Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00507
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/20/2010
Parcel: 2S104AB07800
Jurisdiction: Tigard
Site address: 12075 SW 131ST AVE
Subdivision: MORNING HILL NO. 4 Lot: 107
Project: Wright
Project Description: Gas furnace replacement.
Owner: FEES
WRIGHT, DAVID & Description Date Amount
SCHWITTER- WRIGHT, SHARON L, 12075 SW Furnaces < 100K BTU 10/20/2010 $46.75
131ST AVE 12% State Surcharge - Mechanical 10/20/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/20/2010 $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: 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 k...../ l _O Permittee Signature: _ _ _ 4/-4•4•••-'=d -
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.
OCT -19 -2010 13:15 FROM:GAROKEN ENERGY CO. IN 5033569002 TO: 5035981960 P.1
Mechanical Permit Appiicatio D i.-u,, 01. r lcl: ,,s..: (,,i.) City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 Date/13y: 0 � �� .�• 6
Phone: 503.639.4171 Fax: 503.598.1960 0 C T 1 9 2010 Plan Renew Other Permit:
I I t , \ r I � � Date Inspection Line: 503.639.4175 Dat Ry.
e Ready/By: RI See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: IFFM Supplemental Information
RUILDING nlYISION .
_ TYPE "OF WORK COMMERCIAL .;1F'0 SCHEDULE:- 1ISE CIIlteKLkST ±
❑ New construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
-l- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory buildin ' EQUtPMIv1 n use �r • .
❑ Multi- family ❑Master builder 0 Other: For special information tae checklist.
Description 1 Qty. 1 Ea. 1 Total
�^ '' S .. JOB SITE INFORMATION AND' LOCATION Heating/cooling
/� Air conditioning
J
Job site address: �v" 75 5 44.3 3 / ,../., f�-{/ ,4u Ian showing placement) 46.75
City/State/ZIP: / 'it a,/4_1 1 d -.. f ma ,000 BTU (ducts/vents) ( 46.75
° unlace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: I-r i...0/-.. Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
r Hydronic hot water system 23.32
K t4 , I- -0 - Residential boiler (radiator or
hydronic) 23.32 •
Unit heaters (fttel -type, not electric),
. in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 1 23.32
Tax map /parcel no.: Other fuel appliances
DESC�NPTION`OF WORK. •. Water heater J 23.32
Gas fireplace 33.39
60 S 4 i _ - / y c 7 Flue vent for water heater or gas
fireplace 23.32
Log tighter (gas) _ 2332
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimnev/liner /fuefvent 23.32
O O . . .1' 0 TENANT Other: - 23.32
Name: ''') U A- / Environmental exhaust and ventilation ,
Range hood/other kitchen
Address: C0_ equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( 7 5 q g i ct I Fax: ( ) toilet compartments, utility rooms) 23.32 ,
'Af . 0 APPLICANT O: Q..
. CO NT ACT PERSON: Atticicrawlspace fans 23.32
-
Other: 23.32
Business name: ia..roKe,ir. e,i- t ]e, Fuel piping
Contact name: , v1/4.1„ A --c. G x .. . N � $14.15 for first tour S4.03 for each additional
-
Address:
Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
t
h
Water heater Phone: ( ) Fax: : ( ) Wa -
E -mail: �Qro l�&e v1 e,v�er 41L-Ay & U ev ,zoy". n .e.-A-- , Range
` . 7' ; :•': ; , • CON• RACTOR Barbecue •
Clothes dryer (gas)
Business name: C4R,K"p �,e,N,t e�N Other:
Address: 36 46 - e3 � t7 GP- r � i � ... 7 MECHANICAL�PuRAITF`:PEES +r .
City /State/ZIP:. ad.V Y:C 'e-asel G 0060 •Subtotal G
Phone: (5 et, 4$. 3$3$ Fax: (S O3 3 :7 42 - /t:�� Plan Mini
um
(25 it
of permit fee) 7 �•
CCB tic.: t{� l a 'Z, • l.i. State surcharge (12% of permit fee) /0. ro
TOTAL PERMIT FEE lOa _8L
Authorized signature t Q. ` /-Q�I�- This permit application expires i permit Is not obtained within 180
days after it has been accepted as complete.
I Print name: b v` v.a o Date: /. 0/ / q //v 1 • Fee methodology set by Tri- County Building Industry Service Board
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