Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2021-00195
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/29/2021
A R f3 9 Parcel: 2S112BB12300
Jurisdiction: Tigard
Site address: 14100 SW FANNO CREEK PL
Project: Lethco Subdivision: COLONY CREEK ESTATES NO.4 Lot: 103
Project Description: Gas piping for range and outdoor barbecue.
Contractor: OWNER Owner: LETHCO,WILLIAM L
14100 SW FANNO CREEK PL
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 03/28/2021 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 03/28/2021 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/28/2021 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions� to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: -)-}>�I t 1/'i I Permittee Signature: Or \.�+.�;L 6%4• r 01
I' JJ��\� V�+ Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �`
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
- 31Is -2.
Mechanical'Permit Application
�., Received .,
City of Tigard /i/� �— PermitNo_:/b i- COL i 5-
13125SWHaIIBlvd.,Tigard,OR 9 3ECEIVE[ Plane. )
Plan Review
■ Phone: 503.718.2439 Fax: 503.598.1960 Date/By: 44 Cdher Permit: i t-c, , _en Li73
T I c; \I;I] Inspection Line: 503.639.4175 MAR 1 5 2021 . Date Ready/By: lyric H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: 3/n4a( 11 G, Supplemental Information
:.:f'i les Y OF Ti(4AHr) fi r, �
TYPE OF MITItrINP, niVi$IQNI COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction El Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
D Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*
a1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
aNniii -
y ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/c cling:
Air conditioning 46.75
Job site address: 14100 SW Fanno Creek Place Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
) � Heat pump 61.06
Suite/bldg./apt.no.: I Project name: LL l,f r-t_ , 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: I 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
Additional gas line installation for range and outdoor barbecue connection • fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 1 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: William Lethco Range hood/other kitchen
equipment 33.39
Address: 141(H)SW Fenno Creek PI Clothes dryer exhaust 33.39
City/State/ZIP: Tigard,OR 97224 Single-dud exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(904 ) 718-7000 Fax:( ) Attic/crawlspace fans 23.32
IA APPLICANT ®CONTACT PERSON Other: 23.32
Fuel piping:
Business name: N/A
$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
Fireplace
Phone:( ) Fax :( ) Range 1
E-mail: (,,J l(>tiAw /1 j/ %t, i,�, Barbecue 1
CONTRACTOR Clothes dryer(gas)
Business name: Other:
Owner MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
LaJL0
days after it has been accepted as complete.
Authorized signature: >u:tan o-.r,x.r • Fee methodology set by"In-County Building industry Service Board
Print name:William Lethco Date:03/14/2021
I:\BuildioglPerma\MEC Po otApp,040113_doc 4404617T(I 1/02/COM/WEB)