Permit CITY OF TIGARD MECHANICAL PERMIT
1. . COMMUNITY DEVELOPMENT Permit#: MEC2017-00716
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2017
Parcel: 2S 102C 600800
Jurisdiction: Tigard
Site address: 13115 SW GRANT AVE
Project: MIRANDA Subdivision: NORTH TIGARDVILLE ADDITION Lot: 32
Project Description: Replacing furnace and installing gas piping for furnace and range.
Contractor: FORD FOUNDATION LLC Owner: MIRANDA, PEDRO&SOFIA
13810 SW 100TH AVE 13115 SW GRANT AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-680-0471 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 09/19/2017 $46.75
Type of Use: SF Fuel Piping 09/19/2017 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/19/2017 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 09/19/2017 $29.10
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 95 90. You ma in a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
1110
Issued By: 6�" --..._ C— Permittee Signature: {
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4
Mechanical Permit Application FOR OFFICE USE ONE)'
City of Tigard ..." ceived
IN . dao'tci�a� i::to/By:t //� Permit No.: V 01 r
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Other Permit:
Ti G A R D Inspection Line: 503.639.4175 y t�� Date Ready/By:
Internet: www.tigard-or.gov �� g ;/ �USee Page 2 for
Notified/Method: ElliiS Supplemental Information
TYPE OF WORK ` a l 1v,�� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Ithi nI" Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/r'2p acement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
offivrat
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
ti-family 0 Master builder
0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: '" ---/AS- ejV..) r- Air conditioning .75
v► �'►'vt7, Furnace 100,000 BTU(ducts/venC----- )4
/ 46.75
City/State/ZIP: r 0 3'7 Furnace 100,000+BTU(ducts/ve - 54.91
Suite/bldg./apt.no.: 1 Project name: M Heat pump 61.06
/ !/r e,/_f Duct work 23.32
Cross street/directions to job site: / / 92"'0 '�--) Hydronic hot water system 23.32
`f Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,sttspended,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
„....,A,,,,,,
; ,„r,,,,,,,
r 'DESCRIPTION,OF WORT; 4. v. Gas fireplace/insert 33.39
Flue vent for water heater or gas
Te,44terva---P---eritri-eeC---_ J'� i fireplace 23.32
/k/. /0
J ! Log lighter(gas) 23.32
��` ..� n Wood/pellet stove 33.39
I/� ?7~" '� --� S:1 Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32*. OPERTY OWNER II L T :: Other:�' r
Environmental exhaust and ventilation:
Name: '`<� Range hood/other kitchen
equipment 33.39
Address: I s//‘ cs" ✓ -7—
Clothes dryer exhaust 33.39
City/State/ZIP: ->'71y 2a- 2& 77.07— Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 3) C 9E.�J Fax ( ) Attic/crawlspace fans 23.32
PLICA IT ` �� "7'
s ''. .` � � 'V''''
..� � . �' � ,:.0. � _�� '�: P N `� Other: 23.32
Fuel piping:
Business name: 1 r t /k _„ J�iC�7 P P S
$14.15 for first four;$4.03 r each a ditional _
Contact name: // - Furnace,etc.
Address: /3 Y76 6-7't/ /0"z--79774— Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: /72_,3 Water heater
Phone:(sem �oY* 7/ Fax::( ) 1 Fireplace
E-mail: � Range6....),
�/ i N _ Barbecue
r�
fv `' M' CTORn:,; x. Clothes
`x „,' �'l'�'(gas)
Business name: ikri
` -Y Other:Address: � r'r .: I.,' `' MECHANICAL PERIMT E * , '7
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:(93) 6176 Oill / Fax.( ) Plan review(25%of permit fee)_
State surcharge(12%of permit fee)
CCB lic.: TOTAL PERMIT FEE
7L'i This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signae: ) * Fee methodology set by Tri-County Building Industry Service Board
Print namo!'S1 l/ -fees° Date: r'/f`,
I:\Building\Permits\\CEC_PermitApp_040113.doc 440-4617T(11/02/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$100,000.00 $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_PerniltAPP_040113.doc 2
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13115 SW GRANT AVE, TIGARD, OR, 97223 November 7, 2017 at
9:42:05 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00716
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor