Permit CITY OF TIGARD MECHANICAL PERMIT
31111 ' COMMUNITY DEVELOPMENT Permit#: MEC2014-00679
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/17/2014
Parcel: 2S112BB04700
Jurisdiction: Tigard
Site address: 14145 SW FANNO CREEK DR
Project: Roderick Subdivision: COLONY CREEK ESTATES NO.2 Lot: 30
Project Description: Installation of gas insert
Contractor: NW GAS LINES Owner: RODERICK, JOHN D&
16731 NE WASCO ST RODERICK, MELISSA A
PORTLAND, OR 97230 14145 SW FANNO CREEK CT
TIGARD, OR 97224
PHONE: 503-256-2436 PHONE:
FAX: 503-256-2245
FEES
Specifics: Description Date Amount
Gas Fireplace 12/17/2014 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 12/17/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/17/2014 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 dire • estions . •UN .y calling 503.232.1987 or 1.800.332.2344.
-sued By: , / 01, 1 Permittee Sigr)6ture:
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.
Dec 17 14 02:31p Tony Young 503-256-2245 p.1
Mechanical Permit Apglicati EI - 1 Date/By: /� FOR OFF11 1 l SF ON l,1 ' �� ,
City of Tigard Received m�m r ��
13125 SW Hall Blvd.,Tigard OR 97223 Plan Review Li%�.�:%J a���h
' . ' Phone: 503.718.2439 Fax: 503.598-1960 DEC 1 7 2014 Date/By:
11,:'\R D Inspection Line: 503.639.41"5 Date Ready fBy: tore 21 See Page 2 for
Internet: www.tigard-or.gov CITY(JF '1` I r IY Notded/Methad: Sut plemeabl Information
TYPE OF r • ION COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacenent performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition Other: mechanical materials,equipment,labor.overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
l-and 2-family dwelling ❑Commercial/industrial ❑Accessory building Fersped.aIInfornaatitue use ehetkllsL
Multi-family Master builder [I Other. Description L Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: Y/L/S .,i'VV Fit nil d 6/. (t7 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / I 17 ` Furnace 100.000+BTU(ducts vents) 54.91
/. .i
Heat pump 61.06_
Suitetbldg.tapt no.: Proj !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
Other 23.32
Subdivision: , Lot no.:
Otter 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
A5*J( 11/ �+, fireplace � 23.32
y��, �1 ! Log lighter(gas) 23.32
Wood/pellet stove 33.39
Woodfneplace)nsert 23.32
Chimney'/liner/flue/vent - 23.32
Other 23.32
❑ PROP RTY OWNER I ❑ TENANT Environmental exhaust and ventilation:
Range hood/other kitchen
Name: hN YLIDliS c`t, PO foe equipment 33.39
Address: Souekte Clothes dryer exhaust ' 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
/� toilet compartments,utility rooms) 23.32
Phone:( 3) eh.g.�/ v�V Fax:( ) Attidcrawispace fans 23.32
Iiil APPLICANT ❑ C)NTACT PERSON Other , 23.32
_
Fuel piping:
J C_S �N/'
Business name: 0 /ilk)6„.5-/,),,,s S[4.15 for first tour:$4.03 for each additional
Contact name: /...444.2• Yzi.o 11, . Furnace,etc.
Gas heat pump
Address: /12A31 c � Wall/suspended'unit heater ,
City/State/ZIP: 4 /) r Av gla50 Water heater
/
a Id+��y //�� Fireplace
Phone:(98)a s�,■cp 7g 4 . Fax::( )a Sb` 7 J Range _.
E-mail: h& 4c n�°�2e"`'f ,S7 • fr`�l--_ Barbecue
J CONTRACTOR Clothes dryer(gas)
Other:
Business name: ilk() ,4 J 1 h v[' 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 tic.: /t fJ 9i 4�Q TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within ISO
days after it has beta accepted as cemplrk.
Authorized signature: •
,,I ' Fee methodology sal by Tri-County Building Industry Service Board
Print Dame: 1� �jJl ((-u,!��jl4�Jf� Date:l JJ11 �_([f�/
flBuddiog'Pmnits\SEC_Pc-niit App_040113.roc 44404611t(t /02i M/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14145 SW FANNO CREEK DR, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
December 18, 2014 at 9:02:00
AM
MEC2014-00679
David Young
Violation Summary:
Inspector Contractor