Permit CITY OF TIGARD MECHANICAL PERMIT
s Permit #: MEC2011 -00539
: - It ,- COMMUNITY DEVELOPMENT
1 3125 SW Hall Blvd., Tigard OR 97223 5 03.718.2439 Date Issued: 11/29/2011
TIGARD Parcel: 2S113AB01400
Jurisdiction: Tigard
Site address: 7376 SW DURHAM RD
Project: AMEC Environmental Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30
Project Description: Replace (6) RTU's with new curb adapters and units.
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 11/29/2011 $830.31
Class of Work: ALT Type of Const: Plan Review 11/29/2011 $207.58
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/29/2011 $99.64
Stories: Info Process /Archiving - Lg $2.00 (over 11/29/2011 $2.00
11x17)
Project Valuation: $29,000.00 Info Process /Archiving - Sm $0.50 (up to 11/29/2011 $14.50
11x17)
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 $1,154.03
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Curb
Duct Work: adapters
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 I II work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuanc , 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. The - rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0091 You may btain a copy of the rules
or di ect questions to OUNC :\ callini, 51 - 232.1987 or 1.800.332.2344. '
Iss d By: / / , ® Permittee Signature: 4
Pit
Ca11 503.639.4175 by 7:00 a.m. for the next available inspection .ate. I
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.
e Mechanical Permit App � FOR OFFICE USE ONLY
y � � /' _ —_
n f�� s� fx ° Rece CA
Ci of Ti and P No.: G CS
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V 13125 SW Hall Blvd., Tigard, OR W223 9 2011 Date / �� /' �O� �_DO� 3
tY9 Plan R Review .I t Mill � Other Permit:
Phone: 503.718.2439 Fax: 503.5 $.1�6
Inspection Line: 503.639.4175 Date/By: +' j/,
TI GAItD p TI(i yiD '' PP Date Ready/ :y: Juris: ® See Page 2 for
InteInternet: www.tigard- or.gov ���i �+ `. Notified/Method: Su lemental Information
IAA 1 95iG
YPE 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 ❑ ther: mechanical materials, equipment, labor, overhead, and profit.
Value: $ (2= 07(,
CATEGORY OF CONSTRUCTION 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
7 3 7 ( JOB SITE INFORMATION AND LOCATION Heating/cooling:
T - Air conditioning
Job site address: ;v 00)e N r-/ A yN (requires site plan showing placement) 46.75
City /State /ZIP: /vv Furnace 100,000 BTU (ducts/vents) 46.75
�/JrL �/,�- Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg./apt. no.: Project name: / C, L S- �✓rgn�C�'dG 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 33.39
1� �I�G.? eta" _ ,e / u is v✓J/1 / / -7K/ c (/2 e3 .>'7ro .4°S Flue vent for water heater or gas
/ fireplace 23.32
�JivD L/rs./ / S
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: J���� 7/ !/ . - 7 - / 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: 63 )G. y _.:5 Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT PERSON Attic /crawlspace fans 23.32
Business name: Other: 23.32
Fuel piping:
Contact name: [ ✓!ir .iL� Ly / �t Yk , j ,<,( /N7 $14.15 for first four; $4.03 for each additional
/C�' L�� Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR • Barbecue
Business name: N ,✓ 44,xi. /76 it/A,A, j C4 G ,C2J G Clothes dryer (gas)
Other:
Address: v5 S� l 4 � J 1 MECHANICAL PERMIT FEES*
City/State /ZIP: ��d� /z�,..rf i 1. 1_ 9 ` 7 0/ Ste
Subtotal
( C/ � — Minimum permit fee ($90.00)
Phone:
543) (� �- , / 'g,, (,— s) G- 9 - (.2.0,;,-;---- Plan review (25% of permit fee)
CCB lie.: //99 State (12% of permit fee) -
e surcharge
TOTAL PERMIT FEE � / 15Y.
1,
This permit application expires if a permit is not obtained/within 180
Authorized signature: /// days after it has been accepted as complete.
Print name: l�lyl I-- Date: / / / /jr' * Fee methodology set by Tri- County Building Industry Service Board
C\Building \Permits \MEC- PermitApp.doc 09/09/10 4 0 -4617T (I I /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.
1:\Building\Permits\MEC- PermitApp.doc 09/09/10 2
Building Division
r3
?
Over- The - Counter (OTC) Mechanical Permit
T I GARD Check List
Project Description: 1(
•
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: Type of Construction:
*Type of Use: COZi A Oregon Specialty Code: 20(0
Number of Stories:
FUEL
•
FURNACES
Type: Furnace < 100K BTU Furnaces >= 100K BTU
Gas Pressure: Roof Top Unit (RTU) Tons
Floor Furnaces Unit Heaters
Vents without Appliances Air Conditioning
Heat Pump
AIR HANDLERS HOODS
Units <= 10000 cfm Type 1 Hood Type 2 Hood
Units > 10000 cfm Grease Duct 1 Hour Shaft
Fire Wrap
APPLIANCES
Boiler (BTUs) Vent Fans Gas Line
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire /Smoke Dampers Other Mechanical Units — Describe: 6 .7) C.f:,1i(�
Total Project Valuation: $ Z� FEES DUE
$ - Mechanical Permit Fee
$ 7L) T, Plan Review
$ r�, 6• 12% State Surcharge
$ CO Info Proc /Arch, Lg (over 11x17 $2.00)
$ (A; f) Info Proc /Arch, Sm (up to 11x17 $0.50)
$ Misc. Admin Fee
$ Hourly Rate Fee •
$ Hourly Rate State Surcharge
$ Other:
$ Other:
Building Staff:
•
Date /Time: $ 054--, TOTAL 'EES DUE
*OPTIONS:
TYPE OF USE: COM = commercial; CMS commercial manu . •
CLASS OF WORK ACS = accessory; ADD ,addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system NE \xl — new O'I1 .n other (use for fences, decks, retaining walls, signs, awnings or canopies);
REP = repair.
L \Building\Forms \OTC- MEC.docx 01/13/2011