Permit CITY OF TIGARD MECHANICAL PERMIT
=' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00250
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2011
Parcel: 1 S 133DA07900
Jurisdiction: Tigard
Site address: 12648 SW SNOWBRUSH CT
Project: Burroughs Subdivision: AMART SUMMER LAKE NO.2 Lot: 139
Project Description: Replace NC. Unit must meet 3' minimum rear and side yard setbacks.
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: BURROUGHS, STEPHANIE C
4474 SE MILWAUKIE 12648 SW SNOW BRUSH CT
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 234 -7331 PHONE: 503 - 524 -7394
FAX: 503 - 808 -9108
FEES
Specifics: Description Date Amount
Air Conditioning 06/07/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/07/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/07/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ( J/(/ - y) ,
Call 503.639.4175 by 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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r 13135 514+.'11x11 Blvd,, Tigard, r?R 1 a ' r> xcuiaw
Phone:.503.639.4171 Fat: 593• S' ,..., gl; Datd9Y' Other ?Mae:
1' I 6 A R 1'.k 'McMinn Line: S03 63 .4175 Ana Ree4Y/By: tutu' i3 so Nee 2 for
..Internet www- tignrd,orrgov : loti&edlMethod: e 5upalernental information ,yam
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Mechanical: permit fees* are Fred on tbevaiuc of tine work
Q Neu construction Mdditionlaltcr ttion/replacement performed. hsdimac the Value (rounded to the nearest dollar) of all
0.Dcmolitian . El Other: mechanical materials. spiprnem. labor. overhead,. and profit
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}obi tc.Igi $5: e;.. 4- .� .(:� - r 1i :tti _ (iulres eau! plan ahaw+aFplawroca0 1 46.7'5 �V -'�' I
City/Stag/ZIP: • ":t n , r 1 F� / ` > i )runlax 100.000 BTU (deers/vents) 46.75 •
Furnace 100,0004 BTU tductshrcms) 54,91 •
• Suit*iltM ;gaps. :Jo : Project • name: M j i . r p'" h Heat . um . 1 61,06'
Cron .strlera/directiors.tojailsite: -SN j' C7 MIL , 2132 I
Rwironic hot water system f 23.32
' Res,idcmz1b
.oi'ler (radiator or
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tydromc) a.a_
Unit beams (fuel-type, not electric). I 1
in - wall : ill - dttts. S 1Seended, etc. 46.75
Subdiv I.ot : FIuc/vent for an of above 23.32 _L_______________.10.:. -- Other: MUM.
Tax map/parcel p no � [7 �! Other fuel.a lianas MI
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Gus fir -.lace , 73.39
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Wood/pelletstovc Il 33,39 •
' - Wood fire .lnce /insert 23.32
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Address: • • e tit 'meat I 3339 •
City/Statarre.W: - ' . , Clothes dryer exhartst 33.39
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Phone: (..,,,m:: ., - - 2 Fruc: ( ) toilet' corn ,aus".utrliry rooms) 2332
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Fuel' pipiila I
'Coning ftanlc: S14.15 for fsrst four; 54.03 fo•esch additional
Furnace, ere, I I • .
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Dusintas oar . Heating S Alr Conditioning Otlrar _ I -
Address: 4174 SE. Ave 1. �,rryy ,
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GitylStrur•/Z1l': Portland, OR 97202 Subtotal ..
• Mope:: (5O)2341331 Fax (5( 3) S0 - 91OE Minimum permit fix ($90:00) f •;"-�y
I C13:lic,, 44D.... • ! T Su+rc l s7rr r cha surcharge-( T FEE I �� • sr 1)v
rtutdlorized. si �� • Thu permit npy crpfrtis it a penult Ft am obtaiec4 hltWit+ teU
1 �, d ays after it has ()WI mcerp w complete.
i • Prisii ttalrie' tl t - 1 � a Daze: / ' l ( fV a methD iato5y et by ln•Cuunly tluildiny lndastr} Servic
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ttluildiarrocw111 0.P0..11 ypp.J+w meal /lb • • '• 1 7 T'i'l OXICC+,�.{/IVES) (/
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