Permit C ITY OF TIGARD MECHANICAL PERMIT
�;� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00292
,.� I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/19/2004
PARCEL: 25101 DA -00101
SITE ADDRESS: 13190 SW 68TH PKWY 110
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: C -P
BLOCK: LOT: 003 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Relocate (3) grilles/hvac.
Owner: FEES
SCHNITZER INVESTMENT CORP Description Date Amount
PO BOX 10047 [MECH] Permit Fee 5/19/200 $72.50
PORTLAND, OR 97296 [TAX] 8% State Surcharl 5/19/200 $5.80
Phone: Total $78.30
Contractor:
GOHMAN MECHANICAL INC
412 S BEAVERCREEK RD., STE 602
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 - 650 - 1588 Mechanical Insp
Final Inspection
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 copies of these rules or direct questions to OUNC by calling
(503)246 -6699.
Issued By: t 67 Permittee Signatu
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechan4a1.Permit Application . FOR OFFICE USE ONLY
City of Tigard Received ,-
te/By: .. / i /0 (1 lf,Y..7 Permit No.: l71 /1 e_ V --Od
13125 SW Hall Blvd., Tigard, OR 97223 Da Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
,
Inspection Line: 503.639.4175
A ri k _.,_ 1 ' 7 Date Ready/By: Juris: 121 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: / /6 Supplemental Information
O
"
'..";:eil•:',..i :::lIi -.. / . i' .. /k'1,,,-.... , :.:P."7:':;?:'./ - • - Tr, ,,, . . . , . . .. ,; .,.. ..- ... — • '13 SECHECKLIST
Mechanical permit fees* are based on the value of the work
0 New construction 0 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
'Mc3.1W;f:...11:i".4_1;:t.":-V.'3*fMtiOk101071.5e1:. ..:47;4 Ft.. . . . . . . - — -
..::. ''..A /8YSTEMS FEES*
0 1 and 2 dwelling EKOmmercial/industrial D Accessory building
For special information use checklist.
0 Multi 0 Master builder 0 Other: Description 1 Qty. I Ea. I Total
4:)*,:§i.1040..414i1 : HeatinWcooling
Air condoning or heat pump
Job site address: 13 1 c n s t „, i pc 4, 4:1 i (requires site plan showing placement) 14.00
City/State/ZIP: prrruzN Jr') Furnace 100,000 BTU (ducts/vents) 14.00
--■, Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: sira 54....),
Gas heat pump 14.00
Cross street/directions to job site: 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
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: . 10.00
Tax map/parcel no.: Other fuel appliances Water heater 10.00
&;:i•-,.." 1 )..0cRIPT. J9N:4M. - ;;..! - * * " . . -, '11;t2.,:f" , =:; . : ,-- .1._ 1 _ , ;2 .. .: .:
. Gas fireplace 10.00
' Rc ler) c ta 3 s c% \ ‘es . +4visic Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
D T PHOPERTY.1)WNER !-.' :-.:::..4 , q ..-- A ,, -- a NANT - . -..:: ..: .
''''''"":.'.'" •-• . • ' " . - ' - . - ' ' -. - ' ' P ''' ' . s ' ": ' ' • ' . '' - — 1 ... 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
0 - [g - . :' . n 1 i; ., Attic/crawlspace fans 10.00
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 97045 Wall/suspended/unit heater
Water heater
Phone: ( 503 650-1588 Fax ' ( s0& 655-0514 Fireplace
E mgohman@gohmanmechanical.com Range
:';44::.'4,.r"lz;Z:.':•1;4:-;''.:W...,'.i-;:::,..:4'.,"....1:01iii..404-:;Lit';'..if--.:'::.";?.:::.'--_::4. :::?!:::,.. Barbecue •
Clothes dryer (gas)
Business name: Gohman Mechanical, Inc
Other:
Address: 412 S. Beavercreek Rd. #602 --MECRANICAPiPgRMIT:-.F,EES::
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($72.50) -v, L IZ )
Phone: ( 503) 650 Fax (503) 655
Plan review (25% of permit fee)
CCB lic.: Oregon 119952 State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7'6.
This permit application expires if a permit is not obtained within 180
Authorized signaturrnink days after it has been accepted as complete.
Print name: /140424 I Date' --Oil • Fee methodology set by Tri-County Building Industry Service Board
440-4617T (11/02/COM/WEB)
i \ Building \Permits \ MEC-PerrnitApp doc 12/03
Mechanical Permit Application - City of Tigard • - +
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation:- -Perinit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $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 $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
•
Note: All new commercial buildings require 2 sets of plans.
i:\ Building \Perrnits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
•= .BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
�
BUP
Received Date Requested (C \--- AM PM BUP
Location l� b� —�( �uite (1 D MEC - ---02
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof 1 '
Other: WWI P.
Final A IIW
PASS PART FAIL •
PLUMBING
Post & Beam
Under Slab
Rough -In .1
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
FAIL
MECHANICAL
Rough -In
Gas Line
S ampers
PART FAIL
L ' ICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE L Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS PART FAIL