11390 SW 94TH AVENUE I
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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hail Blvd.Tigard,Oregon 07223.8199 (503)830-4171
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CITY OF TIGARD RECEIVIT OF PAYMENT RECEIPT NO. :93--241030
CHECV� AMOUNT t 0:0. 80
NAME. MI.-,CAI-1- HEATING CO CASH AMOUNT t Q1. 00
ADDRESS soa sw is,rH AVE PAYMENT DATE r 06/0'7/93
SUBDIVISION
PORTLAND, OR 97205-
o.
rx PURPOSE OF PAYMENT AMOUNT r-"All.) PURPOSE OF PAYMEN7 AMOUNT PAID
MECHANICAL. PF 19. 55 ST. BUILD PER 1. 25
cc
BALES
11390 SW 941H
TMAL AMOUNT PAID 20. 0
CITY OF TILARD - RECEIPT Or- PAYMENT RECFIFST NO. :93--24105f
Cl-JECK AMOUNT 23. 4!
NAME MCCAL-1- (311.- CASH AMOUNT171. W
ADDRFBEi 808 E-.)W 15TH AVE PAYMENT DATE 06/08/9".
SUBDIVISION
P17RT1_11ND, OR 97205-
PURPOSE OF PAYMENT AMOUNT PA I D PURPOSE OF PAYMENT AMOLIN'T PAID
MECHAN.1 CAL. PF 5. 45
SALES, 1139QI SW ')4TH
SAL.ANC;F Of: PERMIT FEES THANKS!
,rOTAL- AMOUNT PAID Fj. 45
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CITY OF TIGA,RD MECHANICAL PERMIT Recetpt#t
Permit#
Description
City of Tigard
Table sA Mechanical Code QTY PRICE AMT
—
13125 S.W. Hall Blvd. 'I) Permit Fee -0- -0- 10.00
P.Q. Box 23397
Tigard, OR 97223 1 2) Supplementa!Permit 3.00
639-4175 1t Furnace to 100,000 BTU
incl.ducts&vents 1 6.00 6.00
Furnace 100,000 BTU •f
2) incl.ducts&vents 7•FO
Name of Develop nant Floor Furnace
3) Incl.vent _ 6.00
Job Andreas Suspended heater,wall heater
Address 11390 S.W. 94th 4) or floor mounted heater _ 6.00
lax—tot Map No. 5) Vent not incl.In 3
t rn @lock subdivision applia rice permit
Name(or name of buslneas) �" '�'-- Repair of heating,refr ig.,
Terry Bal-s 6) cooling,absorption unit _ 6.00
Owner
Mallfng Address Phone 7) Boiler or comp to 3 HF
11390 S.W. 94 h 639-4560 absorp.unit to 100,000 BTU 6.00
City/Siete zip 8) Boller or comp to 3 HP-15 HP 1100
Tigard Or 97223 absorp.unit to 500,000 BTU
Nemo 9) Roiler or comp 15-30 HP
McCall Heating Co absorp.unit 112-1 million 15.00
Melling Address PhO1e1 10) Boller or comp to 30-50 HP
1650 NE Lombard 231-3338 absorp.unit 1-,.75miliian 22.50
Contractor City/Siete zip Boiler or comp to 50 HP
Portland. Or 97211 11) absoi p.unit 1,750,000 BTU
31.50
Slat@ Registration No. CI Rus.Tax No. Air handling unit to
'. � 12) 10,000CFM 4.50
00140 00003408 - _
+ hereby acknowredye that 1 have read this application that the Information given is 13) Air handling unit 7.50
cortsd,that I em the owner or autlgdzed agent of the own-,r,that plans submitted are In 10,000 CFM 1
compliance with State taws,that I em registered with rhe Slate Bulld(,re'f3oerd,that the Non portable
number given is rxrrer i pt exempt from State registration please Sive reason below). 14) evaporate cooler 4.50
---- — ^��
-.5) Vent fan connected 3
to a single duct
Ventilation system not
Included In appliance permit _ 4.50
1.) Hood served by
vua.� �nUettI 5_�;._93 mechanicalexhaust 4.50
Signature(owner or Agent) nateDomest(c type �—
Describe work 17 addition O alteration X repair U 19) incinerator 7
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to be done residential' non-residential El_ 1s) Commercial orindustrl,il
f— Existing use of type incinerator 30.00
N buildingor properly Residence _ -
R P Y T Other Ld.,w, dsfove,water
Proposed use of 20) heater,solar,clothes dryers,etc. 4.50
building or property_ I
--- 21) Gas piping one to four outlets 2.00
Type of fuel- oil natural gas Cl ' ^ [=1 electric IJ
LL 22) More than 4-per outlet
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON- _ SUB-TOTAL 16.0
STRUCTION AUTHORIZED IS NOT COMMENCF9 WITHIN 180 S0;F0 446 SURCHARGE .8(
DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR PLAN REVIEW 25%OF S'JB-TOTAL 4.0
ABANDONED FOR A PERIOD OF 180 DAYS A4 Atm.'TIME AFTF,t --
WORK IS COMMENCED. TOTAL 20.8
Special Condilions
--- Date Issued by