Permit OCT 16:53 FROM :GAROKEN ENERGY CO. IN 5033569002 TO:5035981960 P.1
...iv. LJ/ LVV . a•! L' L IU.3dO oOOOV Tsoll 1 Z Ur l aWili W VV1
RECEIVED
7 '1" " Building Division OCT 2 3 2006
•
l:. a Request for Permit Action CITY OF TIGARD
BUILDING DIVISION
TO: CITY OP TIGARD
Perini: System Administrator
13125 SW is Blvd., '1*ggasd, OR 97223
Phone 503.7182430 Faz 503598.1960 w tigard-aegov
FROM 0 Owner ❑ Applicant )Conixactot ❑ City Staff
(check one)
REFUND OR Name: ►/ _
INVOICE TO: (�' VY,4 ,9 40% ' • — 1 40•1
Mailing Address:
V 0 . D city /State /zip: eP.6 � (V, • T
/7�ZY/ //30 4 Phone No.: SD SD �i $ ° 3 - Z�7
%�
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
15 CANCEL PERMIT APPLICATION_
g . REFUND PERMIT FEES (attach receipt, if available).
INVOICE FOR FEES DUE (attach case fee schedule and explain below).
REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: pit r
Site Address or Parcel #: / I , ( 5 to 4 P r vtQ a
Project Name: ( et O' a
Subdivision Name _ �y Lott ##:
EXPLANATION; _ (v l .(,,S �� /7o ( L (a(
Signature: 1
AA.. _ ��_ `, - d ,,_ Date 0l
_
Print Name 1 1111 • v\
Relkoibilat
1. '[Tee Meet= or 8nit+ding official e*ay mix e the =food of
a) any @e which vat eetanamsty paid of collected.
b) nor mete than 80 of the land use application fee when= spplastioe it withdrawn oe canceled betone soy review enact has been espended.
c) ue.t mom dun OM of thu land use application fee foe flawed penoha
c) not more than tapir, of the buitdingpim whew for when an .ppliratioo is ®oiled Wrote any plan =view cI zt has been asps ded-
a) WI moor: slam BO% of the toadies peal* Coo bet issued pats paler to any iova: ou tow=
a R efaed i vll be emceed to dse otighol Payct in the num method to which paymost vas Imbed. Please allow 1-0 tomb for Focusing [elands-
Rte to • Admire Date , a E J . Refs o : : Admits Date /D JO
Refund Pnocebsed: Date ' , B ..:iii invoice Ptoat:exo Dee EMINMEN
Permit Ceiw : Data: V0 0111-W, , elf: TIC ' Date
Receipt #06 '3b 7i) Date /. .2 p, Me ,, .. C L Amount $
mEe wane. - • ••, • • 06 /24/06
7
•
CITY TIGARD MECHANICAL PERMIT
�► DEVELOPMENT SERVICES PERMIT #: MEC2006 -00514
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/23/2006
PARCEL: 2S1 04AB -07400
SITE ADDRESS: 13178 SW KATHERINE ST ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 4 LOT: 103 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
MARK LAMBERGER Description Date Amount
13178 SW KATHERINE ST
TIGARD, OR 97223 [MECH] Permit Fee 10/23/20( $72.50
[TAX] 8% State Surcha 10/23/20( $5.80
Total $78.30
Phone: 503 -579 -7579
Contractor:
GAROKEN ENERGY COMPANY
3565 SW 182ND AVE
BEAVERTON, OR 97006 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 848 -3838
FAX 503- 356 -9006
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: % � b/ Permittee Signature: S O e QS
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.
I
OCT -2.g-2006 11:41 FROM:GAROKEN ENERGY CO. IN 5033569002 TO:5035981960 P.2
■ _ )IL - -:� ',i__'1; ,r.,
Mechanical Permit Appl FOR OFFICE USE ONLY
ty f Tigard Received �J _
13125 SW Hall Blvd., Tigard, OR 97223 OCT i� ,_, 200 Da� � 1 Permit No.�! �� 37 503.639.4171 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
ll
Inspection Line: 503.639.4175
I Date Ready/By: 1
Internet: Line: i.ti d.or.ua I 1'v! .._111j,',.4 - to Sea Poe 2 for
...,._.. y `L Notified/Method
r _ 77�^tR•�'.. I Supplementallaformadon
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hii : •- car S , �'r 1zn ol'? �� (` � Via Zl'�i -;u 1 - i• .4 .• -
'y: "• 5111CII�' - I iJSFf13HE6KLIST
r- Mechanical
Addition/alteration/replacement permit fees* are based on the value of the work
ew construction
tJ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other:
rrrr1 mechanical materials, equipment, fit
°"r� h_� Il c. r `� -nn_I . u }f'tu . j`+: D � o .t. y4 y. s u e• $_ labor, overhead, and pro
r - and 2-family dwelling ,�.,; V al
#...
