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City of Tigard Mechanical Permit Nv 3445
New Installation ❑ Replace U Relocation❑ Addition u Alteration ❑ DATE: I- L6
HEATING7 1 C L
CONTRACTOR Eae,,,l AC' E k- r 'T:� OWNER + /
ADDRESS I -�=� ��—� ��� ' L- JOB ADDRESS
PHONE _ % '6 APPLICANT _-- - --- ---
Heat Input Rating!BTU per Hour) ! Vent Size _.__ Flue Size_ — --
= ---
FUEL OIL❑ GAS []j, ELECT ❑ OTHER
ITEM NO. FEE ITEM NO. - FEE
For Issuon�e of Pe,mit SEE BELOW Each Air Handling Unit or Duct System _ 7.50
New-up to & incl. 100,000 BTUu.00 Commercial Hood System _ 7.50
New 100,000 BUT's & over —_ _ 7.50 Other Equipment • Each — 4.50
Woodburning Stove _ — 4.50 1 Trip Inspection 4.50
Wall-Floor- Suspended _ 6.00 Air Condition Compressor up to& incl.3 H.P. 6.00_
Vent System w/Fan 4.50Air Condition Compressor �.1 to 15.H.P. incl. 11.00
5mair-Heat Cooling _— 6.00 LSI =L' �-^ L-=
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 16.00 Comments:
FEES _77,17
-SUB-TOTAL �' s
96 STATE ' Issued By �-
25%PLAN CHECK_ c�
REC. # _ -
TOTAL 5 -- -- T—
Signature of Applicant
/ Permit No.
Address�Y��___—..—��--��`"e
Name of Occupant Permit charge ___— ---.-----
_ Paid by-------- — —
Date connected
Type of BuildingInspection fee
service Rate
7 Paid by -- Date
_� 11 0
Contractor.— _._ AssessmentPaid _
Size of connection __-_--------
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