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Permit q CITY OF TIGARD MECHANICAL PERMIT 1111 2 CO MMUNITY DEVELOPMENT P #: MEC2011 -00414 Date Issued: 09/15/2011 T I GA1x D 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 1 S133DD16000 Jurisdiction: Tigard Site address: 12987 SW FALCON RISE DR Project: MORES Subdivision:'ILLAGE AT SUMMER LAKE PARK NO Lot: 196 Project Description: Gas piping for stove and barbecue. Contractor: M5 PLUMBING SERVICES LLC Owner: MORES, DARRELL GLENN & KATHERINE PO BOX 821143 12987 SW FALCON RISE DRIVE VANCOUVER, WA 98682 TIGARD, OR 97223 • PHONE' 360- 624 -8376 PHONE. 503 - 872 -4559 FAX. FEES Specifics: Description Date Amount Fuel Piping 09/15/2011 $14.15 Type of Use: SF 12% State Surcharge - Mechanical 09/15/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/15/2011 $75.85 Occupancy Grp: Stories: Fuel Fuel Types. Gas Pressure: Total $100 80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332 2344. Issued By: %" Permittee Signature: - _,` t Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 09/15/2011 07:52 3608285384 M5 PLUMBING LLC PAGE 01/02 Mechanical Permit Application, I FOR OFFICE USE ONLY City of Tigard .� � � Re i `e // r11,; ' 13125 SW Hall Blvd , Tigardf®R.97223. _' '�\ - : v> 0 Plan ,Review PPIMEN l7 Phone 503.71$.2439 Pax•�5�03- .598��960 �- ,Oate/13y, Other Permit. Inspection Line: 503.639.41754 T l Cs f ILll Q �� Date ed /Me 0 See Page 2 for Internet www.tigard-or.gov S� , +° < Notl Ready/By. ethod: Supplemental information TYPE OF WAI C'.�w' - l n El New construction KAddition /alteration /replacement based on the value of the work ❑ Demolition ❑ Other: mechanical materials e ui•men labor overhead and .rofit. ' . CATEGORY Or CONSTRUCTION Yxlue: $ - - RESID NTIAL EQUIPMENT / SY3TEt `k,FS'°' f2'- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ,For speekrt inforrnnlion use checklist- ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. I Total 300 SITE AND LOCATION Heating/cooling: ' Air conditioning Job site address: r 2_9 g "'7 ‹w / 2 /&, ' {' Or ' (requires site plan showing placement) 46 75 / Furnace 100,000 BTU (ducts /vents) 46.75 City /State /ZIP: ' o , ` o i 97z-a Furnace 100 0004- BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: / Project name: Heat pump a ..,,_ 7 s'f CI `g pi �,'. CST (requires site plan showing placement) 61.06 Cross street/directions to job site: V f � Duct work 2332 r ^ Hydronic hot water system 23.32 ' ►V V i 2..' k f'7l/e .. _. Residential boiler (radiator or hydronic) _ 23.32 _ 7 rue. 1 '> ' °'r Unit heaters (fuel -type, net electric), { 5135 bI , ©v.0 in -wall, in -duct, suspended, etc. 46.75 Subdivision: .� ( Lot 00.: Flue/vent for any of above 23,32 lt`I(�' 0 Other: 2332 Tax map /parcel no.: Other fuel appliances: DESCRIPTION OF WORK ' Water heater 23.32 P / -. Gas fireplace 33.39 A a., 0 ra • I stir L - es Flue vent for water heater or gas ' fireplace 23.32 -^ Lug lighter (gas) 23.32 Wood/pellet stove 33.39 - Wood fireplace /insert 23.32 .PROI'RRTY' OWNER , I _ ❑ . TENANT Chimney /linerltlue/vent 23 32 Other: MI 23 32 Nann.e: ,k,,, M -P S Environmental exhaust and ventilation: Range hood /other kitchen Address: i r ' i equipment 33.39 City/State/ZIP: -'-1- f.�f r .' p (Z,_ 72 7-3 Clothes dryer exhaust 33.39 F < 0 . � � Fax: Slogle-duct compartments, r tme n tt (bathrooms, ro oms) 23.32 s, Phone: ( ) ( ) toilet compartments, utility rooms) , , (A.XPPLIC.ANT . ❑ CONTACT PEli?50N ' Attic /crawlspace fans 23.32 name: ( Other 23.32 Business name: p1 wrv'v11 vg. - * .�- tI1 fir/ ice Fuel piping: Contact name: 1{�.. n .f A r ��� •� S14.15 for first four; $4.03 for each additional I Address: Y" lc� Furnace, etc. (y C ,t 1_ Gas heat pump City /State /ZIP: Y` (• srt.A.r c,-r / toi 4- y 25 4012- Wall /suspended/unit heater Phone: 360 6 2 yr y Fax: : ( ) Water heater E-mail: �,{ Fireplace Ci- /"r f th e jek '� /vt' eC.ae Range I e 3 t `tifplc" CONTRACTOR Barbecue - 1 Business name: rig g P /1 b , w Other: dryer (gas) 2 ' - Other: Address: . ' M,ECHAPtfCAL PERMITFT.ES" ' • ' City / State/ZIP: • Subtotal i c. f { f '-- Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) cc a , orb Plan review (25% of permit fee) C;CB lie.: 1, 2:g i 1 ' .,,, state surcharge (12% of permit fire) IfillUM TOTAL PERMIT FEE _ll,."- Authorize a _ permit is not Obtained wit. ill 180 � This permit application expires if a per • _ J` - f 1 J _ days after it ha¢ been accepted ax complete - Pr int n . . �` , '• - - ��♦ Da 7 r Fee methodology set by pi -Comity 0.1diog Industry Service pearl gir 1 \Sullding \Permit- .1MEC- PemtitApp.4oc 09/09/10 440 ' 617t (I 1 /02 /COMIWEB)