Permit CITY OF TIGARD MECHANICAL PERMIT
1111 r: . COMMUNITY DEVELOPMEN Permit #: MEC2013 00263
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2013
Parcel: 2S102DB06700
Jurisdiction: Tigard
Site address: 9143 SW HILL ST
Project: Hornback Subdivision: CHELSEA HILL NO.2 Lot: 44
Project Description: (1) NC replacement and (1) gas furnace replacement Placement of NC unit must comply with manufacturer's
clearance requirements.
Contractor: GAROKEN ENERGY COMPANY Owner: HORNBACK, PATRICIA F &
3565 SW 182ND AVE DONALD W
BEAVERTON, OR 97006 9143 SW HILL ST
TIGARD, OR 97223
PHONE: 503 - 848 -3838 PHONE: 503 - 380 -0274
FAX: 503 - 356 -9002
FEES
Specifics: Description Date Amount
Air Conditioning 05/21/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 05/21/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/21/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 -0090. You may obtain a copy of the rules
or direct ques to OUNCaa(2_,),(K_}(1,1k_i by alling 503.232.1987 or 1.800.332.2344.
Issued B : ,\ Per mittee Signature: CV; d'Lr,.\..
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
MAY -17 -2013 13:41 FROM:GAROKEN ENERGY CO. IN 5033569002 TO:5035991960 P.1
Mechanical Permit A licati WED FOR OFFICE: I NSF a I.l
City of Tigard na�dseed-. tJ � 13 gr Permit No.: .. 3 - ! € J
13125 SW Hall Blvd., Tigard, OR 97223 `' Plan Review
' Phone: 503.639.4171 Fax: 503.598.196tM 2 0 ^ ' 3 Date/By: Other Permit:
1 I c ; A 1 I t Inspection Line: 503.639.4175 Daze Ready/By: Judi: Ii! See Page 2 for
Internet: www.tigard -or.gov Notified/Method: Supplemental loformation
CITY OF TIGARD
. — •• _ 0 SAVING DNISI -
Mechanical Indicate the are based de the value of the work
❑ New construction IKAddition/alteration/replacement
Performed. htdicate the value (rounded to the nearest dollar ) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
- and 2 -fermi( dwelling ❑ Accessory -
.CiCTEGOItY °'OF `CON � 'WCTIOI' k
i'RSIDFNTIAL EQUTNII�7`i % FEEgt
y g ❑ Commercial/industrial ry building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB .S ITE, 1N1 ORMATI(f1V ?AIVD•= I:O�'ATION Heating/soon nR -�
Job site address: q/4 h- ,( c Si-, (requires site plan showing / placement) / 46.75
City /State/ZIP: ' d � � r] �'-3 Furnace 100,000 BTU (ducts/vents) ( 46.75
CS Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg./apt. no.: Project name: In 1--vi CJC.-- Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
- Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
• - Water heater 23.32
DE$CYt1ytioi'= *OM; Water
Gas fireplace
e aG � � � p� 6cto V y\ , UV / ) Flue vent for water heater or gas
fireplace 23.32
g la_O a /'1 a Pe ,Q ! / I -' ( - - bo t k(,42.[• - Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
N • ROEERTY OWNED - _ 0 TENANT Other: _ 23.32 •
Name: 7 Environmental exhaust and ventilation
�lI)1 "111! L Range hood/other kitchen
Address: . a/Y1n Q--- equipment 33.39
City/State/ZIP: Clothes dryer exhaust . 33.39
G ( , l (
3 /0`( �� compartments,
Single-duct exhaust (bathrooms,
(c0 Phone: (�j) Fax: ( ) toilet compt utility lity rooms) 23.32
a- ®. - 0 CONTACT PERSON Attic /crawlspace fans 23.32
r - Other. 23.32
Business name: Idet:r o 11 42-v^ei:-• Fuel piping
Contact name: V /7 kN�Lt SD,e N S14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: Gas heat pump ,
City/State/ZIP: Wall/suspended/unit heater _
Phone: ( ) I Fax: ( ) Water heater Fireplace
E -mail: t4`C'OKey1 'e-V\er t) - 0 eV % 7-on. (l �-k Range
. .CONTRACTOR: -: Barbecue .
•
Clothes dryer (gas)
Business name:
t ay - c , e " ,,tl' t , C L Other:
Address: 35 6 g i,,., i% - ,,.1 - MLCHAMCAL PEamrr PEES'- _
City/State/ZIP: Subtotal 01
Y ' _ �'�! q7 Qan Minimum permit fee ($90.00) q ,3, I
Phone: (503) r.{g. 3s -yil Fax: ('o') 3 6 (a - LICOr;L Plan review (25% of permit fee) Z
1,
CCB lie.: 3 `a, Li. State surcharge (12% of permit fee) Q,�Z, I i •
TOTAL PERMIT FEE agealaP
This permit application aspires if a permit Is not obtained ithin 1 80 r
Authorized signatures �a ^" days after it has been accepted as complete. O
Print name: i o NA, h • Fee methodology set by Tri -County Building Industry Set and
a .. �r� -0/, 1 Date l7 l (
1: 1BuildinstPermitslMEC- PernvtApp.doe 10/01/09 I rr(ll oM/WEB1 a/ / 0 4 r / / /► A-
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9143 SW HILL ST, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
06/12/2013 00:00
MEC2013-00263
PASS - No C of O
Violation Summary:
Inspector Contractor