Permit CITY OF TIGARD MECHANICAL PERMIT
11 / 4 1 COMMUNITY DEVELOPMENT Permit #: MEC2013 -00110
Date Issued: 02/21/2013
T I 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 1 S136AB04000
Jurisdiction: Tigard
Site address: 10066 SW 71ST PL
Project: Walter Subdivision: LOCUST TERRACE Lot: 7
Project Description: Replace gas furnace
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: WALTER, NICOLE & ERIC B
4474 SE MILWAUKIE 10066 SW 71ST PL
PORTLAND, OR 97202 PORTLAND, OR 97223
PHONE 503 - 234 -7331 PHONE 503 - 244 -8772
FAX 503 - 808 -9108
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/21/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/21/2013 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/21/2013 $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 1987 or 1.800 332 2344.
Issued By . ,0 , Permittee Signature: , � /( ( v.`"-
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.
02/21/2013 16:43 5038139257 PAGE 02/02
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