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Permit 'A CITY OF TIGARD MECHANICAL PERMIT B COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00404 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/4/2008 PARCEL: 2 S 112 DC -00100 SITE ADDRESS: 15605 SW 72ND AVE ZONING: I - SUBDIVISION: OREGON BUSINESS PARK III LOT: 002 JURISDICTION: TIG PROJECT: NIKE Project Description: Gas line. Separating utilities. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M 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: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 -WMI PORTLAND, OR 97224 [MECH] Permit Fee 8/4/2008 $72.50 [TAX] 12% State Surch 8/4/2008 $8.70 Phone: Total $81.20 Contractor: GOHMAN MECHANICAL INC 14505 SE HIGHWAY 212 CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 658 -1892 FAX 503- 658 -6925 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 or 1.800.332.2344. Issued By: / /„ ` r Permittee Signature: �0 C . ' Or 9.4175 by 7:00 a.m. for inspections that siness i ay. 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 Application FOR OFFICE USE ONLY City of Tigard t°* ® Received Date/By: D G ©vE Permit No.: �!��V�! • ` ® • 13125 SW Hall Blvd., Tigard, OR 97223 V Plan Review ' ` shone: 503.639.4171 Fax: 503.598 .196 0 Date/By: Other Permit: Inspection Line: 503.639.4175 OQ� TIGARD Date Ready/By: IIMI ®See Page 2 for Internet: www.tigard- or.gov � � � 46) � otified/Method: Supplementallnformatlon „TYPE. OF, WORK �p� • ` \�4�, COMMERCIAL: FEE *,SCHEDULE -, IJSE CHECKLIST .. �JJ a ❑ New construction ❑ Addition/alteratior Mechanical permit s• are based on the value of the work > l4d �°� firm performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑Other: v� f mechanical materials, equipment, labor, overhead, and profit. • Value: $ / 6—'00 CATEGORY OF 'CONSTRUCTION // — •• RESIDENTIAL EQUIPME1PT / SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. J Ea. I Total JOB SITE INFORMATION AND LOCATION Heating /cooling Air conditioning or heat pump Job site address: /S ®‹ SW -7 PD L/ (requires site plan showing placement) 14.00 City/ State/ZIP: �w Fumace 100,000 BTU (ducts/vents) 14.00 I. ��.� '` //G Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: Aiiie . 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 r:-7- . - DESCRIPTION. OF WORK Water heater 10.00 • Gas fireplace 10.00 . •%'`.10 r 7,45 /00 / 6,F- � A 5 G /B/E ,-:7271.-- Flue vent for water heater or gas fireplace 10.00 SL`'J7[,3Z4T) 0 ,4) OF i "JnL! 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 r. Name: Environmental exhaust and ventilation Range hood/other kitchen Address: equipment 10.00 Clothes dryer exhaust 10.00 City/ State/ZIP: Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ❑ CONTACT PERSON 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: 14505 SE Highway 212 Gas heat pump " City/State/ZIP: Clackamas, OR 97015 Wall/suspended/unit heater I Fax: (503) 658 -6925 Water heater Phone: (503) 658 -1892 ) Fireplace E -mail: mark @gohmanmechanical.com Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: Gohman Mechanical, Inc Other: Address: 14505 SE Highway 212 MECHANICAL PERMIT FEES* Subtotal City /State /ZIP: Clackamas, OR 97015 Minimum permit fee ($72.50) 503 Phone: (503) 658 -1892 I Fax: (503) 658 -6925 Plan review (25% of permit fee) CCB lic.: 119952 State surcharge (8% of permit fee) ,77 Authorized signature: ,, TOTAL PERMIT FEE al-) <^E / V----- ` )j al-) This permit application expires If a permit Is not obtained within 180 days after It has been accepted as complete. Print name: D - 1:: — L�� � �fr ,, � Date: y/6 g I • Fee methodology set by Tri County Building Industry Service Board Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • Commercial Fee Schedule: Total Valuations Permit}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. 6 11-7 I:\ Building \Permits\11EC - PcrmitApp.doc 12/30/05 - 2 CITY OF TIGARD .. BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ML.C200E�Otk1O4 Phone: (503) 639 -4171 :Mil 0/4/2000 Inspection Requests (24 Hrs.): (503) 639 -4175 �_ INSPECTION WORKSHEET FOR DATE: 8/1412006 TIME: 7 :OOAM PAGE: 23 SITE ADDRESS: 1560,5 SW 72ND AVE CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK III LOT # 002 TYPE OF USE: PROJECT NAME: NIKE DESCRIPTION: Gas line. Separating utilities. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: GOHMAN MECHANICAL INC • PHONE #• 503 - 656.1892 Inspection Request Scheduled For: Date: 8,14/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 2& Gas line 074169 -01 503 - 793 -8761 Y Corrections /Comments /Instructions: Seeay",/ M,4 Sae- rea r r4- c.)0.-{ _e) 8-/3-08 c,3 , t g 0F 2,S -J 6' eo , C_i is .E ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: �` Date: , (i4G CO '' Phone #: (503) 718- CITY OF TIGARD - , BUILDING DIVISION - --T. PERMIT #: MEC2008 oa4o4 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 8/4/2008 Phone: (503) 639 -4171 Amitoo dI Inspection Requests (24 Hrs.): (503) 639 -4175 ";11.‘ INSPECTION WORKSHEET. FOR DATE: 8113/2008 TIME: 7:00AM PAGE: 25 SITE ADDRESS: 15605 SW 72ND AVE CLASS OF WORK: SUBDIVISION: OREGON BUSINESS PARK III LOT #: Q02 TYPE OF USE: PROJECT NAME: NIKE DESCRIPTION: Gas line. Separating utilities. OWNER: PACIFIC REALTY ASSOCIATES, PHONE #: CONTRACTOR: GOHMAN MECHANICAL INC PHONE #: 503. 658 - 1892 Inspection Request Scheduled For: Date: 8/13/008 Pour Time: Code # Inspection Description Confirm # Contact # Messa.: 610 Gas line 074116 -01 503 -793 -8761 ._------ , 01;30 Corrections /Comments /Instructions: t Z " Ltikl 60 eLGZ F 2 73 • ❑ PASS %1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS I/ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: _ Date: O /3 CJ 8 Phone #: (503) 718- Zgi