Permit CITY OF TIGARD MECHANICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: MEC2009-00342
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/14!2009
Parcel: 2S 113AA01100
Jurisdiction: Tigard
Site address: 16588 SW 72ND AVE, BLDG# B11
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: Spec Space
Project Description: Rooftop unit, exhaust fan and gas piping.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee 07/14/2009 $168.50
#300 Plan Review 07/14/2009 $42.13
PHONE: 12% State Surcharge - Mechanical 07/14/2009 $20.22
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: Natural Gas 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: 1 Vent Systems: Total $230.85
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 0. copy of the rules
or direct questions to OUNC by calling 503 .246.6699 or
m yA Issued By: di amp Q A Q � Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business ay.
This permit card shall be kept in a conspicuous place on the job site until completion of the proj
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicaUCE1VED n IOR OI' IICI: usl: c)N1.).
ill
City of Tigard I'I Received / l r Permit No.: �Ll 5
13125 SW Hall Blvd., Tigard, OR 97223 L 14 2009 Plan
Date/By:
►� � �
Phone: 503.639.4171 Fax: 503.5 119660 Date/By: Af % Other Permit: OWr 7�
® Inspection Line: 503.639.4175 jj OF T IGARD Date Ready/By: INI ® See Page 2 for
Internet: www.tigard-or.gov
BUILD DIVISI Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ❑ Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labo , overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ �j 70 V
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/ � �
Air conditioning ho or in gt pump
Job site address:
r � � S �� � {) �! � (requires site plan showing placement) 14.00
City /State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
5 PL----c___, Gas heat 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:
}�CCi Gas heat pump 14.00
Cross street/diredions to job site: Duct work 10.00
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. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ Gas fireplace 10.00
I / - 7 - 0 r ?i w /�✓GT Pt eit /<-- Flue vent for water heater or gas
/ Fe ki fireplace 10.00
Log lighter (gas) 10.00
C S I'/ I" r7 Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Ot y/liner /flue /vent 10.00
Other: 10.00
Name: ,23 C - nee/ / Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
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:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Fumace, etc.
Gas heat pump
City /State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fa :: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: /7? 1 23 . ) �( --iy Clothes dryer (gas)
i-
Other:
Address:
Sp �'-' S ,vi„.. › G 2 i MECHANICAL PERMIT FEES*
City /State /ZIP: C _4 C. jL46 3 Subtotal
' � Minimum permit fee ($72.50)
i
Phone: (5t1) O lv I Fax: (' ) c25$ 69.2 S Plan review (25% of permit fee)
CCB lic.: //5 P, State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Civ:i Authorized signature. J days afte it has been accepted as complete.
Print name: .w I V L yv i Date: 7 / / I f y /ba • Fee methodology set by Tri -County Building Industry Service Board
(0II/ A40.4617T I I /02/COM/WEB
11Building�PermitsUl�C- PermitApp.dp 19107 ( )
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 $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:\ BuildingTermits \MEC- Permit.App.doc 01/19/07 2