Permit (166) 111 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00621
-j-kGA D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2017
Parcel: 2S10113B01400
Jurisdiction: Tigard
Site address: 12070 SW GARDEN PL
Project: Rokke Sports Subdivision: CROW PARK 217 Lot: 2
Project Description: Modify ductwork for TI.
Contractor: GOHMAN MECHANICAL Owner: ICON OWNER POOL 1 WEST LLC
14505 SE HWY 212 BY RYAN
CLACKAMAS, OR 97015 PO BOX 460169
HOUSTON, TX 77056
PHONE: 503-658-1892 PHONE:
FAX: 503-658-6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/17/2017 $474.71
Class of Work: ALT Type of Const: VB Plan Review 08/17/2017 $118.68
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 08/17/2017 $56.97
Stories: 1 Info Process/Archiving-Lg$2.00(over 08/17/2017 $2.00
11x17)
Project Valuation: $15,000.00
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $652.36
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
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 50/232.1987 or 1.800.332.2344.
Issued By: � /// /, Permittee Signature: ` �� ,
` 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 Applicat' T FOR OFFICE USE ONLY
UPICity of Tigard j _�! Date/By / Permit No.'
13125 SW Hall Blvd.,Tigard,OR 97223 �/ —• ���0,
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ii I)) r Date/By: •ir - — Other Permit:A- �- �, G
T[GARD Inspection Line: 503.639.4175 A') 15. 1 Date Read /B Juris.
Ready/By. ® See Page 2 for
Internet: www.tlgard-or.gov 1 Notified Method:'//,//, 4 Supplemental Information
ciry at-,
TYPE ()stiltI,® *«INC 6? � 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 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value
$$15,000.00
CATEGORY OF CONS I RIJCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AN]) LOCATION Heating/cooling:
Air conditioning
Job site address: 12070 SW Garden Place (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: Rokke Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Modify Ductwork Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
0 PROPERTY OWNER 0 TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 23.32
0 APPLICANT El CONTACT PERSON Attic/crawlspace fans 23.32
Business name:Gohman Mechanical,Inc. Other: 23.32
Fuel piping:
Contact name: Drew Gohman $14.15 for first four;$4.03 for each additional
Address: 14505 SE Hwy 212 Furnace,etc.
Gas heat pump
City/State/ZIP:Clackamas,OR 97015
Wall/suspended/unit heater
Phone:(503)658-1892 Fax: :(503)658-6925 Water heater
Fireplace
E-mail:Construction@gohmanmechanical.com Range
CONTRACTOR Barbecue
Business name:Gohman Mechanical,Inc. Clothes dryer(gas)
Other:
Address: 14505 SE Hwy 212
MECHANICAL PERMIT FEES*
City/State/ZIP:Clackamas,OR 97015 Subtotal
Minimum permit fee($90.00)
Phone:(503)658-1892 Fax:(503)658-6925 Plan review(25%of permit fee)
CCB lic.: 119952 State surcharge(12%of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name:Kelsea Phipps Date:08/17/2017 * Fee methodology set by Tri-County Building Industry Service Board
I.\Building\Permits\MEC-PermitApp-doc 09/09/10 440-4617T(I I/02/COM/WEB)
III City of Tigard • BUILDING DIVISION
Over-The-Counter (OTC)) Me chantcal Permit
Appointment Checklist
Permit Record#: /I/l EC,2 0/7-az.,2-/
Contact Name: /?E 4C Phone #: -S.3 -6,.$?P "/e.�
Business Name: 60#/14/1 t '•iL Appointment Date: 007 e ,e,, oil
Site Address: /,2p 7o SA.7 9- z. / �G-- Bldg/Suite#:
Project Name: /.,0 A.C'e S"O�77-C
Project Description: —Tj-Z ,_6- 49 ogle__
Related Record#:
GENERAL INFORMATION
*Class of Work: A) f. Occupancy Group: 6/ 5 ) Type of Construction: V- b
*Type of Use: aOregon Specialty Code:
Number of Stories: 1
FUEL FURNACES
Type: Furnace< 100K BTU Furnaces>= 100K BTU
Gas Pressure: Roof Top Unit(RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units> 10000 cfm - Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler(BTUs) Vent Fans Gas Line
Solid Fuel Fireplace/ Clothes D ers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire/Smoke Dampers Other Mechanical Units—Describe:
Total Project Valuation: $ 1S)0 o p
$ • Mechanical Permit Fee
$ ) j 8 . 6 Plan Review
$ -c. q. 12%State Surcharge
$ a-- Info Proc/Arch,Lg(over 11x17 $2.00)
$ Info Proc/Arch,Sm(up to 11x17$0.50)
$ Hourly Rate Fee
$ Hourly Rate State Surcharge
$ Misc.Admin Fee
$ Other:
$ Other:
Building Staff:
Date/Timet
$ F s'a.3 TOTAL FEES DUE
I:\Building\Forms\OTC_MEC_021116.docx
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12070 SW GARDEN PL, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Mechanical MEC2017-00621
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor