Permit • CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00684
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/21/2007
PARCEL: 2S 104AA -10400
SITE ADDRESS: 12135 SW 128TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 123 JURISDICTION: TIG
PROJECT: WATTS
Project Description: Install gas furnace
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
CURTIS WATTS Description Date Amount
12135 SW 128TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 11/21/20C $72.50
[TAX] 8% State Surcha 11/21/20C $5.80
Total $78.30
Phone: 503 - 521 -9997
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 848 -3838
FAX 503- 356 -9002
Reg #: LIC 43124
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: Permittee Signature: j C
Call 503.639.4175 by 7:00 a.m. for inspections that business • y
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.
NOU -21 -2007 10:40 FROM :GAROKEN ENERGY CO. IN 5033569002 TO : 5035981960 P.1
Mechanical Permit I I lication FOR OFFICE USE ONLY
City of Tigard ® � Received Permit No.
• 13125 SW Hall Blvd., Tigard, OR 7 ate.. �_ Dee/By. MIAMI: I 11.. , o07 -0 )Cg • Phone: 503.639.4171 Fax: 503.598.19 i = Plan Review
...' - ; `+.:. Date/By: ` Other Permit:
4.
Inspection Line: 503.639.4175 .�a -; •I ji Date Read /B lu re:
Internet: www.ci.tigard.or.us 1 201 Ready /By: S See Page l Information
NOV nvvlYf 1 Notified/Mctbod: Supplemenr9llnformatlon
'J1 {a ..t R a't ^ ,� •at*� i b ' .5 y "� 1 . ,�)L i ' •+cJ tv. i ro t �` `.'f i Ci _:,. 2' � ., E cA i,.,,,t
.:1 cF.�[S._..1 .3 � ,t.._ T.`x r t , .. lobs ^,� .. y •- I .i i;L::etlakn`.a it�ti `YMla (liU7 `�. • i ` Qt .. ?:! ✓� :f5?. •ll`1?F,I =
: ` , � z'' '�. _ 'T3sSFiGEIEC
'ew construction i t'q , 11 Mechanical permit fees* are based on the value of the work
J I Y a , performed. Indicate the value (rounded to the nearest dollar) of all
Demolition t, fit.
r�« T f i � '- . . 11 7 Vai + il ii., n'r ii j Z4'1� n e :1 r _ 4 F * +? X ,ia l $ , Value: $
:: - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building F " "r * > � t i + ? ' i - . ! S4 FEES'
❑ Multi For special Information use checklist.
Y ❑ Master builder ❑ Other:
,; t�. s t r Description I Qty. 1 Ea. I Total
. p ° . ? . {5.xl� ii itii o �b"��t tiro'), i:f`W ole irs; , tc lie: �' d_.c:__. ,�..��+ ..., ..2/r . ��' ' ,t1 Heating/cooling
Job site address: r Air condition g heat pump
A. (requirga O plairsho'ingplacetnent) 14.00
City/State/ZIP: Ft1' ce 100,000 Ea,/ (d ucz/venes) " 1 14.00
Suite/bldg. /apt. no.: Project name: _ a � F BTU (ducts/vents) 1
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14
IIIIIIIIIIII Hydronic hot water system 14.00
,11.1111WOPAt WIMININIRMIll Residential boiler (radiator or
hydronic) 1 4.00
Unit heaters (fuel -type, not electric),
in - wall, in- duct •4c. 10.00
Subdivision: Lot no.:
Mier: any of abovs� 10.00
M er. 10.00 _
Tax map/parcel no.:
Other fuel appliances
_
usf f. ..."•17 1.ti r t a }tit a ,.
'L.'? . •as.'lk. J ti c ... _L - s . l � d r .: (o f Fd o f 1 r .e27. .. rtif 2 �. , t k '' 4 r r g h Water heater 10.00
... _ .L....... _ a .�.._ �.ad3l y i -r .nom:. �.L_ a r. rxn I
Gas fireplace 10.00
I = , ' O Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10,00
Wood fireplace/insert 10.00
t r y d+ SC"'�f71irit n5Lttl F A , ti fit, „ , . _ f ... + .. 13 - 1i Chimney/liner/flue/vent
6� ZI:iLt::..it ar `1 1 . • r*.i.. 4.s J� LA .''� ` lit. ._ r _ ' _ L: t4, ..!t `t.1u 1
r _ �• t _4 -__. y 10.00
Name: ' " - Other: 10.00
Environmental exhaust and ventilation
Address: �' a Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5 3) _ I e 4. Fax: ( )
+ toilet compartments, utility rooms) 6.80
t' ":` I 7 , .L� - r a. . r i '.# e ',• rf) ,t } ri'n1 r 1.-, .. r � fR -,6 t"d .
I ' ~ ' h , 14; Attic/crawl ace fans
' sib... _ .• • _....n.`� [:f ..,,;..el- 1-....L'.::"__ _ ,. , . i
a `", Ml t; -`.7 . _zii+t..:. , SP 10.00
Business name: Other: 10.00
dr r / •4, 0 / - Fuel piping
Contact name: � S S5.40 for first four; $1.00 for each additiona
a AI ` .4 r _44. _44.
Address: Furnace, etc.
/.`.. . - " -» Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: 41 e..� , - , , _ ,, u.e„ -(Zcy . t �Q. Fireplace
' ss r i i . e .. - -, N '4 f '3 l ; t r T r -, 't , 6y - {i {, @ e P a �' t ;: - , ',. , Range
=. . *.- :_c.' a . k ..vsiT _ ti s : _s ', . : Barbecue
Business name: ... --
• • i" Clothes dryer (gas)
'. r _.r..- C� - - Other:
Address:
City/State/ZIP: / • S L- ♦ �;ZNr y }' <7`f 7!:� 474 ;1 ftS e go.
. • . • A 0 a Subtotal
Phone: (S g q ` Fax: (fib , /1 Minimum permit fee ($72.50) - 7�2 �so
• Plan review (25% of permit fee) f
CCB lic.: . - State surcharge (8% of permit fee) Q �
TOTAL PERMIT FEE /J ��/
Authorized si ttir�"' -� e4-....-- This permit application expires If a permit b not obtained wit�d 180
r�r
days after It has been accepted as complete.
.`
Print name: 0 \n� � Y e#ek..--, \ r Date: 0- r A_t)) • Fee methodology set by Tri•County Building Industry Service Board
P
isl8uitdieg etunui1¢C- PttmitApp. 12/03 440.4617T (t I/OVCOM/WEB)
CITY OF TIGARD
• .t 41111
BUILDING DIVISION PERMIT #: MEC2007-00684
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2007
Phone: (503) 639-4171 46 41410111■
1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12112/2007 TIME: 7:00Atvi PAGE: 51
SITE ADDRESS: 12135 SW 128TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 3 LOT #: 113 TYPE OF USE:
PROJECT NAME: WAITS
DESCRIPTION: Install gas furnace
OWNER: CURTIS WATTS, PHONE #: 503-521-9997
CONTRACTOR: GAROKEN ENERGY COMPANY PHONE #: 503-848-3838
Inspection Request Scheduled For: Date: 12/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 061361-01 503-841-3838
Corrections/Comments/Instructions:
9 2P &-tec S- 1/-045
X -44" - A CC fl'
. ' 0 PARTIAL APPROVAL CANCEL NO ACCESS
I FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: , Date: /2---72---c) Phone #: (503) 718-