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CITY OF TIGARD
COMMUNITY DEVELOPMENT DEPARTMENT
13125 SW Hell Blvd.Tigard,Oregon 97223.8199 (503)839-4171
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City of.Tfgard MECHANICAL PERMIT Planck/Rec. #
13125 sw Han Blvd. APPLICATION Permit #
Tigard, OR 97223
(503) 639-4171
oscription
Table 3A Mochanical Code QTY PRICE AMT
ob ~ IS 1) Permit Fee -0• -0- 10.00
AddressI Cl•»
- 2) Supplemental Permit 3.00
y
...of Furnace to'5"Wm
1) d
incl.ducts a vents 1;.00 A
�—acwloo,000 +
Owner ..3 ` 2) incl.duds d vents 7•50
Floo(Furn
C -7. 3) incl.vent 6.00 !
heater.w seater
4) nr floor rmunted hater J 6.00
entrxit tt -to
Occupant r w � 5) appliance permit 3.00
i■rRepair of hea6ng,re rg.
� 6) cooling,absorption unit 6.00
t er or comp,Foal pump,air oond.
7) to 3 HP absorp unit to 100K BTU 6.00
«•v Boder or comp,heat-pump;air Gond.
7533 S.E. LAKE ROAD 8) 3-15 HP absorp ,to 500K BTU 11.00
Contractor - e 4comp,ter or cop, heat pump,ai oor .
652 0345 9) 15-30 HP absorp unit.5-1 mii 9TU 15.00
• N<. •• ter or comp,beat pump,air Gond.
Q 10) 30-50 HP absorp unit 1-1.75 mil BTU 22.50
re yaa owil gp F-1 T}ave read us application,that the ter or comp,boat pump,air cond.
information given i,correct,that I am the owner or authorized agent 11) >50 HP absorp unit 1.75 mil BTU 31.50
of the owner,th-At plans submitted are in compliance with Statoit ancltng unit to r
laws,dial I am registered with the Construction Contractors Board, 12) 10,000 CFM 4.50
that the number given is correct. (If exempt from State registration, Air Nandfing unit i
please give reason below.) 13) 10,000 CTM+ 7.50
Non portable
14) evaporate cooler 4.50
�— Vent Ian connec
15) to a single dud 3.00
esti aao(Tsystem not
16) included in apprianco permit 4.50
•�«ro«w W � sery
17) mechanical exhaust 4.50
Do-slonbe work new U addition U alteration's repair Com,i.erdaTor u�i isutaT
to be done residential( non-residential Q 18) type incinerator 30.00 _
IExisting use of Other i.e.,woMstovo.water
building or property_ _ 19) heater,solar,clothes dryers,etc. 4,50-----
Proposed
.50 --Proposed t1se of 20) Gas piping one to four outlets 2.00
building or property
21) More than 4-per outlet
Typo of fuel-oil O natural gas 0 LPG Q electric Q
NOTICE
Minimum Fee$25.00 SUBTOTAL
PERMITS BECOME VOID IF WCRK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS,OR 5%SURCHARGE �
IF CONSTRUCTION OR WORK IS SUSPENDED OR
ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25%OF SUBTOTAL.
AFTER WORK IS COMMENCED. —
TOTAL
Special Conditions --
- Date issued �— --- — by----— ------
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C i TY OF T I CARD — RECEIPT OF PAYMENT RECEIPT NO. 193--242110
CHECK AMOUNT a 26. 25
K
NfiaVIE s A--TEMP 11EAT I NCS COOLING
CASH AMOUNT a 0. eel
j, ADDRESS a 7533 SE LAKE RD PAYMENT DATE c 07/07/93
M I LWAUK I F_, OR SUBDIVISION a
aAURPOSE OF PAYMENT AMOUNT PAID PURPOSE OF PAYMENT AMOUNT PAID
ECNAN I CAL PE - ::: ,. 00 ST. BUILD PER t. 25
Ai,
�WN
706.3 SW i_OCUST
UT AL AMOUNT v'A I I7 — — — — ) e16. C-15
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