Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00524
T L G A. RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/11/2012
Parcel: 1 S136AB05200
Jurisdiction: Tigard
Site address: 10340 SW 72ND AVE
Project: Ouloette Subdivision: 1993 -089 PARTITION PLAT Lot: 1
Project Description: (1) A/C and (1) furnace installation. A/C must maintain 5' side yard setback and approved rear yard setback. (1)
fuel piping for furnace
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: OULLETTE, JACOB D
4474 SE MILWAUKIE 10340 SW 72ND AVE
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 234 -7331 PHONE 503 - 347 -1059
FAX: 503 - 808 -9108
FEES
Specifics: Description Date Amount
Air Conditioning 10/11/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 10/11/2012 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 10/11/2012 $12 92
Occupancy Grp: Fuel Piping 10/11/2012 $14 15
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
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 or 2344. ,�
Issued By: ■r'�y� Permittee Signature: D ft /Ji)c-16 /1 .T7 O N , t
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.
Mechanical Permit Application,
City afTigard '�
•
aY 101 t� ( r > _ t Ne, LIE C �r�,oD S .
' 13125 5w HAI Bnvd-; Tigzad, oR 972..3.. Plea tL4+tlowi
Phone: 'S03,639,4171 •Fatr..503:598.196(1 Chotr
• Jn5Peet'iertLine: 503 y Oast-W.,. .
1' f s , r h !� L9zte 1tlndYlBY Sec Puzi z,tor - ?
Internet: wwW.tlgtu 0r.8a►' 1llptilsdlMcthod: -rI Co ' Supp atal Wtow:ami is
,� ��y r'., - 7 , s
�,rf,r• a-- ,, 7wa'z?r, F r_71p.ilr iri 'y iC
1! ? fl"'I�f"!� i `i' 1`IC"R' rWc�, u , - -� u•rsr. v :.uu� rWf
.,t F "��Et' 0. i:`Q- -�+... � ; ; hA } �,; ! , L „ 1 � ,,, ~'i�
i r r„v.�}�I 1 • �• �• f;l �f i ( � -. _, }., i l f 7 ,; il ` r, j 0 .. r 1 1 '� '
'1• t . �.,- ,r,rr.r iSi.- ...acr.� � Id�.i�f4 1 :45 ,1 ) I.rx r. r .:I.,�RY 1� ., ow.,c
Q NCW construction PI - . ■ '
_ t ltorllalleratioNrapia*nettt Mechanical pennittetss" web. ,r, aa'tlte value of.t,ht; mark
lit:tttolit1O ❑ Outer pert n ocd..)odientei atmded to thenewestdoll 0
thq vs►t►c (r ar) f � 1
Q i rnectenticalmatain ulpmeet,tobar.owatcad 'i
. s r . kw . 6 ,� .ry % y r? F. , . ,1v1. �Titiii l 1u rl'Ifq rp r} I r VSIuC S 1 • i + ;+, •. .•�-� . r'.. ,L *, 1 , ... •,. ,n - 1,., ' -a.° I i t i --• l; ':'tl'1� �, � ���,,,1 c e� ,�p
.t.7,1�3" ^'a!Q 2 -fitMa 4 . 1' CommerciWindu 1ria1 r ] A pens / bui r 1 j i , l r ' 1 ` V i+ : i r c'( c r�,L � �,i� 1 1 tf, ' 41 �1:LU.l.1 ^ ",.� ly ,�a '�. w +�. w. 6�7 Sl�lllll�
ID Mu1ti•fafnity ' Q 'Mester'builder 0 Other:, ... . Far apec(al hUfvrer+tetarr+iso cheeklfsl,
bcs�i8tian �Qt7'• �;;�. � TutrJ'
f) 1, W �7,1MayT l� ,i �_ -- Z T l y lr,^7' it `'^;, 1 � ., "�! '� r ai l # i 7 �,Y� r r ,-;; f i `i HCbli ' QOatl>t� .rw
.. , •.r _ -may �..
Job Site
address: 10 (i ��, 1 , .. f�+ 1 . . 11i1 C07ltitp�Wn
t J
myairoa the atuashowi to atacemmr] 4675 , si *
Cit lS�ri21P .- C , J fu>«:'WOOU BxIJ(auaeJ►sam t . a4li'75 ' fto
SuitelbldglapL no.: Project acme Htmt 000+B U Menery ntst . . '54,91
Fam>tod;t04 i
ptutt�r 69.06
Crass 5treetldireetiotn'to job site: .. .Duct. work ' ' 23.32: : , .I .
.. ', 14 dronuehat:watet system . . 2332
' .3ttsidential Ier.(radietoror "" 1.
.9tjdronicl ... 23.3.2 l ',' 1
llqu hatters (faei -tsoc. oat &ch ). t
in- rall..in•duct. sum:e nded, inc- .. . ' "' ' ' 46 :75' . f t
' S'litd lrmt foram/ of above . 2332' "'
r
, lQllier ' , 23.32. ...
