Permit as
CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: MEC2010 -00383
Date Issued: 08/03/2010
T I G AR Ei 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112DD00400
Jurisdiction: Tigard
Site address: 15912 SW 72ND AVE B17
Subdivision: OREGON BUSINESS PARK I Lot: 17
Project: JOHN CRANE INC
Project Description: Relocating grilles & diffusers.
Owner: FEES
PACTRUST Description Date Amount
15350 SW SEQUOIA PKWY SUITE 300
PORTLAND, OR 97224 Permit Fee 08/03/2010 $207.21
12% State Surcharge - Mechanical 08/03/2010 $24.87
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 $232.08
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
7r. _
Issued By: Permittee Signatur• • ' —
Ca 13.639.4175 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.
, =viy --e 71c:, n
Mechanical Permit Applict of =- FOR OFFICE USE ONLY
City of Tigard u 1 DateBya � � Permit No.: . 1L�1 ��
ill u
13125 SW Hall Blvd., Tigard, OR 972 IG 3 2010 .
Plan � NC Date/By: Other Permit: ^ p b -0000 Pho 503.639.4171 Fax: 503.598.9 0 a r /" •
TIGARD Inspection Line: 503.639.4175 F,.. Date Ready/By: luris See Page 2 for
Internet: www.tigard- or.gov ' n - Notified/Method: 1 Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value oftlie work
❑ New construction Addition/alteration/replacement
performed. Indicate the value (rounded_to.th st doll. r) of all
❑ Demolition Other: mechanical materials, equipment,.labor, overhead, an ro it.
Valu•: $ 5O00 °.o
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUI ' MENT / SYSTEMS FEE:*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special infor •lion use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description It . .. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /51/2. SW 7 0V ib A r Air conditioning
l f r.. (requires site plan showing placement) 46.75
City /State /ZIP: 7;C A jZ 0 97x2, q Furnace 100,000 BTU (ducts /vents) 46.75
7 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: S/(
O.V . g , 4,/L-, ../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 d cocAri K `F r e 5 7 J /Fros6R -5 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
Chimney /liner /flue /vent 23.32
PROPERTY OWNER ❑ TENANT Other: 23.32
Name: f 7 7 ., s 1 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: ( ) Gad! - , 3 Q V Fax: ( ) c:,,a q - 7 7 S S ' 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
Furnace, etc.
Address:
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)
�O/>/ LCflie ..c)i /6L Other:
Address: j q3 - S(= /7/,,,e7 Z / Z MECHANICAL PERMIT FEES*
City /State /ZIP: e'�C.: A te,if ill AS / ( Dyy 7 7 0 / 5J Subtotal (.. 207 }-)
Minimum permit fee ($90.00)
Phone: (S 6 ) 6 sy. egg Fax: (s ) s'-:"g - X901 Plan review (25% of permit fee)
CCB tic.: 1199,3 %
State surcharge (12 of permit fee) 4 ?A-1, 7
TOTAL PERMIT FEE 4 23)-, 0'
This permit application expires if a permit is not obtained within 180
Authorized signature: d ays after it has been accepted as complete.
Print name: 5Z:46' � Date: gi 0 ' Fee methodology set by Tri- County Building Industry Service Board
I \Building\Permits \MEC- Permit App doc 10/01/09 440.46 t 7T (1 I /02 /COM/WEB)