Permit CITY OF TIGARD MECHANICAL PERMIT
a - COMMUNITY DEVELOPMENT Permit #: MEC2009-00133
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/27/2009
Parcel: 2S104AB02700
Jurisdiction: Tigard
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Site address: 12240 SW MORNING HILL DR
Subdivision: Lot: 0
Project: Rowe
Project Description: Replace gas furnace.
Owner: FEES
ROWE, EILEEN REVOC LIVING TRUST Description Date Amount
12240 SW MORNING HILL DR Fumaces < 100K BTU 03/27/2009 $14.00
TIGARD, OR 97223 FlueNent For Any of Above 03/27/2009 $6.80
PHONE: 12% State Surcharge - Mechanical 03/27/2009 $8.70
Minimum Fee Adjustment - Mechanical 03/27/2009 $51.70
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:
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Fuel
Fuel Types: Natural Gas
Gas Pressue
Total $81.20
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
applicablelaw. 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
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Issued By: / I Q '/ n I \ Permittee Signature: 9 0 � l 1.6
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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.
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71AR -26 -2009 16:13 FROM:GAROKEN EN 0:••%02 TO:5035981960 P.1
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Mechanical Permit Application 1 a lit 111.1• Il 1 1 .1 , ). l.N
City of Tigard MAR 2 6 2009 • Rece a Ice 'On
• 13125 SW Hail Blvd., Ti Y OItO `[ Pvmil Na:
0 ga r:, OR 9 19 Plan Review �J J� r �l 'V
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF MARC Plan Rev Other Permit:
1 , t ,,,, ; ,, Inspection Line: 503.639.4175 BUILDING DIVISIC Nut. r '
Internet: www.tigard- or.gov ^ 1 � see sent l for
Notified/Method:
Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
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El New construction .1 5Additi /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 CONSTRUCTION Value: S
1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL. EQUIPMENT / SYSTEMS FEES'
Multi- family 0 Master builder (] Other: For special information use checklist.
Description 1 Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: '2a /o MDYn11 l / f / /� _ - Air conditioning o heat pump
� M{ 1 �•J/� ►o4aireS3ite clan showing placement) 14.00
City/State/ZIP: / t q �� "7 Furnace 100.000 ii l)(duccswrnr,) 1 14.00
�l Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.:
i Gas heat pump 14.00
Cross street/directions to job site: Duct work
10.00
3 s j/Q--- Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (tucI -type, not electric),
In vall; in- duetrstts 14.00 _
Subdivision: I ( for any of above /
J Lot no.: 6.80
Tax map/parcel no.: � ther 10.00
Other fuel appliances
DESCRIPTION OF WORK Water heater j 10.00
Co a t _?~b C o/ C Gas fireplace I , 1 0.00
�a via." Q Flue vent for water heater or gas,
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10
Wood fireplace/insert 10.00
j ROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
� Other • 10.00 _
Name: l.� 1 1 so e- yl. f ) C C.J� Environmental exhaust and vendlation
Address: l Ems_ Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Phone: (60� 6 eye) _ 34,06, Fax: ( ) Single-duct exhaust (bathrooms,
❑ APPLICANT toilet compartments. utilit; rooms) 6.80
❑ CONTACT PERSON Anic/crewlspace fans 10.00
Business name: 10.00
1 ♦a P.. _ .41 AS - -.& _ Fuel piping
Contact name:
S5.40 for first four; SI.00 for each additional
Address: Furnace, etc.
City/State/ZIP : Gas heat pomp
Wall/suspended/unit heater
Phone: ( ) [ Fax:: ( ) Water heater
Fireplace
E -mail:
L&GI/ez, Prw- e- e v-ev t Lc n . rya-*' Range
CONTRACTOR Barbecue
Business name: - Clothes dryer (gas)
_ Other.
Address: t 7�/2 a ►� ). i KCAL PERMIT FEFS•
City /State/ZIP: , ` fir - k ,
[ � ! 1 Subtotal
Phone: 15-Y9 4 E % -7A3 R I Fax: (�3 )356, _ l � Minimum permit fee (572.50)
CCB lie.: 4 - 3 \ a Li � Cc. � Plan review (25%ofpermit foe)
�T Slate surcharge (l2°% of permit fee) to
r TOTAL PERMIT FEE 0 I
Authorized signs t� This permit application erp1r if a permit Is not obtained witbio 180
Gl �+ v v._.�,z . J days after it has been accepted as complete.
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