Ttot l rt
plporeco;: rrf " , Other
: iN
r,. '' r . �fy TRi M'' ; zF F� r�. .-- FJ (r21?i r ". I E� 1 Lf ' �J {,fg;i1 j 1 g it Water beim'.. .. .1 •• . ' .23.32
5 C.11,5L,____,''' _ Lao vent.Cor: watet'htateror,gas' ' ' ..... .ferepiace 23
.. rt ightxr (Rs:)' 23.31
. Waodlpcfctstovc , : __ ' ' 33 39 "
' • .9Vood f .lau/insert'• ° . 73:32
�� r :z �y1 •em�PTlti;t,,,, -- e s�yt�(, cu j tl - �.;r l r 1 0 ,uA e el± 11 t !• ^ .,i1 Chimoevilincd l{3cty =. 13: .. ..
M ` ,i�"i7l r ' =Y. rl,,„, .,4 � 'r= -. - ��.�` ! ' � ..( _, 6 , �.�- r "". . ' ..,ux i.. ,„.i:? ' 'i , .fltlla:. .. 7332 .
''`� �.J L:.r` K..T� 0 o. .. Enviroameutstrshaustwnd ventilation
Address: f 'M , 33:39 • .
'Cit /Stanr1ZIP!.. 1 , rA„ a ''. . '7 ' , Clothes e7thaast '. n-39 ' U
S' gic Gual
Phone
;rtjt
: 1 '" . :1 i 1..1w�.1 Fax: ( ), taitat' s 'uali ;roams ' 23:32 ' .
..C' w '� �,r� -nr r r ' n . LLt 1' 2° 7, ` R .7ir ii: ARJCI , ,�r,. n rots'
fetFi .� 33.32 ' 1111
a ms s( `' '�� ^ 4 - �.� Fi 9� ! a. ., ; 7 1 + , � .�1, 1 ,..,.., 41 ry a
rF r l:.... ^ - '' .�. a �t(_.' " l' i 'aluGJ'.I c • .L i dL:• other 23,32
Business name nit idpin . . .
Cotdtsct auk: tr for'll'rit fours 54.03!tor inch adds tiotral
...
Address: --- Ftttaiace. ctt
- - Cris heat '.. ) .. .. �ll�
t 'City /5taterilP: ' Will} pc diu it hooter '
W heater' .. .
Fi ••: lace :
Ismail: 'Ran .
,' n ec k coe. '14, n . i, 4 7V. 7� t { I Zfig :11f r e
. p r - ,'( Y' . r r . : t , � r . >." f�i1c . ;} y �anc�cuc" .......,.....,, f .....«...,. -.4
.
'� . °tC c , ,y yl w r r fi f ...rl ° b liri, �,afl�l a }cL. r 4S
othcs th r co . .
M aim:es :ne* o: ? lambs Heating Si. Air.Coadltisutrio, -
Qtht:r
'Address: 4474 SE: M livankie Aye. .
�.. y �. �
tic ,+11' y1Fr: `r` c ,y�i F1 , 7 : 4" , �` .0 map 1' ;:...t,-,;:;.,
' l [ ti r 1t 711,1ELEi � e J 6 r: r.. l l ,� ,. , L �.r • r n r Or1. WI. .(1. 1.i . .
.. ' Subtotat `.
,' City /Statc/ZIP: Portland. OR9.72t12' •
.: Minimum 'portrait. kelS90A09
: Phone:: (503). 2347331 .. Fan (503) S08.910$ Plan review. (25%ofpcth i fie) ' '
CC,13,�tC.: 1441 . Sauc. surcharg.C'(9,111.of.pirtnitfee)
r
. ....., TOTAL'FES 1iTFEE:
. [/. .. 'Mb peezahwppacittioe nom I(4 permleit not optneacd:wert iotea'
Authae'(2edsipltIUC: "' L- & '`^'7r t� " " " 13 (•, .. . .
, dax+ atter Islas been accepted ResotopteTe
Print aimed'
i .
ll `` i.' nom...' w,?' 1 ter . • ' Fcolmutodo7
e407 r rrbY Ti, a ° itta cnt'utd Sic Baud
t wr ,taro0u.mitv.ter~.pam(i!App*. ttuat+u9 440- 4e7t0 tro24cD:,uwM) •
.c4 1
EO /G 3EVd L9ZEEt8E05 9b :80 ZZOZ /tt /0t
S11 PL41%1
1 4 0
0
i IE CTION
r
HOUSE
� .
•` FRONT
STREET
Name . c 1 -
Address i . Sb V -,r!, A1-44-
Model #
Mak =
JACOBS H EATING $5 AC
4474 S 214iIw�Ukje eve.
Portland, OR 97202
(503) ?'84:73 1
(503) 6? 3.9257•'faK
£0/£0 39Vd
LSZ6£T8£0S SO :80 ZTOZ /TT /0T