Permit .
71 ,. _ a C OF TIGARD MECHANICAL PERMIT
: -, COMMUNITY DEVELOPMENT Permit #: MEC2010 00042
T [ G A R E) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/27/2010
Parcel: 2S 103 BB11300
Jurisdiction: Tigard
Site address: 12135 SW 123RD CT
Subdivision: YE OLDE WINDMILL Lot: 32
Project: Flaming
Project Description: Replace a/c maintaining minimum 3' setback.
Owner: FEES
FLAMING, DAVID Description Date Amount
12135 SW 123RD CRT Air Conditioning 01/27/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 01/27/2010 $10.80
PHONE: 503 - 590 -2331 Minimum Fee Adjustment - Mechanical 01/27/2010 $43.25
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006
PHONE: 503 - 848 -3838
FAX: 503- 356 -9002
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: /a 1 . 2_ t....5 , (, \p(� (1 . Perm ittee Signature: C _ Q Q
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day. I
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.
JAN - 4'2010 10:54 FROM:GAROKEN ENERGY CO.IN 5033569002 T0:5035981960 P.1
Mechanical Permit Applica Poi, CEIVED a :.,� . i r , n it o 1 i • 0\1 �u� b;Ti -v-
'T '; Ci o f Tigard R p •
v Permit No., 'ZUI 0'0°042-
� q 13125 SW Hall Blvd. Tigard, OR 972231I n/
Date/By: n Review
�rl� Phone: 503.639.4171 Fax: 503.598.1940A 2 7 2010. Plan
Date/By: ° Other permit:
(I �l c` n4l Inspection Line: 503.639.4175 Date e Ready/By: furls: fa See Page i •r c Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: 2 for
ucot
l (C Supplemental Information
Min DING DIVISION
TYPE OF WORK „''` = COMMERCIAL FEE° SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ,, Addition /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
A a nd 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
- y g ❑ Commercial /industrial ❑ Accessory building For special irlfornrarlon use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description
I Qty. I Ea. I_ Total
JOB SITE INFORMATION AND LOCATION . ,. I cling pump
Job site address: / t2 / 3 - 3-0 lei 3Yci. r+ L ( Air condition' .r heat placement) t CI- � uites :� • an !howl!' • plaamcnt) 14.00
City/State /ZIP: �/ J - 7 ,-'-.-S ,-'-.-S Furnace 10 0,000 BTU (ducts/vents) 14.00
�L Pomace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: i 1, ,,,ii t� 4 heat pump 14.00
Cross street/directions to job site: V
_Gas
work 10.00
AP Hydronic hot water system .
14.00
A - 4- ?,/k,21/ i Va_ S Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: 1 1 Flue/vent for any of above _ 6.80
Lot no.:
Other. 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK ' '• , Water heater 10.00
P A fireplace 10.00
`—, 9 L _ ' V, #. - % Flue vent for water heater or gas
...---..--' fireplace 10.00
- Log lighter (gas) 10.00
W I V\ Q .1A7 1.-A„Y1 \ k r, Wood/pellet stove 10.00
w 1 c.. e 1G � 1� Wood fircplace/insM 1 0.00
lRi v Q- T`' '�X Chimney/liner /flue/vent 10.00
'PROPERTY OWNER ❑ TENANT
Name: // Other: 10.00
D Q,,Up._ \. .3..,vv1 . Environmental exhaust and ventilation
Address: Range hood/other kitchen
Lk�yv...t2— equipment 10.00
City/State/ZIP: Clothes dryer exhaust 1 0.00
Single -duct exhaust (bathrooms,
Phone: 66 4 _ a ( Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT 0 CONTACT • PERSON . Attic/crawlspace fans 10.00
Business name: 1 n.yv re.„, Fuel 10.00
Fuel piping
Contact name: n v.--...a - 55.40 for first four; S1.00 for each additio
Address: Furnace, etc.
_Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
'�J Fireplace
E -mail:
��v PM1resi'tZ .j ,, t Za •n ..r\--a_ Range
CONTRACTOR Barbecue
Business name: L n � O v„ t �� -T Other: dryer (gas)
�tlM �w� Other:
Address: -SS'', < -)1A) 15h '. r.� , . i MECHANICAL PERMIT FEES*
Ciry /State /ZIP:W e-•' 1 1,7a9 / b Subtotal
Minimum permit fee (S72.50)
Phone: (5 1 {R -7_ Fax: i a13 ) 35&. . OZ) �, .
> Plan review (25% of permit fee)
CCB lic.: 4 3 `a 1 f State surcharge (12 %ofpermit fee)
TOTAL PERMIT FEE L k 9
Authorized signer (�/ Thla permit application expires if a permit b not o ' ed within 180
1 , A `_ GL l days after it has been accepted as complete.
.
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• .JAN 2010 10:54 FROM: GAROKEN ENERGY CO. IN 5033569002 TO:5035981960 P.2
fAec
i k `'". GAROKEN ENERGY CO. INC.
SiNcE 1979
3565 SW 1 B2No Ave • BEAVERTON, OR 97007 • TEL (503) B48-3839 • FAX (503) 356-9002 • CCB# 43124
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