Permit •
�"' t CITY �I�� ® MECHANICAL PERMIT
' i COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00646
' R DATE ISSUED: 12/19/2006
TIGAD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
,rsx`, PARCEL: 2S113AB - 00101
SITE ADDRESS: 16101 SW 72ND AVE BLDG A - 120 ZONING: IP
SUBDIVISION: PACTRUST BUSINESS CENTER LOT: JURISDICTION: TIG
Project Description: Relocate existing grills, install fan and ductwork to existing building system. Value: 81250.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 12119120( $72.50
[TAX] 8% State Surcha 12/19/20( $5.80
Total $78.30
Phone:
Contractor:
GOHMAN MECHANICAL INC
412 S BEAVERCREEK RD., STE 602
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -1588
FAX 503- 655 -0514
Reg #: LIC 119952
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copes of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. _ _
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections tha 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 A p . . s, � ,: *' ., ,, FOR O FFICE USE ONLY: ....
Pe '' -
City of Tigard Received
J b �� "•� Uate/By: (CI 1 Permit No 1' ��,- , b _ � oet
13125 SW 1 {all Blvd., Tigard, OR 97223 Plan Review / U la �f0 10
Phone: 503.639.4171 Fax: 503.598.��OC 2006 T: OtherPennic
Da,ei.. y:
Inspection Line: 503.639.4175 1 1
p (�� t`� Date React /B ;r. Juri El See Page 2 for
• Internet: www.ci.tigard.or.us CITY Or .0 iI3ARD Notified/Method: / Supplemental Information
BUILDING DIVISION _
TYPE OF:.WORK „. '. • _ r COMMERCIAL'TEE *•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.
Value: $ t
CATEGORY ,OF ;CONSTRUCTION i / (PCP
/
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 INFORM A ION "AND LOCATION.: '- . : - • Heating/cooling
Job site address. 4!/I I 01 6A..) 7z -4(requires `D O
Air ssite it e plan or an showin g t heap ump acement )
CCC ��/ cores l 14.00
City/ State/ZIP: < C a - Fumace 100,000 BTU (ducts /vents) 14.00
Fumace 100,000+ BTU (ducts/vents) 1 7.90
Suite/bldg. /apt. no.: De) Project name: N• % k k �r� __ Gas heat pump 14.00
Cross street/directions to job site: L��J//"` Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other 10.00
Tax map /parcel no.: Other fuel appliances
'DESCRIPTION OF WORK ;_ _ - . Water heater 10.00 I
�/�,' I Gas fireplace 10.00
I l7 6-A-re y-�5 i 1 q (2- IS Y�� % � \ Flue vent for water heater or gas
f fireplace 10.00
i /Lt .v aJ`,Q 4- C bt -, LL t �'� ST ", — Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
. • .. Chimney /liner /flue /vent 10.00
❑ PROPERTY :OWNER,; •. ;:�::. ..: ❑ TENANT Other: 10.00
Name: Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
., t crawls ace fans 10.00
•� `: ❑ 'APPLICANT � - - K1 , CONTACT PERSON Att c/ p
Other: 10.00 ,
Business name: Gohman Mechanical, Inc.
Fuel piping
Contact name: Mark Gohman $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 412 S. Beavercreek Rd. #602
Gas heat pump
City/State /ZIP: Oregon City, OR 9 Wa11 /suspended/unitheater
Phone: ( Fax: : ( ) Water heater
503 65 0 - 1588 503 655 -0514 Fireplace _
E -mail: mgohman@gohmanmechanical.com Range
CONTRACTOR
Barbecue
Clothes dryer (gas)
Business name: Gohman Mechanical, Inc
Other:
Address: 412 S. Beavercreek Rd. #602 •---- MECHANICAL PERMIT FEES*
City/State /ZIP: Oregon City, OR 97045 ,••• Subtotal paze,
Minimum permit fee ($72.50)
Phone: ( 503) 650 -1588 Fax: (503) 655 -0514 Plan review (25% of permit fee)
CCB lic.: Orego e 1199,2 2 State surcharge (8% of permit fee) �j St)
t TOTAL PERMIT FEE 7'., 3o
1 / ilk , This permit application expires if a permit is not obtained within 180
Authorized ature: ` '' r j 4 As. - days after it has been accepted as complete.
w • Fee methodology set by Tri- County Building Industry Service Board
Print n e: . , / g r i Date:
,. \tiudcing \Pcmus \MEC- PcrmitApp doc 12/03 440-- 1617T(I 1 /o:)coMr \il :B)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation , , Permit Fee
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to S5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up S1,396.50 for the first $100,000.00 and
S1.10 for each additional $100.00 or
1 fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i \ Building \Permits \MEC- PcmiitApp.doc 12/03 2
-art OF TIGARD
BUILDING'DIVISION PERMIT #: MEC2005.00646
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/1912006
Phone: (503) 639 -4171 �U
r � '
Inspection Requests (24 Hrs.): (503) 639 -4175 r''I I
INSPECTION WORKSHEET FOR DATE: 2/13/2007 TIME: 7 :02AM PAGE: 36
SITE ADDRESS: 16101 SW 72ND AVE BLDG A -120 CLASS OF WORK:
SUBDIVISION: PACTRUST BUSINESS CENTER LOT #: TYPE OF USE:
PROJECT NAME: OUALCOMM
DESCRIPTION: Relocate existing grills, install fan and ductwork to existing building system. Value: $1260.00
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: GOHMAN MECHANICAL INC PHONE #: 503- 650 -1608
Inspection Request Scheduled For: Date: 2/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 043326-01 503 -650 -1588 N
Corrections /Comments/ Instructions:
X11!—
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I isi , . -
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITI AL F ES ASSESSED
Inspector: Date: 0 C 67 Phone #: (503) 718- —