Permit 1
",,,',ti m)i'a" MECHANICAL PERMIT
jil ,' ::.1 4� CITY OF TI;GARD
l
,, COMMUNITY DEVELOPMENT Permit #: MEC2009-00569
Date Issued: 10/27/2009
TICA D; 13125 SW Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104AB06900
Jurisdiction: Tigard
Site address: 13089 SW KATHERINE ST
Subdivision: Lot: 0
Project: McGinnis
Project Description: Replace gas furnace.
• Owner: FEES
MCGINNIS, PAUL Description Date Amount
13089 SW KATHERINE ST Furnaces < 100K BTU 10/27/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/27/2009 $10.80
PHONE: 503- 590 -1076 Minimum Fee Adjustment - Mechanical 10/27/2009 $43.25
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 $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 riot 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 are set forth in OAR 952-001-0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or direct questions
f�
l` r l to OUNC by calling 503:246.6699 or 1 .800.332.2344.
111��� L
Issued By: —� y - n ,/1 k 0,, t /�fl I I ksAz Permittee Signature: R ^
���444.i2' /,
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.
AWIF a
• ,... ,. -
„..„..
. .1,0_,:i.„,,,..49.„7_,„,,r,,,,,...,,,,,v,..t,..,,...11.,... N •■■ ,,, l'hrn, IN v.,* . di, ki ?,. tqA, , v
bie 0-4P :',1-Mrtt ■ A“di 1. ., O T egie, , , r i
'Vieth . 1...._LitialtnitA- he 11011. 1 ‘1,,, ,, ,V1 , =” ,1 Iv k,littAfliftko,Aplit,olopiel, I" N l' A 1 IN L 'A '14,40' , A?
rfeNN City Tigard 0 cT 2 2 200 ,
v
=ay.
r ' . Pwrin't No • r't
___ 4k1 - I- - I i a* f• .ki•' .''''
I3125,SW Hail Blvd., Tigard; Olt 97223 Non Review
Phone: 503.639. 1 Fix: 503.598.1960 ,...„, Ti n & u DatriRY: . Other Berme ,
op, pv.,:titiei Inspection,Line ;539.4)75 CITY OF 1 iv 9:)....R.4fiy; N31 g SeeTaao t for
, 6 '-iik iillitattl www.ligard.or.gov % i 1 0 *Illeruivicreort; suripterninue inrariosilee.
BUILDING D
' ...— — .
TOPE OF WORK CO
. . MORCIAL FM SCHEDULE - USE CHECKLIST
Mechanical"Rertnit'fect are based on the value of the work
0 New construCtion AtrAddition/alteration/replacemerd . ,perrorMied,,indicatc die value (rounded u) the nearva dollar) of all
ark,,„ficion 0 Other: . ,
mechanical materials, cquipment. labor. overhead. and .rofit-
-,-- . ,9nlac: S
CATEGORY OF CONSTRUCTION :
--,-...,-- RESIDE,NTIAL EQUIPMENT f SYMMS FEES"
. 15 " - and 2-family dwelling 0 Commercial/industrial 0 Accessory building For s :eclat infUnuafiun use cirecktua.
0 MOW-Family 0 Mama builder 0 other: : Description. Qpi. En; Total
— .
.1011 SITE INFORMATION AND , ' ff . .; inoti ; HcatiaWcoaling
51111
Au condoning MI IIIII. r .
Job site addr wt
ess: birat , ib.. 4. ii .i i , 2 & • . - • ,
, r - wet Me . Ian gloom: , taco ea
0 i 61FtWAMMIIIIII 'Furnace' 100.000 BTU (doenivcam 11' 46_75
IM ICSMOM Furnace 100,000+ FIT13 rdnersivenia 54.91
SultribldgJap( Proj name: _ n n , ....)
., no.: % c.,
. Holpump MN 61.06 EIM
Cross steel/directions to job site: tract 'Work MIME'
, - , Hydronic hen:wilier system 23.32
Residential,bialler (radiator or
hydronic) 23.32
rMIIIIP.Ariv4PIIPVirliFill . .. .
. _ . Unit heaters (lbel-type, not electric).
1 in.wall. in-thact.. sus . ' nded. etc. 46.75
_ 1
--.----- Flue/vent fbr any of above 23 32
Subdivision: Lot no.:
— Other: ' . 2332
1
Tax map/parcel no,: , Other fuel !poll:mares
DESCRIPTION' OF WORK Water heater . 111 23.32
Gas fireplace 33.39
Flue iant for water heater or gas 11111
fl .lace
Mi it- 114.11111Mainlarlial. Log lighter tgai) SEEMS
WeradInellit stow II 33.39 E
Wood lirephtedinsen 23.32
Chimacy/lineaucivent 23.32
11111111VC :' q PEATY OWNER El Tolurr • othcr 23.32
graliP d il I . Eniiironmental .exhitert and ventilation
Range hoodio . r kitchen
Address: equipment 33.39
City/Stme/ZIP: Clothes dryer exhaust a 33,39 1111
Singivdum exhaust Oath:owns,
Phone: (SO - 4P 0 .-- e.> an Fat ( ) • ,bailet compartments, utilitY roams) 23- • • ' CI APPLICANT : : ' 13 CONTACT PERSON •• • . Attic/crawls . ace fans MOBEFill • •
Other , MIMI
• Business name:
, -------.—, ' F'uclitIvilig —
• Conmetnante: S14.16' tor Drat four: 64.031n e each additional
Furnace, etc,
Address: ' :Gas heat . um
City/State/ZIP: ItErTErr=11111=11.
_._—.
Phone: ( .
, ) Fax: : ( ) IIMMITEffill NM .
I 1170213M1"11111.111111".111
E-mail: t. RruNtc =IMMUNE
__
CONTRACTOR liarbeCue NMI .
---.--__-__----- Clothes d 'Cr ( • OS) 11111111111111MIN
fiustacss,tuune: Jacob Hentin & Al r Conditioning
. Other
•Addicss:4474 SE'Mllwoultic Ave • MECHANICAL PERFALIT WES"
. • - _
• - r
City/State/ZLF: P' ordand, OR 97202 Subtotal
.--- mum permit fee (S90.00) laa
.. Phone: (51142,34-733 j. Fax: (503) 808-9108
plan review (25% or permit 1.) ilIMO____ ..._
1
CCB tic.: 1441 glide 5ur eh : .., .02% of permit Pec)
. Iffrala
,• ,
,
• T
Thli OTAL PERMIT FEE 1
1
1 ir • --.
I _zateutifir, ---
pid' applk cabins if o pouait 0 not obtained within 130
Authorixed signature 4104,. j.,..Lcuj.1,VW/ra.101 _ nay. gl fler II bas been aeorpted es complete.
i=w-imonaturiaririam •
Date art — ,, ,j - ,g, ' ' Fee methodology ilei by Tit y g
' BtsatItta IndttafY Scnige Bo"
1.0,1114440amittMEC.P.unaaPP lafal "9 44044117 (ttlariMatiViEW C 70 2 4 4 ( 5--
b tn.+ 0 • ck.c 6103 .
zo/zo 39Vd
9NI2V3H SEODVF
LSZBET8E09 917:9T B//OT
• , .