Permit ,`kfy CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00713
A RID 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/10/2007
PARCEL: 2S103DC -00808
SITE ADDRESS: 13635 SW 114TH AVE ZONING: R -4.5
SUBDIVISION: VIRGINIA ACRES LOT: 006 JURISDICTION: TIG
PROJECT: KAKESAKO
Project Description: Gas boiler replace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
KAKESAKO, RANDALL M + KATHLEEN N Description Date Amount
13635 SW 114TH
TIGARD, OR 97223 [MECH] Permit Fee 12/10/20C $72.50
[TAX] 8% State Surcha 12/10/20C $5.80
Total $78.30
Phone: 503- 624 -8906
Contractor:
ROBBEN + SONS HEATING
2214 SE 8TH AVE
PORTLAND, OR 97214 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 233 -5841
FAX 503- 238 -8849
Reg #: LIC 1884
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ' / i Permittee Signature: ds)-1 � � Ad/
&
Call 503.639.4175 by 7:00 a.m. for inspections 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.
w -D,ec. 11. 2007 1:38PM Robben & Sons Heating Inc. No. 4712 P 2
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M echanical Permit Application °.. w � •, .��� l . r ,,u,t. „ ,� ,, n „ .
��', M1 ,1 f � CE�V ® Received n N NEC)-.°0-007/.1)
City of Tigard Date/13y: /02// d�b penn
13125 SW Hall Blvd., Tigard, OR ''72 Nen Review other Permit:
' A 1.. phone: 503.639.4171 Fax' 503.598.1960 Date/By: -
t9 Ins ection Line. 503.639.4175 DEC 1 (' 2007 pate Ready /By', m ® See rage2 ler
Ti G' RD; S e )
G.. „ Internet: www.tigerd•ot.gov t ' NotiGed/Mel)w I p lemenml information
CITY OF TIGARD 7
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laeement Mechanical permit fees* are based on the value of the work
�' • ddition /alteratjon /re
❑ New construction p performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and proflt.
+ a p� ��e ' ! ' a r Value: S
1 , 1 1 1 `3 �A4eTyieJ`itNi ?a• a l' . i , eTbaJsi? 0 `�lr.' e �,� . ∎-:: :znril6.7 .7 J AIMEiE A il ( ' pp •
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t ,min K ., K' L� i i. . i•
- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use clreckftsr.
❑ Multi- family 0 Master builder ❑ Other Description Qty. Ea. Total
r""t ;,yn� <!: n, °y ± ='tlr! t!. i s r ; Heating/ cooling
Iia g
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Air conditioning or heat pump
Job site address: (requires site plan showing &cement) 14.00
• ' Furnace 100,000 BTU1duds/ven� 14.00
City/State/ZIP; f r. a .41 ••■r
Furnace 100,000+ BTUJducts /veins 17.90 _
Suite /bldg. /apt. no.: Project name: Gas Iteatpump 14.00
Cross street/directions to job site: Duct work 14.00,.
Hydronic hot water system 14.00
Residential boiler (radiator or
hydroniel L 14.00. P-1
Unit heaters (fuel -type, not electric),
in -wall. in -duct, su pended, etc_ 10.00
Flue /vent for any of above i 10.00 1n ,
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no Other fuel a, 'helices
1� }i1 . it, Water heater 10.00
' '! t r 1 � 4 31 ;•., i ,F' • W r 9 1 U. r E ' 1 i ,
, l ! r 1I,,.Ti 1 rli+Fti1 a ! t , : .3 )! .,- > ,r v n , ,i , r i s Gas tire .lace 10.00
(A5 Ill 9 . A .PA/ Flue vent for water heater or gas
1 fireplace 10_00
Log lighter 4E1 10.00 ,
Wood/.ellet stove 10.00
Wood fireplace /insert 10.00
s r ,;,� c .n + ' ' ,K 1� 1 it .r ° t y( �,( r, . r� ,! f f Chimney /liner /flue/ven 10,00
I;., rrl I.,..:,il• `d . �i;:o tl=i ,, a ?i > - lu „ 10.00
Other -
x/41 W...1Frul Environmental exhaust and ventilation
Range hood/other kitchen
Address: t (o'3 I, 14 t /L7 equipment 10.00
City /State/ZIP: �` ! a Clothes dryer exhaust _ _ 10.00
Sin exhaust (bathrooms,
Phone (' 3) (La, 1 toilet compartments, utility rooms 6.80
si}I,.q ,1, 1 �y yt r.,:: ,a �l� .w a + 7si t G t + "q AVM Attic /ctawlspace fans 10.00
+, ?1 ;' 1 . .4 F _ .IP., -.,. • . l t i I. I A . i i i
Other. 10.00
p en a- ••A._ AM _ Other:
i in;
Contact came: t \) h.\ j % $5.40 for firs( foul 51.00 for each additional
1 , s . Furnace, etc.
Address: � i An' Gas heat pump •
A ! i WalUsuspended/unitheater
Phone: cv3)_- ,‘ j -:x::( a �%,',...• Water heater •
—
Fireplace
it V Ran!?
♦>1► A. ,III tv J• �� � �, �u L` ,h Y r , r t5 ins+ r• Barbecue
ilI. a c+ >liti'+` � "1 2 4 .. . 1 ry, _ .q' �o " '.L r.. it i i . B. ! ! f , '� : 10 l e t
,fi tl ,. ,,._�.or tt,„ -i t ,. : P. _ , v c ....,,m - s[ ,c d- . t n . . it .Jf':.
Clothes dryer (gas)
.L WO_ I Ai q Other:
1 y -: , o ,,y , i '
Address: altar 1 ` �, i „ii; i.' lritit ( i,! 01 ..4 ,�',�' ?1. �, i . -iri {Y
Subtotal r9l•I
Minimum permit fee ubtota
- to 4,) ds 3— s Fax: (g)N ....w.4 Plan review (25% of permit fee)
t...,B lic.: r'l a State surcharge (8% of perntit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained w 180
Authorized nat.re:
days after it 1 been accepted as complete.
NM,
Print name: \ATZ ' F Inelhodology set by Tri County Bu ilding Industry Service Board
Date: /v 1
I:V3uildingMeim il la - PermilApp,dOc 04106106
440.40177 (1110VCOMIWEB) ”'