Permit (40) CITY OF TIGARD MECHANICAL PERMIT
l'i _' . COMMUNITY DEVELOPMENT Permit#: MEC2016-00361
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2016
T[t, g Parcel: 2S108CA00100
Jurisdiction: Tigard
Site address: 15300 SW FINIS LN
Project: LUBRANO Subdivision: FINIS MEADOWS Lot: 1
Project Description: Gas piping for outdoor fire pit and BBQ
Contractor: T&T PLUMBING &DRAINS Owner: CALCUTTA ESTATE LLC
PO BOX 33045 BY LUBRANO, OCTAVIO S& KALPANA
PORTLAND, OR 97292 15300 SW FINIS LN
TIGARD, OR 97224
PHONE: 541-337-3080 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 05/23/2016 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 05/23/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 05/23/2016 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct q UNC calling 503.232.1987 or 1.800.332.2344.
r
Permittee Signature: i l
Issued y: / / 1 i 044 jil -16
lta.,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. ! l
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application r()R ()I I II I I "I ()\I v
City of Tigard CEIVED Raet� 5m � WW /4 oa 3�f
,� 9gDatelBy: / Permit No.:
13125 SW Hall Blvd.,Tigard,OR Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960Other Permit:
Inspection Line: 503.639.4175 MAY 2 3 2016
Date/Sy: M�rafll(c "�� 3
1 I c \h t, Date ReadyBy: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
(R�``C'ITYY'OF TIGARD
r1,PE'AIp'�Al1tK1O DIVISION COMMERCIAL FEE* SCHEDULE —USECHECKIJST
Mechanical permit fees'are based on the value of the work
0 New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES'
-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:c� Air conditioning 46.75
Job site address: 15300C.)U) . `(\5 1 Yl Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: �\,0 R 9-1a Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt no.: ��"�' Project name: ',.�/ Heat pump 61.06
Lt t J►t:Y h o Duct work 23.32
Cross street/directions to job site: OW Qv\1 i l r\ Hydronic hot water system 23.32
1 ,�' 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
1 / I Flue vent for water heater or gas
1 C 1 �11(�i otA.+Aci"`- 1 :m re PI f Lu"1Ci rb fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other:
0 PROPERTY OWNER 0 TENANT23.32
Q � Environmental exhaust and ventilation:
Name: Oe-b...,t D11 b' 0 Range hood/other kitchen
�l equipment 33.39
Address: i g":36-) SW, (r1,5 it) Clothes dryer exhaust 33.39
City/State/ZIP: 17et,aci -/7 9 / Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: f pitt• me,, y awl iorat„, Fuel piping:
$14.15 for Rist four,$4.03 for each additional
Contact name: ,,j1.5 !--- -it././74-- Furnace,etc.
Address: -U x S-- Gas heat pump
WalUsuspended/unit heater
City/State/ZIP: C01 kkuldaz q7 .-2 Water heater
Phone:( )5W-337--3051) Fax::( ) Fireplace I
E-mail: Range
Mad f"5+>< 'tJ �i�'lCL//, C' Barbecue
—�`'�/,, .C,O/NTRACTOR Clothes dryer(gas)
fr ! 1 /U.f�YJitil ail(I )ca..t °cher.
Business name: MECHANICAL PERMIT FEES*
Address: '---Pi.) k .5v )Nr Subtotal
City/State/ZWP ,y,,,it ae. q7,21 Minimum permit fee($90.00)
Phone: )✓73Plan review(25%of permit fee)
7"3C� D Fax:( ) State surcharge(12%of permit fee)
CCB lic.:„,2405-111.9 TOTAL PERMIT FEE /00•SU
This permit application expires if a permit is not obtained within 180
ii4Fee days after it has been accepted as complete.
Authorized signature: • methodology set by Tri-County Building Industry Service Board
Print name:'Dail wit '8It°1/4IL Date:,/�3l)l .
1:\Building\Permits\MEC_PermitApp_040113.doc 440.46177(11/02/COM/WEB)