Permit CITY OF TIGARD MECHANICAL PERMIT
tt COMMUNITY DEVELOPMENT Permit #: MEC2010 -00619
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/30/2010
Parcel: 2S112CAl2200
Jurisdiction: Tigard
Site address: 15555 SW 76TH AVE
Project: Hubbard Subdivision: RENAISSANCE WOODS NO. 2 Lot: 46
Project Description: Gas furnace replacement.
Contractor: A TEMP HEATING & COOLING INC Owner: HUBBARD, STEPHEN A &
16000 SE EVELYN ST DEBORAH J
CLACKAMAS, OR 97015 -9519 15555 SW 76TH AVE
TIGARD, OR 97224
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/30/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/30/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/30/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.19r 1 R00.332.2344.
Issued By: / Permittee Signature:
Call 503. •. y 7:00 a.m. for the next available inspection date.
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.
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11/30/2010 06:43 5035572990 A TEMP HEATING PAGE 02
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City of Tigard Received
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' ' Pho 503,639.8171 P 5t 3.s9B. ILDING DIVISIO P h a )BY: r '' -
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1 , Inspection Uric 503.639.4175 jy Permit
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to job site
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in-wall, ink suspended, etc.
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Tax mep/percel no,: -
23.32
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