Permit �� CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00656
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 12/12/2012
Parcel: 25111 BCO2000
Jurisdiction: Tigard
Site address: 10070 SW INEZ ST
Project: Baker Subdivision: TIGARDVILLE HEIGHTS Lot: 21
Project Description: Install heat pump Unit must meet required 5' side yard setback and required rear yard setbacks.
Contractor: JACOBS HEATING & AIR CONDITIONING Owner: BAKER, HELENE
4474 SE MILWAUKIE 10070 SW INEZ ST
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 234 -7331 PHONE
FAX: 503 - 808 -9108
FEES
Specifics: Description Date Amount
Heat Pump 12/12/2012 $61 06
Type of Use: SF 12% State Surcharge - Mechanical 12/12/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/12/2012 $28.94
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: Permittee Signature: ifi '97° L.. /6.9--70.1 /
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.
12/12/2012 11:29 5038139257 PAGE 02/03
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