Permit ,, CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00272
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/15/2011
Parcel: 2S110AA91821
Jurisdiction: Tigard
Site address: 10723 SW CANTERBURY LN 102
Project: WALKER Subdivision: :ANTERBURY CREST CONDOMINIUM: Lot:
Project Description: A/C instllation.
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Contractor: GAROKEN ENERGY COMPANY Owner: WALKER, JEFFREY BRIAN
3565 SW 182ND AVE WIEBE, LISA
BEAVERTON, OR 97006 10723 SW CANTERBURY LANE, #102
TIGARD, OR 97224
PHONE: 503 - 848 -3838 PHONE:
FAX: 503 - 356 -9002
FEES
Specifics: Description Date Amount
Air Conditioning 06/15/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/15/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/15/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or
Issued By: Permittee Signature:
Call 50 .39.4175 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.
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JUN -14 -2011 16:16 FROM :GAROKEN ENERGY CO. IN 5033569002 TO:5035981960 P.1
Mechanical Permit Application
V 1)lt OFric I t .Si U:\1,1
il ...:. . City of Tigard R eceived
13125 SW Hall Blvd., Tigard, OR 972 {� Date/By: V 0 A � !
Phone: 503.639.4171 Fax: 503,598.1 9> +1 Plan Review
I Lt , , I , 1 -, Inspection Line: 503.639.4175 1
��\ DatwBy: Other Permit:
Internet: ww v.tigard- or,gov 1 S� Date Ready /By: See Page 2 for
( Notified/Method: Supplemental Information
\U ti
F�
T YPE OF WO . „�v� r l •
� 1 C3 ` � o R Ci<Ai._ ?�� • scl�epui,>v: :use- ci�+crcr:><sm ,
❑ New construction XAddition/alteratiorgepta 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.
C ATEGOR Y OF • CONSTRUCTION Value: $
- and 2-family dwelling RFSIDENTIAL EOOPMENT/ /;SYS,`!!'EMS FEW.
Y g ❑ CommerciaUindustrial ❑ Accessory building
❑ Multi ❑ Master builder For special information use checklist.
❑ Other: Description 1 Qty. [ Ea. I Total
JOB SITE INFORMATION AND LOCATION HpuH ao tog
Job site address: /o70/_ 3 sw C ur L .N . F t b - O � Air cond p
I1 �( (requ (p
i e p an showing placement) r 46.75 /{ 7�
City/ State/ZIP: 7- r n4 r - g-7(,,.• / G Furnace 100,000 BTU (duets/vents) 46.75
/a L no.: cam- � Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bld
g P Project name:
of Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
g- Z! q ! , Hydronic hot water system _ 23.32
�c Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended. etc. 46.75
-
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION `OF WORK Water heater 23.32
�} ! Gas fireplace 33.39
�� f l Ct� f rIryC,P -I Flue vent for water heater or gas
fireplace 23,32
E -' • / �_ ' I�'arss 3 Log lighter (gas) 23.32
I Wood/pellet stove 33.39
/`e el• Wood fireplace/insert 23.32
tyBERTY OWNER Chimney/liner/flue/vent 23
PR
L 0 TENANT. Other:
Name: 23.32
O - r ,r A 7 � e,e_._, Environmental exhaust and ventilation _
Address: 4 Range hood/other kitchen
equipment 33.39
City/State/ZIP: ` Clothes dryer exhaust 33.39
Phone: ( Sr(�3 3 a _ �[ j S Fax: ( ) Single -duct exhaust (bathrooms,
[� t toilet compartments, utility rooms) 23.32
0 - APPLEICANT. • ❑ CONTACT PERSON Attic/crawlspace fans 23.32
1/e `� Fuel 23.32
Business name:
R ' Y � ' � �r�/ _ Fuel piping
Contact name: \‘")0.v‘.‘,...\... O N $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: WalUsuspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -m QK"p Ke.y► e v�ev 9 , e-v, Z:CiY1- r1 e._-4- Range
CONTRACTOR, Barbecue
Business name: rd Clothes dryer (gas)
Q
e," to e-V^ Cii. C , d.-0- L Other:
Address: 3 4,g S, .k c, ,I. t.0 MECHANICAL PERMIT FEES *.
city / State/ZIP: e. L.l.11 se _sc - 1 _ op-.. 91 C at, Subtotal 46, "75 ,
Phone: ( 503) c qz, 3 Fax: (5 o 9 ,3 7 ea , 9 Z) L Minimum permit fee r mit fee C
` ; f � _ Plan review (25% of permit fee)
CCB lie.: I-� :3 . - i f State surcharge (12% of permit fee) /D. rD
TOTAL PERMIT FEE //27 ..27'42
Authorized signature: V p� S14.--1.-- This permit application expires if a permit is not obtained within 180
(,� 777 days after it has been accepted as complete.
Print name: �p „`� /� ! • Fee methodology set by Tri -County Building Industry Service Board
r���� D ate: lL
I:\ Building \Permits1MEC- PermitApp.doc 10/01 /09 440-4 17T(I /OLCOM/WEB)
JUN -14 -2011 16:17 FROM:GAROKEN ENERGY CO.IN 5033569002 TO:5035981960 P.3
EGER GAROKEN ENERGY Co. INC.
SiNcE 19'79
3565 SW 1 B2ND AVE • BEAVERTGN, OR 97007 • TEL (503) 84B -3838 • FAX (503) 356.9002 • CCB# 43) 24
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