Permit '� '), r - CITY OF TIGARD MECHANICAL PERMIT
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2 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00134
�< . Date Issued: 03/31/2010
TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
; , Parcel: 2S114BA11100
Jurisdiction: Tigard
Site address: 16455 SW WOODCREST AVE
Subdivision: COPPER CREEK NO. 2 Lot: 64
Project: Dykema
Project Description: Install gas furnace and NC. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
DYKEMA, EUGENE Description Date Amount
16455 SW WOODCREST AVE Air Conditioning 03/31/2010 $46.75
TIGARD, OR 97223
Furnaces < 100K BTU 03/31/2010 $46.75
PHONE: 503-598-9692 12% State Surcharge - Mechanical 03/31/2010 $11.22
Contractor:
JACOBS HEATING & AIR CONDITIONING
4474 SE MILWAUKIE
PORTLAND, OR 97202
PHONE: 503 - 234 -7331
FAX: 503 - 808 -9108
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /' • Permittee Signature: OA
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RECEIVED
Mechanical Permit Avnlication 1..( )1( (.)Fni. I.: t;s1: t.)!. 1.1
.
City of Tigard MAR L 0 ; 7 ...,._ ' . " ,:, - AM . ..iriM Pv2'6"4. , ., OP -A# ..gy ,
11 4 . 13125 SW Hall Blvd., Tigmd, QR 97223
Plea • •
' _ .. • Phone; SO3439.4171 Fax: 59159L40,
V1 OP TIGARD Datedir Met Pamir.
• • • Inspection Line: 501639.4175 • . ..• - • - Data asody/Or , • -16, :. Sealase 7 far_
1 I ' ' '''' I ' D gnaw; wwwhigard-or.gov BUJ.L.D'...1‘ D I i S:ON Notlfiedihtettiod: supplemental tarerwation
' r .': ' .j..t : '......''' • ,. :.:::':'• . a ...,;'.,..: ' .. r .',, 143 E ---F-jr- T --'7 :: ------ SC;gEDEildE USE dijECKLIST
Mechanical penrut fees* are based on the value of the work
9 New congruction 1;#-Additionialtetationfraplacernent
performed. Indicate the value (rounded to the nearest dollar) of all
13 Demolition 13 Other: mechanical mai:,i ats. equipment, labor, overhead. andprofit.
• Vidue: S
Pi., ...., : . : CjtJ • 32r5:17 77 'v:i ' . ' z4;. .
:: 4140.0014 . 1 46.1) WM* 1 8W k*.trilfr
g 1 and 2 dwelling 0 Corrunomial/industrial 0 Accessory building
Far special information use cireckha
0 Multi-ftimily 0 Mager builder 0 Other: Description I Q. 1 Ea. 1 Total
laillabigaETOLI:=7=21 7:0 .1 •'''1; ficannrjosollng
Mr conditioning
Job site address: 11_04 IN.) C: A-4. --ulnas Mr .11in Maude -., ma 1 46.75 4671
City/StaterZ1P: - r - E , ei 0 (7,_. Cl "1 ...=Li., Furnace 100.000 BTU alseithenu Ermsalso
----- Furnace 100 000+ BTU dueurvauss 54.91 .111111
Suite/bldg./wt. no.: Project name:
Neat pump 1111 61.06
Cr039 strect/directiens in job she: Duct work 23.32
- Hydninic hot water system 23.32
Residential boiler (radiator or
h ohmic III 23.32
..- ._ Unit heaters (fuel-type, not electric),
in-wall, in-duet, suspended. cm. 4,5.75 E
_ even
Flu1 for any of above 23.32
Subdivision: Lino.:
Other 2,332
Tax mop/parcel nix:
Other fuel appliances
q o ) ., o : .;;;;;;;;;;iit. - •••t:'14:.',.;;:fc . Water heater 23.32 • _
ties fireplace 33.39
Flue vent for water heater or gas
,-- • .
12 v4L- C
__. fireplace _ 23.32
.- Leg bgbier Om) 2332
Wood/pellet stove 33.39
Wood . lace/insert MIIIIT121111111
.. !A•.;_ ..,_, .4 r ir clii* . ,•.; ; : ,, , :: : , Li::,, Chisuter/Iludegot
Chino: 23.32
Name: . if 1<g_
Environmental exhaust and ventilation
ddress: _
Runs hood/other kitchen
A
_... _ equipmem . 33.39
CiolStairdZIP:
_Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms.
Phone: 3 % .(_ Fax:( ) toilet cam -annuals . ; rooms 2132
• ..i' .' ' 4 i .7, .. .1. ''•..J.. . ' ), Ir 4ion Vret , I.,, 5 ,....1... i d: _■:,.. c •.i.Ly, ... .. Ani v_., farts 23)2
Other
, 23.32
Business name:
___
_ , Fuel ORloo
Contact name;
----..., 514.15 for env four; 54.03 for each additional
.. _
Address: Furnace. sic.
_
- Gas hem pump
City/StaterZIP:
-
Wall/suspended/unit heater
Water heater
- Fireplace
f-mail:
-
RuriLi
,„, ',-...,•:,,,.; ,7,:i•, .,.:;?' -
,, :i!!! . .ti..... 47.7. 1 7 :1Zia - ,..':.;i.! .. :....i . .:',. .'' ii--;... 4:7 Barbecue
Business name: Jacobs Heisting & Mr Conditioning Clothes dr ier (gas) MINN
. Other:
A : 4474 SE =kit Ave
- ..., r.. _._/_;;;•. : - .■,1_ 3 • .:, • :.•::.'. :.
City/State/ZIP: Portland, OR 97202
Subtotal gia.o
Phone: (503) 234-7331 I Fax: (503) 0110-9108 - Minim permit fee (590.00) 1.11
h./ CCB lie.: 1441 , - --- Plan review (25% of pun* foe/
____
-
___. . Siam .- : - (1254 of penult fee) awn.
TOTAL PIERMET FEE 'col 712
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Job Name -
Address
Model 4/
Make
SITE PLAN
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HOUSE
FROINI1'
•
JACOB S HEAI'ING & AC
4474 SE Milwaukie Ave.
Portland, OR 97202
(503) 234 -7331
(503) 813 -9257 fax
DIRECTION
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