Permit ii j ,,g CITY OF TIGARD MECHANICAL PERMIT
.n - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00579
.a _ Date Issued: 10/30/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
4 ,, ,,
:, , .a Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15875 SW 72ND AVE
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: Calypte Biomedical
Project Description: Modify ducts, install dehumidifier.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 10/30/2009 $130.46
PORTLAND, OR 97224 12% State Surcharge - Mechanical 10/30/2009 $15.66
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 $146.12
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules - . • pted by the Oregon
Utility Notifi atiaa. nester. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You - o.tain a copy . the rule1
or dir questions to Ol7N b 50 .246.6699 or 1.800.332.2344. dif
Iss d By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that bus' es day. '
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I�Mechinical Permit Application < . , r t ` � ,9 u � i . „
}� Rece ive
ae pT�
r . City of Tigard Permit No.: -
tY g Date/By: Re f�Roo t - D057
a � 13125 SW Hall Blvd., Tigard, OR 97
' a Phone: 503.639.4171 Fax: 503.598.E : ECE�IED Plan Review Other Permit:
Date/By:
. 1 . 1 try A • R D': Inspection Line: 503.639.417 Date Ready/By: Juris: 53 See Page 2 for
}--, Internet: www.tigard - or.gov oc 3 U 2009 Notified/Method: t o Supplemental Information
TYPE OF We OF l '1G Altij COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
VISION Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alt$c nt performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical material equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ / ' o
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ I- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total
JOB SITE. INFORMATION AND LOCATION Heating/cooling
- / 7/ _ Air conditioning
Job site address:
`�- 7 h 7_2 p D G? v (requires site plan showing placement) 46.75
City /State /ZIP: - /" 4e JD 021.... ' '9 2��riss Fumace 100,000 BTU (ducts /vents) 46.75
/ � 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: I Project name: c . , ~ - 7 - "z i v y 7-c- ./ ( - 7 / 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: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
y'/?�D /F / =- 52 L)t C7 C 7 77--E--x-e_.- Flue vent for water heater or gas
_ 9 — / fireplace 23.32
A/ ('�lii/ rD'a7Z ''✓ Log lighter (gas) 23.32
T 7 , .57 ^ :ef G L
(7/y . � 7 ,F ,11� Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue /vent 23.32
PROPERTY. OWNER I 0 TENANT Other: 23.32
Name:
p,,6c /7/ C / , 5 i O���J Ty 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: (j 3 ) �,p,cl/— l� 3 O ev Fax: ( ) toilet compartments, utility rooms) 23.32
• _ ❑ APPLICANT ❑ CONTACT PERSON . Attic /crawlspace fans 23.32
Other: 23.32
Business name: Fuel piping
Contact name: r �j 7- c $14.15 for first four; $4.03 for each additional
Address:
ill t.. -g .j i/ F urnace, etc. I
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
/� . C a J L---
Clothes dryer (gas)
Business name:
m a / �� C Other:
Address: /evs- D ----; ` 7\4 2 / .2 MECHANICAL PERMIT FEES*
City /State /ZIP: �� adG d -
,-) 1 U` 170 / 5 Subtotal
Minimum permit fee ($90.00) /,5 . 5/4i
Phone: ( 3) � 5 --- .e, - / qc,_ Fax: (50 - - /cola 5 Plan review (25% of permit fee) _ --'
CCB lie.: f/ c .,.°•7
Z .. - State surcharge (12% of permit fee) / IO O
TOTAL PERMIT FEE / 4 „, l am
This permit application expires if a permit is not obtained within 180
Authorized signature:`.. days after it has been accepted as complete.
Print name: e iyy t � t Date: / ��3 V61 * Fee methodology set by Tri- County Building Industry Service Board
l: 1iuilding1Permits \MEC- PermitApp.doc 10/01/09 440 -4617T (I I /02/COM/WEB)
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.
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