Permit (2) CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2020-00027
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01l14/2020
Parcel: 2S103DB02300
Jurisdiction: Tigard
Site address: 13455 SW GENESIS LOOP
Project: MAYHUGH Subdivision: GENESIS Lot: 17
Project Description: Replacing(2)exhaust fans.
Contractor: FORDE ENTERPRISES Owner: MAYHUGH FAMILY TRUST
12855 SW 113TH PL BY MAYHUGH,TED&JANE TRS
TIGARD, OR 97223 13455 SW GENESIS LOOP
TIGARD, OR 97223
PHONE: 503-670-0168 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Single Duct Exhaust(Bathrooms,Toilet, 01/14/2020 $46.64
Type of Use: SF Utility Rooms)
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 01/14/2020 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 01/14/2020 $43.36
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain _a of the rules
or direct questions to OUNC by calling 503.232. 87 or 1.800 .2344.
Issued By: g...„. l--1. Permittee Signature: e
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received C /ef/� J' -lb
I3125 SW Hall Blvd.,Tigard,OR 9722 ECEIVED Pla
Plann Review
Phone: 503.718.2439 Fax: 503.598.19 Date/By: pot` " .eanis'-
I I G:A It O Inspection Line: 503.639.4175 n rrtt Date Ready/By: Juts- El Se' age 2 for
Internet: www.tlgard-or.gov I ;l!2i" Notified/Method: Suppl rental Information
TYPE OF WORK' I I Ut- I IUtinv COMMERCIAL FEE* SCHEDULE —USE CHECKLIST
.,, fl, fl nlAri C�l(1Ix1 - Mechanical peon tfees*are based on the value of the work
❑New construction ®Addition/alteration/replacement per ormed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 495.00
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 Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:13455 SW Genesis Loop Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Mayhugh Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SW 115th & SW Genesis Loop 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
2- new bathroom exhaust fans 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. 23.32
C. PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name:Ted &Jane Mayhugh Range hood/other kitchen
equipment 33.39
Address:13455 SW Genesis Loop Clothes dryer exhaust 33.39
City/State/ZIP:Tigard, OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) tWO 23.32 46.64
Phone:(503)968 8819 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Forde Enterprises Inc. s14.15 for first four;$4.03 for each additional
Contact name:Chuck Forde Furnace,etc.
Address:12855 SW 113thPI Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tigard, OR 97223 Water heater
Phone:(503) 784-1043 Fax::( ) Fireplace
Range
E-mail:chuck@fordent.com Barbecue
` •7 "'7..,«' 4*'`4`'7 s CTOR Clothes dryer(gas)
Business name:Forde Enterprises Inc. Other:
MECHANICAL PERMIT.,. ii z.
Address:12855 SW 113thPI Subtotal 46.64
City/State/ZIP:Tigard, OR 97223 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( 503) 784-1043 Fax:( ) State surcharge(12%of permit fee)
CCB tic.: 103842 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:' * Fee methodology set by Tri-County Building Industry Service Board
Print name:Chuck Forde Date:1/14/2020
I:\Buildmg\Permits\MEC_PermrtApp_040113.doe 440-46171(I 1/02/COM/WEB)