Permit CITY OF TIGARD MECHANICAL PERMIT
t II COMMUNITY DEVELOPMENT Permit #: MEC2012 00440
Date Issued: 08/21/2012
ilG'AFiD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S111CD04900
Jurisdiction: Tigard
Site address: 15995 SW BRENTWOOD CT
Project: Trant Subdivision: SUMMERFIELD NO.9 Lot: 508
Project Description: Replace gas furnace and NC. Unit must meet 5' minimum side and applicable rear yard setbacks.
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: TRANT, JOHN
4474 SE MILWAUKIE 15995 SW BRENTWOOD CT
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 234 -7331 PHONE: 503 - 730 -6214
FAX: 503 - 808 -9108
FEES
Specifics: Description Date Amount
Air Conditioning 08/21/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 08/21/2012 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 08/21/2012 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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: QN f�P�L i e , 9 9 -re / �
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.
echanical �ernt i• • REC EI M i t A 111 city of Tigard A UG 2 0 2012 ved I:I :' }FFI( i
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{ 13125 W/fan Blvd., Tigard, OR 97? I3 rtwa , 2/ /Z ; -
■ Permit tvo„
_F Phone: 503.639A171 Fay 503 .598.19(�R T Ab w.f� �ar...1 .0 yy
i tai; , , inspection Lute: S 1 Dst aRe` erBY
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Contact name: Gael • • a, ?3.32
Address: 4t4.15 for first four 54.03 fo�®dditional
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Address: 4474 SE Mihvaukie Ave 3 thc ^ J � .
City /State/2 P: Porttoed, OR 97202 --- Subfo
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' (503) 234.7331 Fax: (503)1308 - Subtotal 1167
Minimum perm fee (S90.00) IRIMIll
after
1 , CCU lie.: 1441
TOTAL PERMT FM
State surcharg (12% of p eenlit f ix) /
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wall application =Au Ire permit L not dimmed within 180 , „ , / e -
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