11435 SW 92ND AVENUE 11435 SW 92ND AVNEOE
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City of Tigard Mechanical Permit No 3 4 8 8
New Installation ❑ Replaces R Relocation❑ Addition ❑ Alteration ❑ DATE:
HEATING
CONTRACTOR ��� "rL_.— OWNER
APDHESS `�� -7 _��;..__— JOB ADDRE S��`r
PHONE `� -- APPLICANT
Heat Input Rating(BTU per Hour) %' Vent Size Flue Size
FUEL OIL❑ GAS,& ELECT ❑ OTHER
ITEM NO. FEE — ITEM NO. FEE
For Issuance of Permit SEE BELOW Each Air Handling Unit or Duct System 7.50
New up to & incl. 100,000 BTU 6.00 Commercial Hood Syte
sm 7.50
New 100.000 BUT's & over _ / 7.50 Other Equi ment Each 4.50_
Woodburning Stove __— 4.50 1 Trip Inaction 4.50
Wall-Floor_Sus ended 6.00 Air Condition Compres.or - up to& incl.3 N.P. 6.00
Vent System w/Fan_ _ 4.50_ Air Condition_Compressor_ 3.1 to 15.H.P. incl. 11.00
Re air-Heat Cooling 6.00
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comment:
FEES s`..
SUB-TOTAL 7 4-t-. ----- �—�------ e�._—
„;196 STATE_ Issued By
2596 PLAN CHECK
TOTAL /f RE C. _ _—
ignature o pplicant
N www We e e e
Address ? __Q�_�Z __�ur(�_ Permit No.^� CJ
Name of Occupant _ Permit charge
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------ ---- -- Paid by.—--- —— ---------
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Date connected 7_�T
Type of. Building__ Inspection
Service Rate_-__-- L 00 ___-- Paid by _-_- -- Date
Contractor. Aswament2(, 7(9.-_Paid
Size of connection