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Permit
CITY OF TIGARD MECHANICAL PERMIT INI Is . COMMUNITY DEVELOPMENT Permit #: MEC2010 00168 Date Issued: 04/15/2010 ,TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S 101 BC01800 Jurisdiction: Tigard Site address: 12490 SW KNOLL DR Subdivision: TIGARDIA TERRACE Lot: 5 Project: Beaudoin Project Description: Install gas furnace. Owner: FEES BEAUDOIN, MICHAEL Description Date Amount 12490 SW KNOLL DR Furnaces < 100K BTU 04/15/2010 $46.75 TIGARD, OR 97223 FlueNent For Any of Above 04/15/2010 $23.32 PHONE: 503 - 620 - 4586 12% State Surcharge - Mechanical 04/15/2010 $10.80 Minimum Fee Adjustment - Mechanical 04/15/2010 $19.93 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: Natural Gas 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: O — A - Permittee Signature: .6N � .PL / . 4.9- --- 7 - 704/ Call 503.639.4175 by 7:00 a.m. for an inspection that business day. 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. APR -13 -2010 11:39 FROM:GAROKEN ENERGY CO. IN 5033569002 TO: 5E135981960 P.1 Mechanical Permit Applicati ? CEIVED 1 l►It ...Her a: l 5I' t >\ 1.1 City of Tigard Date/By: t 4 / /0 , j /fir 'emit No/9 o /0 - DO /.cP ' 13125 SW Hall Blvd., Tigard, OR 97223 � PR 1 3 2010 plan Review Phone: 503.639.4171 Fax: 503.598,196 DaIeJBy, Other Permit: ii ., .\ 111 , Inspection Line: 503.639.4175 Internet: www.tigard- or.gov CITY OF TIGARD Date Ready/By: riM 65 See page 2 for BUILDING DIVISION Notified/Method: Supplemental Information TYPE OF WORD O E40-1 L. II `SCHEDULE '_:USEtCHE 40 ❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work ❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead, and profit. CATEGORY 'OF-'cON' ' ,'UC"' ION Value: $ 1 -and 2- family dwelling ❑ CommerciaUindustrial ' IDa t• !J-� Tf / <S .kft117S'FX.FOr, 4, ❑ Accessory building For special information use checklist, ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION ,AND LQCATION Heating/cooling Job site address: f.j � q -' 1 J� /C Air conditioning / h l pJ .wires site :lanahowi :. acemen i_ 46.75 City/State/ZIP: -- 4rY 6 9 a3 umace 100,000 BTU ducts/vents) r 46.75 Furnace 100,000+ BTUSducts/vcnts) 54.91 Suite/bldg. /apt no.: rojectname: LL�� `�`p •_ /7.-: .C., Heat pump 61,06 Cross street/directions to job site: Duct work 23.32 / Q 1 / / . Hydronic hot water system 23.32 6 r �J ` d Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel - type, not electric), in - wall, in - duct, suspended, etc. 46.75 Subdivision: I Lot no.: Flue/vent for any of above 1 23.32 Other: 23.32 Tax map/parcel no.: Other fuel appliances DESCRIPTION 'OF Water heater 23.32 � Gas fireplace 33.39 _ ( C© It 'l2)9 r) /2 A` Q . Flue vent for water heater or gas �w, - r fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 PROPERTY OWNER , , I ' ' t] TENANT '' ' Other: - , Chimney/liner/flue/vent 23.32 23.32 Name: n,, i / � _ e.) � 4 J / - t l.� �C.LS -ICJ Environmental exhaust and ventilation Address: Range hood/other kitchen ,. _ equipment 33.39 City/ State/ZIP: Clothes dryer exhaust 33.39 ) Single -duct exhaust (bathrooms, Phone: 0Q 3 tp a0. y 5 8 Fax: ( ) toilet compartments, utility rooms) 23.32 A-- 0:- APP1I0 Jft . • QT PFASOiV =. - Attic/crawlspace fans 23.32 � � : I�i�CONTA_ n Other: , 23.32 Business name: �t.(0Ke ∎ t:AAeV-0\ Fuel piping Contact name: V••)n lt.s.,.,.. - N S14.15 for first four; S4.03 for each additional Address: _ Furnace, etc. Gas heat pump City/ State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater AEA E -mail: ta-`�'a KeX1 �vter r q & U ev ■ zovl. r1 AEA- Range i'" ' , , 'CONTRACTOR: ' . Barbecue _ Business name: �Q Y" G K e N e - CE:. `r- . Clothes dryer (gas) 1 t �� Other, - 4 � J Address: s 75. ,A,t.ue r a ivic -trti i►trr i ll . . City/ State/ZIP: (, e e 1 _ Q () oil o04� Subtotal is C T�� _ 1`r t 90r);2.. Minimum permit fee ($90.00) G0,DO Phone: (. p 3j ' a �` . 3s3.51 Fax: (50 '3647- e I I•{ o� / CCB tic.: P lan review (25 /a of permit fee) 3 ` y' State surcharge (12% of permit fee) /O. S"D TOTAL PERMIT FEE hD , g(7 Authorized signature � ,rN,. v..� a CIS.Q""-- This permit application expires it a permit is not obtained within 180 days after it bag been accepted as complete. Print name: ' p v. tr•-ol. 0 Nra Date: v • Fce methodology set by Tri-County Building Industry Service Board V t�� 1:\ Building \Per,nin/MEC.Ferm&App,doc 10/01/09 T(1l/02/COM/WEB)