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Permit 4 CITY OF TIGARD MECHANICAL PERMIT 11111 :- .. COMMUNITY DEVELOPME Permit #: MEC2013 00162 T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/25/2013 Parcel: 1 S 135C D05600 Jurisdiction: Tigard Site address: 9702 SW LONDON CT Project: Shannon Subdivision: LONDON SQUARE NO.2 Lot: 8 Project Description: (1) gas fireplace replacement Contractor: JACOBS HEATING & AIR CONDITIONING Owner: SHANNON, ARLEEN M 4474 SE MILWAUKIE 9702 SW LONDON CT PORTLAND, OR 97202 TIGARD, OR 97223 PHONE: 503 - 234 -7331 PHONE: 503 - 639 -1408 FAX: 503 - 808 -9108 FEES Specifics: Description Date Amount . Gas Fireplace 03/25/2013 $33.39 Type of Use: SF 12% State Surcharge - Mechanical 03/25/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/25/2013 $56.61 . 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. I D Issued By: J Permittee Signature: OM AP U @ 4 rim 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. 03/22/2013 13:51 5038139257 PAGE 02/02 Meehanical_Permit A rtplicati ;; t : i -, ,; , „ I 1 City of Tigard J ECEIVED 4 S ,...e- 1HM TOR ��C o�U 0/ In Phonic S03.639A171 Rut 503.598.1960 , OtharPennic too 303.639.4173 Mk 2 5 2013 > r• see Poge zfar Date CITY OFTIGARD T1 Co sit 1o'e'° ,, •i, -11., .I _ .: _._ _.:3•:. %.. .••1.s,.. :_..r ,r_ 1 . .c � ; ;.:I .a "_ .. � �. a 1 , f - T ❑ New 000islrt1Aion ►�/'�, , r . on/altelali0ofreptaoeetieat Medioeical pare fees' are bind on the rains of the Tani r El Ddeotition Other: performed. Indicate the value (rounded to the nearest dolls) of all - - - - °7r''''- riF' :} :'_cr -i � :. - ; _ zscr -• :r)-\ ; _ : F*':.. - ,... Woe; S � et- - - i_ l V 0 Cameeet ... i_ A _ ;r { 1 f�� t 1 1 J 1 (] Mule i`bmilY dwe�r ©Neater builder a _ Other: For - O use ekarltist -- r— Li_ Air conditioning L , :_ she • 46.75 1 e r i( • _3 Furnace I COO BTU r 46.75 NM Saitestbldglapt. ma: Project name: Pomace 1 r I O0o+ ani enem Cross street/directions to job site: _ 61.06 Duct work ummtnriiiimnnt Residential boiler radiator or �� ' ' Ids 23.32 Unit heater* (t'ei•type, not electric), In - wail r 46.75 Subdivision: Flue/vent fir : above 23.32 �.. ono.: Tax tgap/parool no.: Other: 2332 1;; _ , ,, _ Other !Yell a : 1 , . - _ • (}es MIN 3339 Mar; k cLc.& Cau.S t` r r 1 &«. 23.32 Mill � 23.32 MI 3339 IMO . -_ _ -,'`' i r - _ . r .". • — - r,.. 23.32 - fi ' r_! r r ' i _` _ - , ::'`.: - , :-. :: /li�/A 2' IMIM r- ,•_ : - ._. ..� ' 9 'P ., - , - . . _ V !L ; . -_... .:..- - .Mg.` �~ . ''1 ' d' - ;. ^:: �_ Name: 23.32 _ :. _:_ _ _ „ Other: ' 1- . _ • ■ A in/Y-1 bl!' Environmental esbaast and ventilation Add: Rams hood /other latch® (5* ) . CeteSta dZ P; Clothe* • 33 39 now 3 f — i Fax ( ) - 33 39 MEI ., r I ,_ „• utu' \ roams 23.32 : 8 r -6,. .,. __ _. t - ., , .. .. .._ :.�' . _ '' :._ . . . , '. -7 AaiCiela ,. °e ,. fe 2332 ° Contact eeaeac thu` 1i': r 7332 MI Adders: S14.15 for gra gm S4.03[ , ...I,,,. . CiiyantetZIP: t3asbe at � . ~� �.. � Phase , "tom - NMI MEM : { ) Fax:: ( ) Water tenter '� fettag; ti IMITM11111.11MMI I= 111111111 MIN Balinese name. Jacobs Eating & ; , : ti .i ;' ,, a .. ,_. - . _ ;!; . Barbecue Mill • — B Air i'::ui z7a�J �� AddRas:4474 SE MUwa ldeAve Ones; �� City/Stare/Mt Portland. OR 97262 E S : � � � `. _ i = . �'zt_ =' _ ;"- . _'��' — _ (SQ3) 234-7331 Phone: I i� �1 l Few p 11084108 MMinim= ' - , , the(DOM 1W GCB lie.: 1441 Staleamcharge 12% of . - . tPee) 1111fflta kutborixed Signature: f 3'oTAR. + �� � IMMir . .t i i;,,,/ . . WA i„y /i I� Mb permit sYpIRSits ppallrh oat �8heoed within 'foot tratR� f ial a Dale: • d 'a' a h lm t am oeape,d as complain rao weserewervermacAmmoome c 1, _. tOiy cm byTilCo®,y Seulillog IminvoySetvica Bari* iaorioe woasrrrti ...., .