Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00108
T t G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/15/2011
Parcel: 2S113AB00600
Jurisdiction: TIGARD
Site address: 16160 SW UPPER BOONES FERRY RD
Project: Dow Agrosciences Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project Description: New RTU's, duct work, grilles & gas lines.
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 03/15/2011 $6,112.71
Class of Work: ALT Type of Const: Plan Review 03/15/2011 $1,528.18
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/15/2011 $733.53
Stories: Info Process /Archiving - Lg Sheet (over 03/15/2011 $12.00
11x17)
Project Valuation: $220,000.00 Info Process /Archiving - Sm Sheet (up to 03/15/2011 $80.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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 $8,466.42
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
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
issuan , or it ' • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
UN' Notification C- 'ter. ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -009 You may tain a opy of the rules
or irect questions to O by •; in 503.232.1987 or 1.800.332.2344.
Is ued By: l I Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection 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.
Mechanical Permit Applicat' FOR OFFICE USE ONLY
City of Tigard r l / E Date /By: ��� 1 Permit No.: -t �I1�etvo $
• 13125 SW Hall Blvd., Tigard, OR 972 3
Plan Review Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 MAR 1 5 2011 Date/By:
I 1 \ ,� I , I Inspection Line: 503.639.4175 Date Ready/By: Juris: Vi See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
("Try r c Trt %,1� pP
TYPE OF WORK. COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value 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 rofit.
Value: $ `� 0 Q C V
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 16160 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 A
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: Project name: Dow Bulding C Heat pump
(requires site plan showing placement) 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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace
New RTU's Ductwork, Grilles, and Gas Lines repla 33.39
Flue vent for r water heater or gas
fireplace 23.32
— Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: p
A , ? "U$T 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: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Other: 23.32
Fuel piping:
Contact name: $14.15 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
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Gohman Mechanical, Inc. Clothes dryer (gas)
Other:
Address: 14505 SE Hwy 212 MECHANICAL PERMIT FEES*
City /State /ZIP: Clackamas, OR 97015 Subtotal
Phone: (503) 658 -1892 Fax: (503) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 119952 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized Signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: -'1',�1 71V .,`, j Date: 3/ / / * Fee methodology set by Tri County Building Industry Service Board
1:\ Building \Permits \MEC- PermitApp.doc 09/09/ • 440 -46ITf ( I / 02/COM/WEB)