Permit CITY OF TIGARD MECHANICAL PERMIT
II
COMMUNITY DEVELOPMENT Permit #: MEC2013 00754
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/12/2013
Parcel: 1 S 136AB04500
Jurisdiction: Tigard
Site address: 7138 SW MAPLELEAF CT
Project: MYERS Subdivision: MAPLELEAF Lot: 3
Project Description: Furnace and A/C installation. Placement of the A/C unit must comply with manufacturer's clearance requirements.
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: MYERS, RON D & CAROL A
4474 SE MILWAUKIE 7138 MAPLELEAF CT
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 234 -7331 PHONE:
FAX: 503 - 808 -9108
FEES
Specifics: Description Date Amount
Air Conditioning 12/12/2013 $46.75
Type of Use: COM Furnaces < 100K BTU 12/12/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/12/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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:
i /
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.
12/12/2013 10:17 5038139257 PAGE 02/03
l nlcal YCTI11it Application
f a EC,►J • � � Receiv • I n)L (11 =1 1C't: I tiE : I Z1.1
City of Tigard _
13125 SW Flail Blvd., Tigard, OR 97223 Plan 3y, /• } Permit Nn.: t ;
Phone: 503.639.4171 Fax: 403,598.1960 Plan Review
P y (0-7 61 1' i C: A r I, Inspection Line: 503.639,4175 DEC 1 2 20 13 �s1Bp: Other Permit.
Interact,, www.tigard .or.gov �E dare Re�dy!➢y:
r i R.dahod r
A Notin[d see Page 2 for
+ '�� supplemental
nomanon
a lijLIi USE CHECKLIST ❑ New canstnt ction - �� =�� S
0 Addition /alteratiofi - •�Ilemcnt Mechanical permit fees' are based on the value of he work
0 Demolition
0 Other: performed. Indicate the value (rounded to the nearest dullard of all
rte.! _ r mechanical materials a • in
JJ I• and . firm Q r mCCeial/in i —v... ,
,yr overhead, and profit
mcnt, kabor,
.A 2- family dwelling Commercial/industrial 0 Accessory building 4 ' 'E iNEllti" /S1" CEMS FEES•
❑ Multi - family 0 Master builder firm
Other:
special rrtfnrmatlpn t, cherilw
Description Qty. ) a. Total
- dtj .7f#,.,...,,.;:-,—,; te . i.�st r a a 1t w r 41 . Heating/cooling
s-- Jnb site address:
b Air conditionin
it. a�.iL l mean �1 )
� City/Stow/ZIP; Furnace 100,000 STU (ducraven
�" ' (rc s showrrn pincement) � 46.75 u) / 46.75
■ 5uitc/b1d /;Ipt nn.: I Project name: Furnace 100.000+ BTU (doers/vents) j 54 -
Cross street/directions to job site; Heat pump
61.06 �,
Duct wort:
33 j
.32 I
Residential boiler (radiator or
hydrvnte) 23 3 , 1
Unit heaters (fuel-type. not cicctric),
in -wall, in -duet. sus. (fed. etc. 1 46 7 K
Subdivision
Lot no,:
Fine/vent for any of above 2
3, 3_
I T:t,s map/parcel no.; Olhcr.
'• • 23 32 J
, � .�. Others t sip . lances
5•''
1 [� � " ., �' + Water ter
I Z,I,Z2 . _ i
� ��... `,� Gas ferplace 33
- f a cnt for water heater nr g ry
AM Las. _ _ \ ( fir -lace �; t2
t L. hi. ter =
1 Wood/, let stove Mill 33 39
Q -PR(II t1NQ Q EIt `. - ,; ° : " Wood fir . lace insert ].:. 32 1
r r I " fATt Chimney/liner/flue/vent 23 32
Name:
Other;
*} 37
• Address: Environmental exhaust and ventilalion
Range hood/other kitchen I
City/State/ZIP: equipment 33.39 I
Clathra d exhaust -
Phone, (_ )
Fax ( ) Single -duct exhaust (bathrooms. ]331>
- —.
D .. j•" r Y <5 .. t „•u ;'; .� ti . n, .� toilet compa•tments, whit% rooms) 2 32
CT'�'.�i�i`Y
Arti fan
fi[rsi - name: � : ,
Other Conlrtct _^ 23 32
�� fra me: Fuel i i "� --
.vGdre �" S14.15 for first four: $4.03 for each additional
-
._.. = latc/Z1P: ..._...—•, Furnace, etc, •---
�" `�' Gas . hcat .c,,,,. . -
P hnne; ( � ) ��_ '"— -- -�_ Wahl/sus ndedJunit healer "� �
-� �..
1 n Fah: ( ) Water heater _ --
Fir ,_ --
Ran e
.. : ..
,, . Barbecue
11 U 5 4nCRS nitRle Jacobs tictttin & Alr(:tlndltionlng ecuc �
ClWhesd crf'as
Address: 4.17.1 SE AliMaOde Av e — — '
-�= Other: I -j
rty /Stale / /Ip• P ,--�
Portland. 017 2 ?202 CW1.1CALPERMIT FEES"
'hone: (,iD,i) 23 {_7331 ,��,� �r
Fax: (503) 802.9102 Minimumperrnitfee(S90.00) `
'C'D tic.: 1441 Plan review 1 ter)
St ate s urcharge (12% of permit feel
ltithnrizcd '., nturc; •
1111, (� TOTAL PERMIT FE& 1 � 7�
T h, permit •ppgrinne tpice.,ira [ 10K•
'ring name: �- __� ^" li p i. pot nArain N,e in in days after rr 6119 been accepted at en mp 1 eta.
ra , m- s:ramr.�j • •• ' - Fec methodology let by Tti•C`.wnty Building In facia Se ire Pooh(
n App dm inoval W
trtlWAifl (r V /COM��1't'