Loading...
Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2012 -00237 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!14!2012 Parcel: 2S104AA07900 Jurisdiction: Tigard Site address: 12685 SW KATHERINE ST Project: Mathena Subdivision: BELLWOOD NO.2 Lot: 106 Project Description: Install new Air Conditioner. Must meet required 5' side yard setback and rear yard setback Contractor: JACOBS HEATING & AIR CONDITIONING Owner: MATHENA, ROY 4474 SE MILWAUKIE 1717 SE ORIENT DR, #325 PORTLAND, OR 97202 GRESHAM, OR 97080 PHONE: 503 - 234 -7331 PHONE: 503 - 502 -3921 FAX: 503 - 808 -9108 FEES Specifics: Description Date Amount Air Conditioning 05/14/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 05/14/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/14/2012 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: 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: ✓1 ,rl i Permittee Signature: DO AOU CAT) 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. 05/12/2012 11:27 5038139257 JACOBS HEATING PAGE 02/03 Mechanical Permit A l i c a t i o , , : ) t : , , � : i , 1 , I t `,l. t , IN_ City of Tigard ECE1VE ' pNe 9 Ao - 003 13125 SW Hall Blvd., TWAOR 97223 p iew heee: 503.639.4171 Foot: 503,598.1960 Plm R°' 14 2012 - r . , , t, Inspection title: 503.639.4175 MAY f)m�l><rptih: internee Date iteadyeBy: — n rran6tdMahad _ CITY 0 G AS ;. �. CI F TI - r+r P r T�lj. �� 77.cc—�. — 2 � 1" .5,^_'l. tf �•,J`�sv2 . a :�.; -:P- li �/ _ � -.% `` .. •�. �,;`+.: 1. .4 1:.).L = =1 d = L 1' • t •-_ -= Y-S T -} ' 1 1 - 1, �,> - t lr, f. ? - 0 New construction �Addition/alteratioof reptacentenl Meth permit fees* are ba an the value of We work ❑ Demolition ❑Outer performed, Indicate the value (rounded to dm neatest dollar) of all �_; ,: — �,. -� ..7;--y•--2. — —_ - - -7-'--F-7 - - -- -- idedianieel mafe ials. cow l abor, overhead, and profit. .A '' ,:- .. .f .1 f:! : S(1 1re. N r; 4 , - ; " 1 _ Value: _dl' and 2 - fbmily dwelling 0 Commercial/industrial ia ❑ Accessory building t "� — " ._ - ° ` ` El Multi- feat*Y © Master builder 0 Oar For sAeeml b�ora�mro r ere checklist. s - «. �i o ' � 3 > . } Qty. Fa Total a +r i' _i. - .L ir •?c :f - r = :`: � i' J' ` :.''.� ` . F-x 7 . F All cenditioniag 1 - hka- t1 ' C' te/21p: , . , s� , • a laruvin : •lecem, 1 46.75 YID• ° CitylSta t •' Ot+C T i L ` yy Furnace 100000 BTU (doetalve ) 46.75 Suite/bldglapt, no.: Project name: in ' I a..4k Q.1/1LL Furnace 100 BTU . •. _ 5491 - - 111.11 61.06 Cross street /doe to job site poor wink 23.32 H .' • bre venter system 23.32 Residential boiler (radiator or *drank) 2332 Unit Iwoers (fuel -type, not electric), ion.- _mm- ddnct, Sodded, eta 16.75 Flue/vant for any of above 23.32 Other 23.32 11111111 _ � — Other (eel • Ilaeen fi' .'Y' i. -1. � �r'� ro7 1 c f '- 107En.11111111111111111.MIIIIMIMIll - - 111.1111171E1 11 �t Flue vent • water berm or gas Woodlpcietstove 33 4 _ _ Wood faeplace!mrert 23.32 Loclisliter (sTs) 23.32 I. fCO ° , . ..- . o' �. � ,-- � x.^ _r F ',;,, .. "=7'! 1- _ s � _ -t -t'cr- , ;- • c 1 • ^ t =1 M1 _� � � 23.32 �`�"1 4 `_ : x Other 23.32 j G 1 ► a-'T� ` Environment almost end ve 4htton Adders: Range hood other kitchen 33.39 City/State/ZIP: _ Clothes • - exhaust Phone: (LS/13) ,; Fax:( ) Single 33,39 _ _, toils . ••. trill rooms IM 23.32 iM'�' '--,_ : ~ a1 -_ ; ^1 �r_ 1 r 5, Auld fans 2332 2._ Easiness name: Other: 7332 Contact name: __.- —_ Feel plop_ S14.15 for first lour 54.03 Ibr each additional Address: .1,1 -_ Ciry /stet : Gas heat Veal, MI - - W 1/mspended/unit heats Phone: ( ) J Fart:: ( ) Water heats � � E -mail: Fireplace Rarge ,, i,.,V 1:. vt'- L.' f,6rf �av —f� _ - - - =pia : „.(•. E .,_?_...•=7:-.-,4•.r: _..i; 2 _,____.4V- 'i� - - - „�. y :� :'- - ;':i- Min . v ... . '+' s '"• t TiL. ?iia:' �r..K: Barbecue Business eta Jacobs R entin g & Air Conditioning �t>thes dry / Address: 4474 SE Milwaukie Ave - Ciry/State/Z1P: Portland, OR 97102 i , ri - _ "_ ._ ' ' .. 1 :: , Subtotal Phone: (503) 234 -7331 , Fax: (503) 8084308 Minimum parou toe ($90.00) •c"O I IZ —_- it fe — Plan review (25%ofpesme) 11 CB lie.: 1441 1 V1 lr _ State s u r c h a r g e (1296 of.'- it fee) 4 - . TOTAL PERNOTFEE /pd • &O Authorized signature:. ..w. =��� Tab er pmit implicated d expires Ita permit 6 erg obtained %Mlle ice - l51�� C+�1 � days after hai been accepted m complete. complete. �1' a�1ia`�!Z t Date: • Foe mbhodology m by au Tri�eawfY 8m7dia81echuay Sav+ex 8emd 1MundireWelehnM PmmkArp eoc ado 1/09 . uo fit. Cwonsw /�� 1 05/12/2012 11:27 5038139257 JACOBS HEATING PAGE 03/03 SITE PlAN rttV ( 1 ON Z �.: SG-) ,e • • a. , Name 5 !1 ir"iGtSvA d dre ss �Z ,� � S ) X S 1 �... Jr, a JAW :JP r JACOBS HEATING 8: AC 4.;= A'. Pore;and. OR 97202