Permit 111 y p CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2014-00282
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/09/2014
Parcel: 2S102BC00400
Jurisdiction: Tigard
Site address: 12625 SW GRANT AVE
Project: Gavojdea Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 5
Project Description: Gas piping for range conversion
Contractor: OWNER Owner: GAVOJDEA, CONSTANTIN
CONSTANTIN GAVOJDEA GAVOJDEA, MIRELA L
12625 SW GRANT STREET 12625 GRANT
TIGARD,OR 97223 TIGARD,OR 97223
PHONE: 503-620-8425 PHONE: 503-620-8425
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 06/09/2014 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 06/09/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 06/09/2014 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions) !
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct q -. . : •UNC by calling 503.232.1987 or 1.800.332.2344.
Issuetli By: Permittee Signature: I l��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard '��']j ii 0 � DateBy: ( '/// / - l Permit No.:��� / -QO ag�_._
• 13125 SW Hall Blvd.,Tigard,ai'-423 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 9 i 4 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris BI See Page 2 for
Internet: www.tigard-or.gov f 13f1�U
IJ Notified/Method: Supplemental Information
CITY ` f I '^,
TYPE 4 l f` COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES"
❑ 1-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: /2 2 s\.,o G N P- 4y Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / /61--R-o O, 9 722 Furnace 100,000+BTU(ducts/vents) 54.91
1 Heat pump 61.06
c
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
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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Q e l7 C/•S z n P 04 Shove fireplace 23.32
/ if 7Y(P I'•t�/./e" Log lighter(gas) 23.32
/�/JJJ���t'��L Wood pellet stove _ 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
❑ PROPERTY OWNER ❑ TENANT Environmental exhaust and ventilation:
Name: Gam//s 777 ;/j/ G iJ 470 E?/t Range hood/other kitchen
equipment 33.39•
Address: /`z6 Z .T _Cu) 6£'d tVP Clothes dryer exhaust 33.39
City/State/ZIP: 7—/6, . : Q� 972�3 Single-duct exhaust(bathrooms,
// +_/ 1 — toilet compartments,utility rooms) 23.32
Phone:(c 3) 626:9 127.z c Fax:( ) Attic/crawlspace fans 23.32 .
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas) _
D -,J, V!, r EA Other:
Business name: MECHANICAL PERMIT FEES"
Address: Subtotal 9e e"'
City/State/ZIP: Minimum permit fee($90.00) �—
Phone: Plan review(25%of permit fee) �—
( ) Fax:( ) State surcharge(12%of permit fee) /)•clO
CCB lic.: TOTAL PERMIT FEE /00 • CCO
�.,w � This permit application expires if a permit is not obtained within 180
/� V C/`' days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: G6/(S T Ai-"1//7Y d iL/;A i Qi /,
1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T( 1102/C• EB)
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_PermitApp_040113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12625 SW GRANT AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
June 11, 2014 at 10:11:53 AM
MEC2014-00282
George Heimos
Violation Summary:
Inspector Contractor