Permit Support Document •
CITY OF TIGARD 11
MECHANICAL PERMIT
■ # COMMUNITY DEVELOPMENT Permit#: MEC2021-00676
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 s ��' Date Issued: 9/1/2021
Parcel: 1S134CB11300
. 11 Jurisdiction: Tigard
Site address: 12285 SW MILLVIEW CT
Project: KOVACH Subdivision: MILL VIEW Lot: 13
Project Description: INSTALL AND VENT TANKLESS WATER HEATER. 9/1/21: REPRINT to add(1)gas pipe for the water heater.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: KOVACH, GREGORY J/SHIRLEY M
13150 S CLACKAMAS RIVER DR 12285 SW MILLVIEW CT
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: (503)557-2220 PHONE:
FAX: 503-557-0919
FEES
Specifics: Description Date Amount
Water Heater 09/01/2021 $23.32
Type of Use: SF Flue Vent for Water Heater or Gas 09/01/2021 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Fuel Piping 09/01/2021 $14.15
Stories: Minimum Fee Adjustment-Mechanical 09/01/2021 $29.21
12%State Surcharge-Mechanical 09/01/2021 $10.80
Fuel
Fuel Types: Natural Gas
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
Issued By: 11#Al2
Permittee Signature: //,/J ‘
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.
it c '4bus'l a i permH-54)tgard-o► IN
Mechanical Permit ApplicatioN E e�E I V E
City of Tigard tved Permit No.:M /021--.lflrn7
:114
_ 11 13125 SW Hall Blvd.,Tigard,OR 97223 S �' RAJ `�
7 Plan Review
Phone: 503.7181439 Fax: 503.598.1960 Ef 1 1021 Dg�By, Other Fermi:
i I,.,1,i, Inspection Line: 503.639.4175 7�/ ❑t , Date Ready/By: Juris PI See Page 2 for
w Internet: ww.tigard-or.gov ivl I 1 OF I T IGAR Notified/Melhod: Supplemental Information
! I DING DIVI II
.F OF aVO;:!..
Mechanical permit fees*are based an the value of the work
o New construction Addition!alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
TEGORY OF Value:S
gg I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special inforerorton use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/coollog:
�N Air conditioning 46.75
Job site address: w 'w 7 I VICIAI O Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: II i i / Cjfl3 Furnace 100,000+BTU(daets/vemr) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Duct work 23.32
Cross street/directions to job site: 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
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
D)SGItI, Gas fireplace/insert 33.39
rt_ P rat t 2 2 r 7� Flue vent for water heater or gas
��f� fireplace 23.32 -
Log lighter(gas) 23.32
a T t{ IIU IN H Wood/pellet stove 33.39
t Wood fireplacrrplacdinsat 23.32
Chimney/liner/flue/vent 23.32 _
Other: 23.32
gaakt
Range dntal r kitch and vrntllation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:(I ( No-ray-to I Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT Other. 23.32
Business name:Same as Contractor
Fuel piping:
S14.15 for first four;54.03 for each additional
Contact name:Diane Mason Furnace,etc.
Address: Gas heat pump
Wail/suspended/unit heater
City/State/ZIP: Water heater 1
Phone:( ) Fax::( ) Fireplace
E-mail: Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Tri County Temp Control Other:
MECHANICAL PERMIT FEES`
Address:13150 S Clackamas River Drive Subtotal
City/State/ZIP:Oregon City,OR 97045 Minimum permit fee(S90.00)
Plan review(25%of permit fee)
Phone:(503)557-2220 Fax:(503)557/0919
State surcharge(12%of permit fee)
CCB lie.:72623 TOTAL PERMIT FEE
• This permit application expires if a permit is not obtained within 180
/��,2,.., ' days after it has been accepted as complete.
Authorized signature: V M • Fee methodology set by Tri-County Building Industry Service Board
Print name:Diane Mason Date: 4 j f(zoz.J
1•43uildieglPamns,6 EC_PermitApp_04o113.de, 440.46I7T II I102-COµwEB)