Permit L�y.t% -
' MECHANICAL PERMIT
' , CITY OF TIGARD
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.,'- COMMUNITY DEVELOPMENT Permit #: MEC200900528
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171
Date Issued: 10/07/2009
Parcel: 2S101DCO2700
Jurisdiction: Tigard
Site address: 7630 SW FIR ST
Subdivision: Lot: 0
Project: Brian
Project Description: Gas Furnace
Owner: FEES
BRIAN, THOMAS M Description Date Amount
7630 SW FIR ST Furnaces < 100K BTU 10/07/2009 $46 75
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/07/2009 $10.80
PHONE 503 - 639 -1182 Minimum Fee Adjustment - Mechanical 10/07/2009 $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
Gas Pressue
Total $100 80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100 You may obtain a copy of the rules
or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344
Issued By: Ath ia Permittee Signature: it' e 6vt___
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• .e-' ' 14114 -
RECEIVED
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Mechanical Perlmllit Application DC T
0# 2009 f.. 01..i..1(•-•1: tisl..()NLI
Ili City of Tigard ltareind
13125 SW Hail Blvd., Tigard, OR 97223 CITY OF TIGARD y: p """ i "� °� - �vsa
' Phone: So3.639.4171. Fax: 503, I DIVISIO�t CT Pittvor.
1 rcrn -i, 0 Inspection Line: 5D3.639.4I75
lawmen www,tigard-or t?uc R�$/J3Y: ) O• % lice Pagel for
Notified/Method: Supplementnt Information
• TYPE OF WORK - COMMERCIAL PEW SCHEDULE - 11.4E CHECKLIST
El New co nstfue [ itsn 'ddllion/alterotian /rtiplacamont Mechanical permit fees• arc based on the value o 11k
performed, Indicate the value (rounded to the nearest dollar} of all
0 Demolition Q other:
_ mechanical materials. cguitunett1. labor. verhead and profit.
CATEGORY OF CONSTRUCTION _ Value: S
" and 2- , dwelling 0 Commercial/industrial ial /industrial 0 Accessory building RESIDENTIAL EQUIPMENT /SYS EMS FEES'
—
0 Multi- family 0 Master builder 0 Other: �� cat! tnlw rearlar use ekeekldtf.
_ JOB S ITE INRORIHATION AM) LOCATION Description Qty Total
. Heatinicoaling
Job site address:� ._.) F t .. Alf eonditiott —
( site plan ing plwwinl p hcrntct tJ 46.75
City /State/ZIP:
w g � , D-� pomace 100,400 BTU educta'►e.,i 1 46.75 �IIO -'�S
Suite/bldgJapt. no.: Project name: Furnace 190,000+ BTU tductslrantst 54.9k -
Cross strect/directipgs 10 job site: Heat pimp 61.06
Duct work 23.32
_ _ Hydronic hat Muter systcrrl 23.32
Residenti�a boiler (radiator or
hydronici 23.32
Unit heaters (filet -type, not Clectricr
hi -wall, in -duct suspended, etc, 46.75
Subdivision_ Lei no.: Flnelvent fbr any of above - 23.32
Tax map/pnrcel no.: Other: 23.32
Other lad appliances __
DESCRIPTION OF WORK .— . Water heater - . 23.32
C.l �j� rh Gas fireplace 33 39
--__--_ Floc vent for water heater or gas
fireplace 23.32 —
Lop lighter (gals) 2112
Wood/pallet stove 33,39 '
Wood fireplace/insert 23.32
'E: PROPERTY OWNER 0 TENANT
Chimney/Iiaer/Iludacnt 2332
-
Name: Other: 2332
- �� ' C - l Environmental exhaust and ventilation
Address; , Range hood/other kitchen - —
City/SCatcJC,P: cglllpme_ _ _ 33 39
Clothes dryer exhaust 33.39
Phone, ,(t3) (p J� - I 1%2- Fax: ( ) Single -dot t exhaust (bathrooms. .
•
toilet comportments. wilily rooms) 23.32
0 APPLICANT CJ CONTACT PERSON Atticdcrawlspacc fans _ 23.32
Business name: Other: 23.32
Contact name: - Fuel piping
514.15 for Oral four; $4.03 for each additional
Address: Furnace, cm I
City /State/ZIP: Gas heat pump
�"— WalUsuspended/unit homer
Phone: ( ) ( )
Fax: • Water heater
E -mail: Fireplace I m
Range-
CONTRACTOR Barbecue
— T
Barhetanc
Business name: Jacobs Heating & Mr Conditioning Clothes dryer (gas) ,
Address: 4471 SE Mihvaukie Ave Other: —
City /State/ZIP: Portland, OR 97202 - MECHANICAL PERMIT FEES"
�"�� Subtotal •
Phone: (503) 234_7331 _ Minimum permit Coe (Sg0 -44}
I Fox: (503) 808 -9108
_ �'IO.tap
CC13 lit.: I441 l 1 11 0
Plan review (2555 of penult fee}
State surcharge (12%ofpcnnii fee) )�.edo
Authorized signature: �,� CY� t �/\ I t TOTAL pERA_ FEE Y�o- , -
L 4� 1 This peewit application expires if a permit is ant abialacd widths um
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