Permit II : CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC2011 00385
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/31/2011
�I{'rRU Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15115 SW SEQUOIA PKWY 180
Project: Spec Space Subdivision: PACIFIC CORPORATE CENTER Lot: 2
Project Description: Run approximately 40' of gas line to existing RTU for newly created tenant space.
Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES LP
14505 SE HWY 212 ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 658 -1892 PHONE:
FAX: 503 - 658 -6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/31/2011 $69.06
Class of Work: ALT Type of Const: Plan Review 08/31/2011 $17.27
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 08/31/2011 $8.29
Stories:
Project Valuation: $500.00
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 $94.62
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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 ..rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N. cation Cent-r... Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0091 You •:y ob -in a copy of the rules
or dire. questions to OUNC • callin• : 3.232.1987 or 1.800.332.2344. /
Issue. ;y: I / G[��'� ` P erm i ttee Signature: � I
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Call 503.639.4175 by 7:00 a.m. for the next available inspecti. 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 Application . FOR OFFICE USE ONLY
City of Tigard Received �� �� Permit No.: Q (/y �3g' T
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R I:)
Inspection Line: 503.639.4175 Date Ready/By: luris: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
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 profit.
CATEGORY OF CONSTRUCTION Value: $ 61:10
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. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
F' Air conditioning
Job site address:
/ S W �� (/ DI 2 J .i 1l1/�/ `
(requires site plan showing placement) 46.75
City /State /ZIP: Furnace 100,000 BTU (ducts /vents) 46.75
Suite/bldg./apt. no.: /10 - Project name: Vi� C - Furnace 100,000+ BTU (ducts /vents) 54.91
A) / 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
/(l('A/ q/(5.s 4 //Vt _ 76 ( k1.STM) . /E?77J Flue vent for water heater or gas
C_.QVL Y O l fireplace 23.32
/` V 1 Spii(k / ' 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: 2-D,„z-nz., v S i 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: (- 0</.. 3 a ® Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name:
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
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: /4115:7171,
Clothes dryer (gas)
)1 1A ° I Other:
Address: / 5/ o 5
!,t y Z JZ MECHANICAL PERMIT FEES*
City /State /ZIP: C L,6c led, l cyh . Subtotal
! Minimum permit fee ($90.00)
Phone: (� �3) �� - / D ca Fax.(5Q3) c .._ -_ c_,9,2 Plan review (25% of permit fee)
CCB lic.: 7/9 7 . c - a State surcharge (12% of permit fee)
TOTAL PERMIT FEE 191/41 - Authorized signature:
ca-0 � This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: rL` L % ' v ,✓ L Date: '_ - / J, * Fee methodology set by Tri- County Building Industry Service Board
, C\Building\Permits\MEC- PermitApp oc 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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