Y 8 ❑ Commercial /industrial ❑ Accessory building
. 11 4414 t 'g /'SY$ MS:FEFS•
s
❑ Multi - family ❑Master builder For special information use checklist.
Other. Ea. 1
- �, '
� 3 . x J � _ y l � • .i � 1. ,k 'WIZ'''. 1 _ •' Description Qty. a. Total
h 1 r ;!�, u P ( Heating/cooling
Job site address: . �� Air conditioning or heat pump
`j ' (re sires site plea showing placement) 14.00
City/State/ZIP: - C - L_ /State/ZlP �
- r 4 -1
-.�._ umaee 100,000 - BTU (duetorventa ( 14.00
Suite/bldg. /apt. no.: uL2� vent) _ 17.90
• • M' aa� = Gas heat pump 14.00
•
Cross street/directions to job site: _ Duct work
14.00
IIMMINIMIWAMPOMINW • Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fbel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no • Flue/vent for any of above ( 10.00
Other: 10.00
Tax uparcel no.: Other fuel appliances
� S : iT .e .F .rr1: ., .:n;V"„ � L Water heater t 10.00
4 Gas fireplace 10.00
_ ■
Flue vent for water heater or gas
fireplace 10
Log lighter (gas) 10.00
Wood/pellet stove 10.00
-{� , �� Wood fireplace/insert 10.00
:; ,iii_ •` a 1 ' , ' r ' " , t 7ti 6i .1 ' ,rte i� ;;;; 4F , _ ,,, ,-.K r Chimney/liner /flue/vent 10.00
:._ ,L1. ,_ � rL * -..L J!r r`a 4 moils :1i..'LI:1 Other. 1 0.00
Name: p ■ C s A A.* -• • r- Environmental exhaust and ventilation
Address: 0 • Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Phone: (SDI WLVRIII Fag ( ) Single -duet exhaust (bathrooms,
la- toilet compartments, utility rooms) 6.80
r. ::17 e t_ 1.1- (! .✓ \ �+ --i 1 "-', h .4, t 3 s t r r" ' - '' 4.,4 a
F< -4 '.L.V44 ; c _. �as't ( . � . OJAN � 0+tr a a ,., ,2 Anic/crawlspaee fans 10.00
Business name: Other. 10.00
dr Contact name:
- Fuel piping
$5.40 for first four; 51.00 for each additional
Address: Furnace. etc.
City/State/ZIP: Gas heat pump
Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail ♦ et,..-z � n C b r @ 1/P� ■1_ -ey. Range
rb .• j _ ,S Range
i Y" rr 'F i T. `r C h 6 - u3� �- .`....._&.. ' I�t, 1Ar! -� 2'1 '[.n1,' , t t v+ ',
• , __.. - l _�a4.f __1�i , 7 :' ' `,•i' ':. �2' _:...1 ... Yf. ;i.;_ Barbecue
Business name: -- C Clothes dryer (gas)
- Other:
0 _ `� ;5f1 • < gaNt oAYfil? l lV1 .
City/State/ZIP: tr • • . • was 4,: 0 a 4 Subtotal
Phone: G $ . _ Minimum permit fee (572.50) "7z, SG
Plan review (25% of permit fee)
CCB lie.: a- State surcharge (8% of permit fee)
TOTAL PERMIT FEE 1X , S 0
Authorized si f ur n- G.,- This permit application expires If a permit la not obtained within Igo
days after It bar been accepted so complete.
Print name: v w�v,�v . y c a^ _ I Date: 13 .41 1 • Pee methodology set by Tri- County Building Industry Service Board
1 . ‘auitdiagWermiutMEC- PermitApp.doe 12/03 440.4617T(11102/COMNY13B)