Permit +� � , n k MECHANICAL PERMIT
n CITY OF TIGARD
° COMMUNITY DEVELOPMENT Permit #: MEC2010 -00202
Date Issued: 05/04/2010
iTIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
tSz„ ,_r,.,, 1,.'e{.: Parcel: 2S112DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE# 100
Subdivision: PACIFIC CORP CENTER Lot: 0
Project: Coca Cola
Project Description: Relocate ducts and grills
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 05/04/2010 $398.51
PORTLAND, OR 97224 12% State Surcharge - Mechanical 05/04/2010 $47.82
PHONE: 503 - 624 -6300
Contractor:
GOHMAN MECHANICAL
14505 SE HWY 212
CLACKAMAS, OR 97015
PHONE: 503 - 658 -1892
FAX: 503 - 658 -6925
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $446.33
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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. II work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issu• e, or if work is s peed for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ity Notification Center. Those r -s ar; set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You . obtain a copy of the rules
or direct questions to OUNC b ailing 503 '6.6699 or 1.800.332.2344. / Of
Issued By: � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 Applicati pppp , .. - oRi ti Fvio:l i i ;:y . -.
i t i '" �� Received
City Of Tigard yam+ (' DateBy: 7 t, /, e4/ Permit No.: M -. t k c.2
13125 SW Hall Blvd., Tigard, OR 9722 w , : F: a �i
4 Phone: 503.639.4171 Fax: 503.598.1960 : . C t Plan Review
Other Permit:
l
2 010 Date/By:
I c A IL I) ' Inspection Line: 503.639.4175 MAY ,4 Date Ready /By: ® See Page 2 for
:,,,_+•- , Internet: www.tigard - or.gov Notified/Method: //6 Supplemental Information
CITY OF TIGARD
• TYPE OF ■ING DIVISIOI 1 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.
CATEGORY OF CONSTRUCTION Value: $ A QC V
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ I- 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
•
Job site address: / 3 - 3 3 3 5),,/ J6� vr / A f�,�Ct G Aiconditioning
(reg(requires site plan showing placement) 46.75
City /State /ZIP: / � 7 . f , ( , 0 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name - Dc _ C fiz.A Heat pump 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
Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
/R-- -- 7. )0 )Z / % tv(j7Z / /C✓1l/ Flue vent for water heater or gas
FLOC- p fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney/liner/flue/vent 23.32
ROPERTY OWNER ❑ TENANT Other: 23.32
Name: Pxic / T lc , (1 � L / r/ 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: (3 G ay 6 3 pro Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping
Contact name: $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR . ' Barbecue
• Business name: Clothes dryer (gas)
n ot0hl v �L�
Other:
Address: / `' 05 s 47 a/. MECHANICAL PERMIT FEES*
City /State /ZIP: C7_,oC < Subtotal
Minimum permit fee ($90.00)
Phone: t 3 ) ( ;j - / g9 ^, Fax: S ) G -cd7� S Plan review (25% of permit fee)
CCB lic.: / /q o) �� State surcharge (12% of permit fee)
/ /)� TOTAL PERMIT FEE � L�, 3
( This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: t 7? . y 7 Date: f /� //� • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doC 10/01/09 440-46 7T
Mechanical Permit Application - City of Tigard •
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total. Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
l: \Buildin \Permits \MEC- PermitApp.doc 10/01/09 2