Permit q CITY OF TIGARD MECHANICAL PERMIT
11111 I • COMMUNITY DEVELOPMENT Permit#: MEC2014-00633
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/19/2014
Parcel: 2S104AB13700
Jurisdiction: Tigard
Site address: 12407 SW 133RD AVE
Project: YOZAMP Subdivision: MORNING HILL NO.7 Lot: 165
Project Description: Replacing gas fireplace insert with fuel piping.
Contractor: GASPRO INC Owner: YOZAMP, GRANT R
7603 SE LOUNSBERRY LN YOZAMP, KIMBERLYN A
PORTLAND, OR 97206 12407 SW 133RD AVE
TIGARD, OR 97223
PHONE: 503-775-7020 PHONE:
FAX: 503-775-7019
FEES
Specifics: Description Date Amount
Gas Fireplace 11/19/2014 $33.39
Type of Use: SF Fuel Piping 11/19/2014 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/19/2014 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 11/19/2014 $42.46
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio, the rules adopted by the Oregon
Utility Notification Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
y: `� i Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available insp: tion date.
This permit card shall be kept in a conspicuous place on the job site it completion of the project.
Approved plans are required on the job site at the time •f each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard - DateBy: / /tiI Permit No.: ).
IMill
• 13125 SW Hall Blvd.,Tigard,OR 9 Plan R
Phone: 503.718.2439 Fax: 503.59 Plan Review e: Other Permit:
Inspection Line: 50(3.639.4175
T I t;n R D 19 2014 Date Ready/By: MI See Page 2 for
Internet: www.tigard-or.gov ��gOV Notified/Method: Supplemental Information
TYPE OF W 1 s�4 D COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
111 , '����1c1"� Mechanical permit fees*are based on the value of the work
❑New construction Addition/alter i ti ep acement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 1v2 v0 S(,J /33 71-t
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7 j g } a- 7d7---5 Furnace 100,000+BTU(ducts/vents) - 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work 23.32
-
Cross street/directions to job site: Hydronic hot water system 23.32 ,
,� / Residential boiler(radiator or
i34-1()L ,.4 - hydronic) g 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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 1 33.39 33.39
Flue vent for water heater or gas
j?Letei.oecy l3--)ke 91L'-e Zej #xi7- fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
AS-PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: v° 4 A..70 7 5-L4-7-v '2 Range hood/other kitchen
/ 7�: equipment 33.39
Address: !01 7 r�O 7 S(4J 13 3 Clothes dryer exhaust 33.39
City/State/ZIP: _..-i J AGD at c`7 d-0)-- 3 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( '3) c" /,0 d1YCi Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: (I\° etS Q b-/1J_ $14.15 for first four;$4.03 for each additional_
Ork Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace i / i' (7
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
/J/7, '� Other:
Business name: �
691 1NG MECHANICAL PERMIT FEES*
Address: 7C,o3 SE L,f,,•„/sSv,tr 4/ Subtotal
City/State/ZIP: W� if_ 97�J(p�// Minimum permit fee($90.00) 90,cb
1 ff`�' - Plan review(25%of permit fee) —
Phone:(P3 )7?5--70,20 Fax:( ) State surcharge(12%of permit fee) J O ,Erri
CCB lic.: TOTAL PERMIT FEE /
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:. / • Fee methodology set by Tri-County Building Industry Service Board
Print name: 6c e,,,,,,7- tGZ/trpli7 Date:I/--T - Zc/y-
l•\Building\Permits\MEC_PennitApp 040113.doc 440-46171(II/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$1 00,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12407 SW 133RD AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
December 1, 2014 at 11:42:40
AM
MEC2014-00633
David Young
Gas line 29 psi, 15 min.
Violation Summary:
Inspector Contractor