Permit a CITY OF TIGARD MECHANICAL PERMIT
IIIL
2 COMMUNITY DEVELOPMENT Permit #: MEC2010 00418
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/20/2010
Parcel: 2S102DB02500
Jurisdiction: Tigard
Site address: 13552 SW CHELSEA LP
Subdivision: Lot: 0
Project: Booms
Project Description: Gas furnace replacement.
Owner: FEES
BOOMS, PAUL W & SHARON L Description Date Amount
13552 SW CHELSEA LP Furnaces < 100K BTU 08/20/2010 $46.75
PORTLAND, OR 97223 12% State Surcharge - Mechanical 08/20/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 08/20/2010 $43.25
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: Natural Gas
Gas Pressue:
Total $100.80
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.
c
Issued By: � 2 � T, � Permittee Signature: . ���� / '�„ 1
i
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.
08/19/2010 14:06 5038139257 n r,- ,� _JACOBS HEATING PAGE 02/02
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Mechanical Permit Application AUG 19 2 :
..' y of Tigard y���
13115 SW Hat! H1vd.,Tiggtd, OR 97723 CITY C' o „ _ I
tPIm Rtview
Phone: 503.639.4171 Fax: 5015951964 BUILDING Di VI :� y: Other Pewit:
r 1 ,, Inspection Linc: 303.639.4175 Da - . r , -: &
' e Pap 2 far
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❑ New construction �l dart (otvatteration /reptocetrtetu pMechanical Indicate vague (rounded the the nearest of d Marjo,' ali
❑ Demolition 0 Other. mechanical mtttarials. ewipm nt, labor. ownlamti, and profit.
,. ? ��1T. a ., ,.. .., 1 r Value: $
r... • . 14. .p.•,• ll” 1 `' , tip• ^ce - .•. s r:t: ; :':. ;' . � -
0 - and 2- i`binily dwelling ❑ Commerciallirtdustrial 0 Accessory building = '.
Multi- family p Maser builder ❑ Other: Far sprat! ul/ormmron toe checklist.
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ot It a Air conditioning
Job site address:
1 I/. Sect_ cap (maim site *A d:wire olsoentenn 46.75
Ci ta1/Z1P: l Cl, rot- 0 • 7 3 Furnace 100,000 BTU (duosIsuataZ .. / 46.75 y(p.
F
uiee/bldgJnlpt no.: Project name: Furnace 100.000+ BTU (davarvesn) 54.91
S
WI Heat pump 61.06
Cross street/directions lo job site: Duct work 23.32_
�
Hydro :hot water system 23.32
Residential boiler (radiator or
hWdtuol') 23.32
23.32
Unit beater! (tuel•type, not electric),
_ in^well, in•daot, slrsparded, etc. 46,75
Subdivision: ) Lai BIM
Flue/vent
only of abort etc.
~ areal no.: - Olio. , 23.32'
Tex
P Other fuel sapilanees ,
• `'•:- : "1 . ' Gas • water Marts 73,32
. � ?�� . :�:ti. .� , _.,,�. r......� ` .��4: . ,ter • . �,,. • ' ��-` •
Illeplace 3139
T _ Flue vent for water heater or gas
901�e
C a-S u,r r Qc f. , f —� ' - . z3 .3Z
Log Witter (hart) n.32
Wood/pellet stove 33.39
Wood fireplaeciiasert 23.32
.i.: r '', +�=i< 7 1 ' ' . e A L T . ' . w `;' h:^ a • i: �± tcNiluerVCn 23,32
r1aW� #d.Li i. ▪ omen 23.32
Name: , L 1 CI) ) rY)S Environmental exhaust and ventilation
Address: Range hood /other kitchen -
- p 33.39
33.39
City/Stase21P: Clothes dryer ededam Plume: a (0 L - 01 I : ( ) eo feast utility (bathrooms.
,. f _ .. _ ` . anlitrns) 23,32
.. �'` + 'r • ,1 a ier lsn�rT� 16 i � + .k'1i. �.Vr 1r'7 TI i . • a Aitickra Ylspaele raw 23.32
Bashing Seine:
Other; 23.32
Fuel pipes
Contact names y _ 514.15 For first Four; 54.03 lbr each addition!
Adds Furnace. etc
Gas beat
City/State/ZIP: wall/suspended/0th heater
Phone: ( ) Fax:: ( ) Water heater
Ermal7: Fireplace
Rieke ,
:.7. .. Jy 2r `�..•:��.'. ,�:�� •y "';see A - : �:�-•'" 9aibeCYe -- _
Basiucae name: Jacobs Beating & Air Conditioning Clothes dryer (sat)
Address: 4474 SE Mllwaakle Ave t „ --
City/SUM/ZIP: Portland. OR 91202 --� r � r 3 ° „ L ,
Subtotal Y(p � 7.5
Phoi r ( 503) 234 -7331 i Fax (503)11021-9108
1ldmatn Pub flee ($90.00)
Plan nwlew (25% of permit ibe)
CCB lie.: 1441 J _State surcharge 02%ofyerrnit foe) j P . SO
TOTA1 P icRb1]T FEE ;71
Authorized : �/r�
A NEM 7 Mb penult implication etplr s If. permit it not athomed minds Ise days other blots
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