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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00383 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/29/2009 TIGARD g Parcel: 2S102CB04600 Jurisdiction: Tigard Site address: 13410 SW BARNUM DR Subdivision: BARNUM PARK Lot: 6 Project: Olson Project Description: Install gas furnace and a /c. Owner: FEES GRAVES, DENCY OLSON Description Date Amount 13410 SW BARNUM DR Air Conditioning or Heat Pump 07/29/2009 $14.00 TIGARD, OR 97223 Furnaces < 100K BTU 07/29/2009 $14.00 PHONE: 12% State Surcharge - Mechanical 07/29/2009 $8.70 Minimum Fee Adjustment - Mechanical 07/29/2009 $44.50 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 $81.20 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: 9 , / L'C6 /C/■,/ 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. - 07/27/2009 16:47 5038139257 JACOBS HEATING PAGE 02/03 Mechanical Permit Application i , ho OFFICE E 1.1SI: ONLY • City of Tigard JUL 2 7 2 u (1 $ ° ) _ ' I,l �� • 13125 SW Hall Blvd., Tigard, OR 97223 ' Phone: 50,3.639,4171 Fax: 503.598.1960 .. - ether Pamir Inspection Line: 503.639.4175 CITY OF TIG' r n• ® see Page 2 for - Intemet: www,tigard- ar,gev BUILDING DIVI: . hm Suppt ...o ...Ilan :;s .. uc;,f : ,:: , ,716F&4rS1KOl'L[ " -` .., , , �, . . ` i , ,ctli01►? .1 vs.... Q New canstru Lion - AdditIon/alteration /replacement Mechanical permit fees' are based an the value of the work performed- Indicate the value (rounded to the ncarmt dollar) of all ] Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and prof t. . Value: $ . .RE.riIDENT1AL EtaJIPMENr.tSYSrEMS FEES* .1- and 2 - fam ly dwelling ❑ Commercial/industrlal [] Accessory building " For ;pedal bformatlon use checklist, Multi - family 0 Master builder Q Other Description Ea I p I Total - i -JOIE STTE 1NFORM LOCATION ; • • ' J Heusi : coo address: ,�,� �r Air conditioning or heat pump Job site addr 1 _ 9IQ - Sc' ,re (Inman-ask plan rhowinptaeemenj 1 14,00 Nf -tom City /StaterZIP: 17 cvn I cl , iw.,-.3 Furnace 100.000 BTU Nam/your) 1 14,00 W .tom Suite/bldg./apt. n I Project name: Furnace 100,000+ BTU (duels/vents) 17.90 Gas heat. pump 14.00 Cross street/direciintts to job site: Duct work 10.00 Hydronlc hot water System 14.00 I - Residential boiler (radiator or hydrenic) 14.00 Unit heaters (fuel-type, not electric), in wall - duct suspended,_ etc. 14,00 Subdivision: i I Lot no?. Flue/vent for any of above 6.80 Other: _ - 10.00 r Tax map/parcel n5.: Other Diet Appliances . •, `:Iit, gat rricgq. or WORT{,' Water heater 10.00 - Gas fireplace 10.00 G ` --- �....r e.4.L.Q AO -- _ - Flue vent fur water beater or gas fireplace _ 10.00 . . Log ti, ttcr (has) _ 10.00 Waod/pelles stove 10.00 Wood Croklacdinsert 10.00 Chimney/liner /flue/vent 10.00 • - #©>p> 4 F1<7,5gg „ . _ .---- 11 ' • ,.- , ... 1E61SilT -- - Other: 10.40 Name: Zhu C) \ C) Environmental !chasm and vermin t ion Address: Range hood/other kitchen . equipment 10.00 _ City /State Z[P: i Clothes dryer exhaust _ 10.00 - . Single-duct exhaust (bathrooms, Phone. ( .p - . 1 3 Fax: ( ) toilet compartments, uulitY rooms) 6.80 • 1--1 yiT ti , '' ' D , CnNr# JA IRSON Attie/crnwlapace fans 10.00 . , ' ether: 10.00 Business name: Fuel piping,. Contact name- i _ _ _ 55.40 for first four: SI.00 for each addltlonni Address: ' Furnace,, etc. - Gas heat pump City/State/ZIP: Wall/suspended/unit heater - - Phone: ( ) Fax :: ( ) Water heater - - Fireplace E -mail: Range CUNrRAC`'rOR :. .,i`; -' . A.": Barbecue 13usint t t name: Jacobs Fleeting & Air Conditioning Clothes dryer (gas) Other: I - Address: 4474 SL' Milwaukee - •MECHANIC;MM rkkOprr. , City /Stuto/ZIP: Pcrtland, OR 97202 Subtotal Phone: (S03) 234.7331 Fax: (503) 808.9108 Minimum pe rmit fee ($72,50) y,� Plan review (25% efpermit fee) CCD tic,: 1441 State surcharge 12 of resmlt fee) %.1 t ) TOTAL PERMIT FEE qd 1. �O Auiborizzd signature Otte . { v)c . rye tA . r, nit permit application etplep if o permit is oar obtained within BO days goer it bill been accepted All complete. Print name: C c,rti , ( - 1 - 11w01t„ Date: S - ._7 me - , Fee methodology cm by Tn- County Building Industry Service 8eatd tgiuddleekermitiUItCterMiUpp doe 01/14 10 MO - abtrrt I 1 /O2/COWYWED) ■ •07/27/2009 16:47 5039139257 JACOBS HEATING PAGE 03/03 SITE PLAN 65 DIRECTION . H OUSE r r now sTRE VVIt Name \ f_Dc) A (.1 cirt‘5:5 ' 4 0 .,53 moci,:[ Mkc JACOBS HEATING & AC 4474 SE Milwaukle Pori:411u] , on 972O2 (5031234-733 I. (503) 813-6257 fax