Permit a CITY OF TIGARD MECHANICAL PERMIT
; COMMUNITY DEVELOPMENT Permit #: MEC2010 -00594
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2010
Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16320 SW 72ND AVE B3
Project: SERVICE PARTNERS Subdivision: OREGON BUSINESS PARK I Lot: 0
Project Description: Replace ducts with new.
Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES
14505 SE HWY 212 15350 SW SEQUOIA PKWY #300
CLACKAMAS, OR 97015 PORTLAND, OR 97224
PHONE: 503 - 658 -1892
PHONE: 503 - 624 -6300
FAX: 503 - 658 -6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/18/2010 $263.41
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/18/2010 $31.61
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $7,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $295.02
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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
applica. .w. • ••: will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
iss ce, or if work is sus. ded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
ility Notification Center. Tho - rule :e set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -00•r. You '� ob:in a copy of the rules
or direct questio s to OUNC b callin. ..232.1987 or 1.800.332.2344.
I
Issued By: — / /. Permittee Signature: A
Call 503.639.4175 by 7:00 a.m. for the next available inspectio date. O
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 C
FOR OFfICC t1,5E�ONLI' '"
City of Tigard Date/By: = Permit No. N - (O �00 5
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review I
li g Phone: 503.639.4171 Fax: 503.598.1960 DDate/By: Other Permit: Jo r n
i , o - • ,
T I G A It D Inspection Line: 503.639.4175 Date Ready /By: Juris: Ed See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
` TYPE OF WORK COMMERCIAL, FEE* SCHEDULE - USE CHECKLIST
❑ New construction jAddition/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, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 7 n
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 INFORMATION AND LOCATION • Heating/cooling
// �a 8 i t, 7
Air conditioning
Job site address:
j 5 /� ► � A v� B 3 (requires site plan showing placement) 46.75
City /State /ZIP: 77-<- �,4 ,z 0 01— Fumace 100,000 BTU (ducts /vents) 46.75
Fumace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: 52r le tocc. /p A0 - z55 Ai 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
,d - C_C- ,iG77 7 vt// % // A/6 _ 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: p,6 . i z US 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: 03 -) 2 / --6321Ei Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: piping
Contact name: /� _ / Q Fuel P $14.15 for first four; $4.03 for each_ additional
Address: ✓
5 ' Furnace, etc.
5/174t Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:
90 ,,,,A, fit_ Ndiri<r Other:
Address: p/s s L. PA7 Gl t MECHANICAL PERMIT FEES* 4(
City /State /ZIP: ��d� , s �� Subtotal
l Minimum permit fee ($90.00) $90.00)
Phone: (S63) r ,/� q Fax: ) 6 �:,,, Plan review (25% of permit fee) _.d
CCB lic.: / / of State surcharge (12% of permit fee) 3 / - (p/
TOTAL PERMIT FEE #? 95-, 072,
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: j----'- At_/,.T Date: * Fee methodology set by Tri- County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 10/01/09 440 -4617T (11 /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
•
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