Permit (2) CITY OF TIGARD MECHANICAL PERMIT
II I COMMUNITY DEVELOPMENT Permit#: MEC2020-00026
T I CAR 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/14/2020
Parcel: 1 S135CC01000
Jurisdiction: Tigard
Site address: 10425 SW MEADOW ST
Project: Holland Subdivision: MEADOW,THE Lot: 15
Project Description: Replacing(1)range hood for kitchen remodel.
Contractor: FORDE ENTERPRISES Owner: HOLLAND, SHARI &SCOTT
12855 SW 113TH PL 10425 SW MEADOWS ST
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503-670-0168 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Range Hood/Other Kitchen 01/14/2020 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 01/14/2020 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/14/2020 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of th rules
or direct questions to OUNC by calling 503.23 .1987 or 1. 0.332.2344.
Issued By: Permittee Signature: `
l�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVED Received / P^ o.G
;. i 13125 SW Hall Blvd,Tigard,OR 97223 Dan By- f `, CI7 y,/'���2`-0 /0,
Plan Review v` ' '
Phone: 503.715.2439 Fax: 503.598.I9��N 1 4 2020 Date/By: '—'e-Pca . //( -
TIGARD Inspection Line: 503.639.4175 Date Ready/By: orris: WI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD NotificdiMclhod'. Supplemental Information
R ILI DING DIVISIC?p,
TYPE OF WORK COMMERCIAL FEE* SCHEDULE —USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑ New construction ®Addition/alteration/replacement performed. Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
.mi'.,, ,,.. Value:$ 495.00
iitn-i ,, to%t&I L4TEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
IM I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:10425 SW Meadow St 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:Holland Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SW Tediman &SW Meadow St 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
Range hood venting fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
IN PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Scott&Shari Holland Range hood/other kitchen
equipment one 33.39 33.39
Address:10425 SW Meadow St
Clothes dryer exhaust 33.39
City/State/ZIP:Tigard, OR 97223 Single-duct exhaust(bath wins,
toilet compartments,utility rooms) 23.32
Phone:(503)620 9396 Fax:( 1 Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Forde Enterprises Inc. $14.15 for first four;$4.03 for each additional
Contact name:Chuck Forde Furnace,etc.
Address:12855 SW 113thPl 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
CONTRACTOR Clothes dryer(gas)
Business name:
Forde Enterprises Inc. Other
MECHANICAL PERMIT FEES*
Address:12855 SW 113thPl Subtotal 33.39
City/State/ZIP:Tigard, OR 97223 Minimum permit fee($90.00)
Phone:( 503) 784-1043 Fax:( ) Plan review(25%of permit fee)
�� / State surcharge(12%of permit fee)
CCB lie.: 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: e * Fee methodology set by Tri-County Building Industry Service Board
Print name:Chuck Forde Date:1/14/2020
1:1Building\Pcrmhs\MEC_PermdApp_040113.doc 440-0617T(I 1/02,COM/WEB)