THE UNDERSIGNED HEREBY APPLIES FOR A PERIMIT FOR TIME WORK HEREIN INDICATED BUILDER PHONE'�y,'�" OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE 3.-5 !K� !� ���///���... 4 A' \'-4- 4- LOT NO. OWNER q, SON JOB ADDRESS T� �A'!t •'G G ARCHITECT � #* ENGINEER DESIGNER BUILDER VS ADDRESSQ0rs / STRUCTURE ❑ NEW REMODEL J A.00ITION 0 REPAIR ❑ RENEWAL ❑ FIRE DAMAGE ❑ DEMOLITION ��.�— — ❑ RESIDENCE COMM ❑ EDUCATIONAL ❑ GOV'T ❑ RELIGIOUS ❑ PAT 10 ❑ CARPORT- GARAGE 0 STORAGE ❑ SLAB❑ FENCE OGGiiPANCY LANDUSEZONE .0 .3-._BLDG•TYPE FIRE ZONE — _PLANCHECKBY -_HEATy� T°A 64 Rot as . ' �•s i«b. �r1. _� .,+°�s �c�q,°�►'• _ __ __ SEWER PERMIT M OCC.LOAD jovpp-RFLOOR LOADCOh�1L HEIGHT lep NO.STORIES AREA,2 4/8_ NO.BEDROOMS VALUi#/j*t'J0 BUILDING DEPARTMENT SETBACKS FRONT P101 REAR _ LEFT SIDE RIGHT SIDE 1 Permil 2Nz"m 1HIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZO�I?NG 16, X13 REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE Plan .n Check WOR`• WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE T D— — p r� — WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE S� ( I. RESTRICTIVE COVENANTS.CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS i7 LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATING. State Tax � soc— j t M �.Pe f+ „ F�S Total to _ PDCII APPLICANT OR AGENT Receipt No. ADDRESS — PHONE Approved SDC SEWER CONNECT'- N 5 SEWER INSPECTION $ SEWER SURCHARGE 6 _ I��pwu/�17T'�G.svpo Trysa.q Amo- 66L fij : 95-I1 x 27-z J(h0N x i8 720 pA 4 �c.e.. 10 x t-c• S� -� I ♦.t 1 ting Depart1i L' l✓ i ��� �!'.3�u li ���:� Lil�:t 4 _ ClA ---- Buildment NO. Residential ❑ Commercial [� New Installation [}� Replace ❑ Addition ❑ Alteration �( t ❑ Date ILicensed GOR tM L ,/ 60 T �. {'GILT �j?Uwi✓ - Plumber Owner r �tP6OAZ Io 1� 1�/�� � VUR IM ,vNvl _-- -- ----- Address ( J Address Phone `�r2 _ 3�c�� Applicant f c CITY BUSINESS LICENSE REQUIRED FOR ALL CONTRACTORS AND SUBCONTRACTORS IITEM N0. FEE TOTAL ITEM NO. FEE TOTAL t Fixtures Traps 7.50 _ l Sewer:First 100 It. 30.00 Dishwasher 7.50 Each Addil.100 ft. 15.00 IGarbage Disposal 7.50 Ejector Pump 7.50 Water Heater 7.50 *7,5O Water:First 100 ft. 20.00 Backflow Preventer 7.50 Each Addit.2001t. 15.00 Storm&Rain Drain:First 100 ft. 30.00 Each Addit.200 ft. 15.00 Mobile Home Space —25.0-0 — Other 5.00Other(Specify): Rain Drain-Single Fam.Dwelling 15.00 I I PERMIT FEE IJ_� Comments: I ' STATE Issued By: TOTAI Receipt No. ---. -- Apptir_anl_�rw��C= /v/, y�� - -- - -- /- GAG-KOL fl - ._•--- I I � i � I ►�,ntu, rtla.unNtt;n►, ►'►;lit-It r Pe � ) t c r m i( V- Ct(y of Tit ata 13115 SW Hall BIVd . - -- P-(1, box 23397 T ir MeW4001 Code QTY pklCa _M vgard OR 97223 1) Permit roe -a to- 639--4175 1 2) Supptomontal Permit 3.00 1) Furnace to 100,000 BTU incl. ducts& vents 6-00 i 2) Furnace 100,000 BTU +� Name of Development incl, ducts& vents 7.50 3) Floor Furnace ••• incl.vent 6.00 Job .� � TI � 4� � G Zc. _. - Address rax La IAep o. 4) Suspended heater, wall heater or floor mounted heater - 6.00 Lot Block Subdlvlal•xn Name (a neme or bualn•ea) 5) Vent not incl. in G Id C r\ G U L" r ,�A e appliance permit^.-J- --- 3.00 `- Halling Address Pt,ono 6) Repair of heating, refrig., Owner _ cooling, absorption unit 6.00 ctYrstae 23P 7) Boiler or comp to 3HP _ absorp. unit to 100,000 BTU 6.00 Name 8) Boiler or comp to 3HP-15HP VAl-( ►t t_rQ►�p s absorp. unit to 500,000 BTU 11.00 Melling Address Phone 9) Boiler or comp 15-30 HP absorp. unit yz-1 million 15.00 _ Contractor CRY?-Slate 71p 10) Boil^r or comp 30-50 HP _ absor . unit 1-1.75 million 22.50 State neglstratlon tic. City Bus. Tax No. 11) Boiler or comp 50 HP absorp_. unit 1,75_0,000 BTU 31.50 1 hereby aCknowl•dg• that I haw read this application that the information 12) Air handling unit to given Is eon«t. flat I am the owrwr or authorized agent of the owner, that lO,Odb CFM 4.50 Pt4ns aub oltiod are In Corroano• with State laws, that 1 an reglslered with the 51410 Builders' Board• that the number given Is correct. (ft exempt 13) Air handling unit Irom State registration please glue reason belowl. 10,000 CFM_+ 7,50 14) Non portable - -- - - - evaporate cooler 4.50 15) Vent fan connected to a single duct _ 3.00 16) Ventilation system not Signature (owner or agent) pate included in appliance permit - 4.50 xeric 17) Hood served by Describe ❑ addition❑ alteration(-] repair❑ mechanical exhaust 4.50 to be done residential ❑ non--reslepritial -- - -- 18) Domestic type Existing use of _ incinerator 7,50 building or prolxfrly_._-__ -_ - 19) Commercial or industrial Proposed use of _ type incinerator 30.00 building or property— _ ._ 20) Other I.e., Koodslove, water / Type of fuel — oll❑ natural gas KI I_PGC] eIeCIrIcH __ heater, soler_clothes dryers, otc / 4.50 `1r 5- NOTICE 21) Gas piping one to four outlets / 2.00 V THIS PERMIT 6ECOMES NULL AND VOID IF WORK OR 22) More than 4-per outlet CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN �� cue-TOTAL -TZT S(� 100 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED ax sunct+Ana- _ (o �� OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS COMMENCED - PLAN REVIEW 251E OF SUB-TOTAL --- - TOTAI t -Z Special Condlllons l