Permit Irr CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006-00642
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/15/2006
PARCEL: 2 S 103 D B -06 500
SITE ADDRESS: 11330 SW AMBIANCE PL ZONING: R -4.5
SUBDIVISION: GENESIS NO. 2 LOT: 021 JURISDICTION: TIG
Project Description: Replace gas furnace.
CLASS OF WORK: OTR 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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
RANDY CARRIER Description Date Amount
11330 SW AMBIANCE PL
TIGARD, OR 97223 [MECH] Permit Fee 12/15/20C $72.50
[TAX] 8% State Surcha 12/15/20C $5.80
Total $78.30
Phone: 503- 639 -2255
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: S_ Q
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.
f
DEC -14 -2006 14:36 FROM:GAROKEN ENERGY CO.IN 5033569002 T0:5035981960 P.1
Mechanical Permit A, t Fi �i> ; r + , • ? x, FOR OFFICE USE ONLY t. ' • Received
City of Tigard Date/By: or -/ . v Permit No)i G _. O6 • ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 C A 2 Other Permit:
Inspection Line: 503.639.4175 - • . 1 1 I • y
to Date Ready/By: BI See Page 1 for
Internet: www.ci.tigard.or.us d .p�8'1/ l �{t r , � NotiSeyMethod; Supplemental Information
E: ..... ) •r"<;(�! � -�,.:a :1'E?L i'F�dr�� Q _ . . : :1 �- .., r � a •4 .wt -! t T f .,, . - � .;A. . 7.. ar .4 ka;,- ,
: 4 _" L Rc. 1Ft,i'.�ia L 7f W ASS P: 1�7V � ,F,E li • S ,�] Eotr r- 1•3SE'CHECKLIST
ew construction Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
J Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
~ 4 r f"9-P4`;* . Q a 4 eg:[a ::. ':;:: ! ` r,f Value:
dwelling ❑ Accessory building is),' x ! E .UI , _ NT i SYSTEMS FEES*
and 2-family g ❑ Cornmercial/industrial
❑ Multi- family ❑ Master builder 0 Other: Far special information use checklist.
- Description I Qty. I Ea. I Total
a. - E , < . ? d. 1 ° ,. .h 1,. i. 'o , ° V47/;1179.11 -; t Heath_ coolln: •
Job site address: /�• S 9 sa.) M 6 t r , )ce r pi-, Air conditioning or heat pump
(requires site plan showingplacement) 14.00
City /State/ZIP: -1--) sa v A. d12 ° a a3 Furnace .1.09,Ot t • t IVES -_ nts) 14.00
no.: urnace 100,000+ BTU duc_y� 17.90
Suite/bldg./apt.
1 Project name: C.ei.y rt e, r 14.00
Cross street/directions to job site: Duct work 14.00
C›<-1-..-(- t S ( Hydronic hot water system 14.00
-14 Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.: Flue/vent for any of above ® 10.00
Other: 10.00
Tax map /parcel no.:
Other fuel appliances
r
• + .. . l tax . P i-i;'s t; ,e F. cie : Ae a '7 * '; #PZ llx `Y, "' Water heater
, N,ds ;" c ;i.Ilic .ss::: :^rlL lei, JE� +.. t ed.u.1,-t....4i if ..... .N t`Ne. t 10.00
Gas fireplace 10.00
( it f & J7L.Y) f7(4 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
w' ,1,0:r --!!0 i.A_ . ., b -- r e r � 7,4F ] v t , ,. , , ,, `, e , n n „ 0 K 1 , .11 : .. ` other: Chimney/liner/flue/vent 10.00
Name: T...,.,4 d/Ce ` €'r Environmental exhaust and ventilation
Address: Range hood/other kitchen
St*,.w equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single-duct Phone: ( So3 .- � (03' - a a 55 - Fax: � i; ) toilet compartments, utility rooms) 6.80
;
, .-E,.*. • ms ': s ,,, 1 , S „�d ``i+t ,y U� � , �iti 4 4 x �l'''� pC g t 4Y 6Si _ �. yl' o ,
1 � M Attic /crawlspace fans 10.00
`S u.r .�:.� ,. i,,. s r_ ,.., s. 14 � .+t w rd L. . ' � 10.00
Business name: C L'YO Ka A .
'mil Fuel piping,
Contact name: c $ for first four; $1.00 for each additional
Address: j „ l� „� Furnace, etc.
�' { �'' S '`� e ' Gas heat pump
¢
City / State/ZIP: WalUsus uspended/unitheater _
Phone: ( ) I Pax : ( ) Water heater _
E -mail: Fir lace
. r 0k, e."4 -+r �.0eiiP \ZZS,'1
r.�r r r . , rw . c, , : Range
_ � n
%§` ;: Wi �Lv 1 L. I � *".Fte..A.....' o3. �'ii' ;.lj r hy � r,„ b.l ii �: '°q:141' -
-. s_ __ rY . c.�. .6_ : . i t , k Barbecue
Business name: �' - ,� Q � r 1/ M t ' X 1
Clothes dryer (gas)
Address: l S �t / 1Q� `cJ a. t L1M Other: . � �„, �, ,
7 (Q . J 1 D of ,, i .. ie- fi:?C tri y
f. Y
City/State/ZIP: GI) P,.a Qx�V ' ` f)R 1 ,, 61l10C) Subtotal
p �e� ` Minimum permit fcc ($72.50)
Phone: �o $ y l - 7 n ?7 Fax: (•S'b-5) '72-1 l /� ()
Plan review (25% of permit fee)
CCB lie.: t„_,rF) 1 - State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7Zt pu
Authorized sigtlatUre: ��� p �� This per application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: \ �v A. y I Date: • Fee methodology set by Tri -County Building industry Service Board
i:lBuilding1Pcmtita CPcrnritApp.duc 12/03 440.4617T (I I/02/GOM/WEB)
CITY OF TIOARD
BUILDING DIVISION PERMIT #: MEGP:006-00642
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/15/2006
Phone: (503) 639-4171 AA
0
Inspection Requests (24 Hrs.): (503) 639-4175 - LL
INSPECTION WORKSHEET FOR DATE: 1/29/2007 TIME: 7:05AiVi PAGE: 50
SITE ADDRESS: 11330 SW AMBIANCE PL CLASS OF WORK:
SUBDIVISION: GENESIS NO. 2 LOT #: 021 TYPE OF USE:
PROJECT NAME: CARRIER
DESCRIPTION: Replace. gas furnace.
OWNER: CARRIER RANDY PHONE #: 503-639-2255
CONTRACTOR: GAROKEN ENERGY COMPANY PHONE #: 503-848-3038
Inspection Request Scheduled For: Date: 1129/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 042610-01 503-639-2255
Corrections /Comments/ Instructions:
410 e " i )d 6 6C - riti 1A:4 14.A._w■LE) hAibet. Ci 7 5 A.c.de-/-, ta.egivr
1 -4--
P I PARTIAL APPROVAL fl CANCEL NO ACCESS
I I FAIL El CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: i Phone #: (503) 718-