Permit q CITY OF TIGARD MECHANICAL PERMIT
: COMMUNITY DEVELOPMENT Permit #: MEC2011 00598
Date Issued: 12/21/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S102DD03300
Jurisdiction: Tigard
Site address: 8358 SW DEEANN CT
Project: DAVIS Subdivision: FINLEY PARK Lot: 17
Project Description: Gas furnace installation.
Contractor: GAROKEN ENERGY COMPANY Owner: DAVIS, NANCY C
3565 SW 182ND AVE 16869 SW 65TH AVE #113
BEAVERTON, OR 97006 LAKE OSWEGO, OR 97035
PHONE: 503 - 848 -3838 PHONE: 503 - 624 -5857
FAX: 503 - 356 -9002
•
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/21/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/21/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/21/2011 $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 1.800.332.2344.
Issued By: - 1111 - W - Permittee Signature:
Call 50 .- -. 'i •y 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.
DEC-21-2011 16:1 FROM: GRROKEN ENERGY CO. IN 5033569002 TO: 5035991960 P.1
Mechanical Permit ApplicationWS) . . . _ .1:01( Oil l( um,: oNi., , ...,. . ....
City of Tigard Received ; :if' IIMMEIMIMN
Plan Re
• I Phone: 503.639.4171 Fax: 503.S8.1960 •- Other Permit:
1 icrAv Inspection Line: 503.639.4175 .\".C_, 1 \ Date/By.
O
CAO \''‘ Jun, El See Page 2 for
Internet: www.tigard-orgov \21••••• ( c‘,„ ,..3,0 N a o t t e Ready/By
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4 daviethrxi. 1716, ,-- Supplemental information
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rifn OF sy*R,oCc. T.: • . • :- - .. .''..coi
Mechanical permit fees are based on the value of the work
0 New construction 2Addition/alterVion/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CA:kG012*:.OF: COATIIITFT014._ ; :
Value: $
• ,r '.-- . 1 PEITi!liiki,g4. 0 frWIO*14-f00.1 8 0 - 4$7 ';', '::■
- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I CO. I Ea. I Total
jOB SITE ' INFORMATION AND..'ILOCATION :: Heating/cooling
Job site address: g3, 5ri...4.. 111 `e e avl vl C.4- Air conditioning
59
(recta; , : 3 o • •acement) 46.75
City/State/ZIP: 7 c , k 0 A a 1 qi 0-_,-1., Furnace 100,000 BTU . etshents) ( 46.75
Suite/bldg./apt. no.: L- Project name: t
Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
14‘.141 - Hydronic hot water system
23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in in suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map/parcel no.: Other fuel appliances
, . . _
- - • -, •. . •• .' iligscRuntvii woik - Water heater 23.32
Gas fireplace 33.39
(7_06(.C> ;1_Y r ilt-C-IZ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23,32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
- 14....PROBERTYOWNER - ' : .1 . , " O .T Other
ther: 23.32
_
Name: „, i 0 i .4 2 . is Environmental exhaust and ventilation
Range hood/other kitchen
Address: /6,1- q s it) 4 & ll /
, equipment 33.39
City/State/ZIP: 4. 0 5 mi-P--e 1 °35- , Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: 5; ) 4, z_i_ , 5 I_ Fax: ( ) toilet compartments, utility rooms) _ 23.32
,* ' -r. • • ELAPPLIOANT . El: CONTACT PERSON • Attic/crawlspace fans 23.32
. .... ,, • _ . , , • " i Other: 23.32
Business name: 64..y ci Ke" .1 7 : 2 1 1 RA-e. Fuel piping
Contact name: I, -
$14.15 for first four; $4.03 for each additional
v....N. g --c X"' Asa vl
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E-mail: e&g...`C key, e....-Ntw ‘1‘-is & ".) ev 1 Zccil• f\
- • CONTRACTOR Barbecue
.. . „ - --
Clothes dryer (gas) Business name: e..,, y- 0‘..< e , I , N ‘ E,V1e..,31" C.L..3/4 C-1.) - C- Other:
Address City/State/ZIP: p... g. ,.. zu ex _k_ o ., a ci 1 oc h„ Subtotal
Minimum permit fee ($90,00) 90.,00
Phone: ( 5(0) Si Lk 3s3 Fax: (56) '3 '5 /a - 9 Plan review (25% of permit fee)
CCB lic.: Lk ... k i4 State surcharge (12% of permit fee) /D. r a
TOTAL PERMIT FEE /
This permit application aspirin if a permit is not obtained within 180
Authorized signatur --.36---
days after it has been accepted as complete.
Print nan ),., ,,,. a f .... • Eco methodology set by Tri-County Building Industry Service Board
I \Building \Pr rrnitsWIEC.PennitAp0006 10/01/09 440-4617T (11/02/COM/WEID •