Permit ,, CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00661
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/21/2010
Parcel: 2S113AB01201
Jurisdiction: TIGARD
Site address: 16290 SW UPPER BOONES FERRY RD
Project: Dow Aerosciences Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: Mechanical for TI.
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 12/21/2010 $5,528.71
Class of Work: ALT Type of Const: Plan Review 12/21/2010 $1,382.18
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 12/21/2010 $663.45
Stories:
Project Valuation: $200,000.00
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 $7,574.34
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: ERV's (5)
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 ollow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-:190 You • . , obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 r 1 8 0.332.2344.
Issued By: `/ Permittee Signature. .
40111110 Call 5 7:00 a.m. for the next available inspe on date. /
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.
AZ, _ ' al0 /0 - o0c2t
Mechanical Permit Applicatio FO R O F F ICE U O : � ; ..
City of Tigard • R t Received rl, A ' permit No.: .
1 3125 SW Hall Blvd., Tigard, 0R , ' 4 . Date /By: /t �i 16
0 Review
Phone: 503.639.4171 Fax: 503.598 9 0 y �� :ts: � � Other Permit: J �O�t
raril p 1) 212010 D ate /B —
TIGARD
Inspection Line: 503.639.4175 Date Rea. • :y: luris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: ` ` 5 ' Supplemental Information
CITY OFF TIGARD
,a "'i a u Rre TY P �"R. . bi TAI{ utAl i mt ,ga , _ qr _r . - MMERCIAL ;SCHEDULE _ - USE CHECKL IST
Mechanical permit fees* are based on the val of the work
❑ New construction ®Addition /alteration /replacement performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
- : ', c CA7 EGORY OFs CONSTRUCTIOn :' '' i, D Val $ r
x.. RESI ENTIAL EQUIPMENT'/ SY TEMS FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB STTE I TORMAIION A LOCATION , , *4 j ` -: Heating/cooling
Air conditioning
Job site address: 16290 SW Upper Boones Ferry Rd
(requires site plan showing placement) 46.75
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: Project name: Dow Bldg E 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) 2332
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
`fax map /parcel no.: Other fuel appliances
.• N - y .. h DESCRIPTION OF AWORK 0 j ; '' Water heater 23.32
Gas fireplace 33.39
Install 5 RTU Exhaust, Gas, Piping, and Duct Work 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
w 4 ,., Chimney /liner /flue /vent 23.32
® PROP -ERTY :OWNER " 2 `�� "' r - TENANT Other: 23.32
Name: Pactrust Environmental exhaust and ventilation
Range hood /other kitchen
Address: 15350 SW Sequoia Parkway Suite 300 equipment 33.39
City /State /ZIP: Tigard, OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)624 -7787 Fax: (503)624 -7755 toilet compartments, utility rooms) 23.32
0 a w° APPL ) � r .. CONTACT PERSON A' Attic /crawlspace fans 23.32
Other: 23.32
Business name: Fuel 1 in
PP g
Contact name: 514.15 for First four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax:: ( )
Water heater
Fireplace
E -mail: Range .
a , ; ; .'.2".„..w.):40 ,, ,,:- , ':,,-...,, ,,,, , ,, '
C OCT
ROR t ,, �, y ', f ; ... Barbecue
Business name: Gohman Mechanical, Inc. Clothes dryer (gas)
Other:
Address: 14505 SE Hwy 212 =MECHANICAL PLRSH f FOES* 2
City /State /ZIP: Clackamas, OR 97015 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 658 -1892 Fax: (503) 658 -6925
Plan review (25 %of permit fee)
CCB lic:: 119952 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 7 5 , .- Li
Y This permit application expires if a permit is not obtained w.thin 180
Authorized signature: g days after it has been accepted as complete.
Print name: Jeremy Hunt Date: 12/21/2010
* Fee methodolog,y set by Tri- County Building Industry Service Board
I:U 3uil ding \Permits1MEC- PermitApp.doc 10/01/09 440 -4617T (1 I /02 /COM/WEB)
Building Division
Over- The - Counter (OTC) Mechanical Permit
TIGARD Check List
Description of Project:
GENERAL INFORMATION
Class of Work:* i\--(7 Floor Furnace: Evap. Coolers:
• Type of Use:* . Unit Heaters: Vent Fans:
Occupancy Group: Vents w/o Appl.: Vent Systems:
Stories: 1 Boilers, Comp, Heat Pump, A /C: Hoods:
Fuel Types: • 0 - 3 HP: Domestic Incinerator:
ELC / GAS / NG / OIL / OTHER 3 - 15 HP: Com. /Ind. Incinerator
Max Input: BTU: 15 - 30 HP: Repair Units:
• Fire Dampers: 30 - 50 HP: Wood Stoves:
Gas Pressure: H / M / L >50 HP: Clothes Dryer.
No. of Units: Air Handling Units: Other Units:
Furnace <100k BTU: 5_10,000 CFM: Gas Outlets:
Furnace >_100k BTU: >10,000 CFM: sA
• Notes:
INSPECTIONS 1 FEES DUE
•
Post /beam mechanical $ Permit Fee
Gas line $ State Surcharge
Mechanical rough -in $ Plan Review Fee
Fire damper $ Additional Permit Fee
Duct work $ Additional Plan Review Fee
Smoke detector $ Investigation Fee
Investigation inspection $ Misc. Fee
Misc. inspection $ Hourly Rate Fee
Final inspection $ Hourly Rate State Surcharge
$ Total Fees Due
OTHER PERMITS REQUIRED
Building Electrical
Plumbing Site Work
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure.
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
. or canopies); REP = 'repair.
•
I:\Building\Forms \OTC - MEC.doc 09/22/06