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Permit CITY OF TIGARD MECHANICAL PERMIT • I COMMUNITY DEVELOPMENT Permit #: MEC2011 -00575 1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/14/2011 TIGARD 13125 Parcel: 2S 112DC00500 Jurisdiction: Tigard Site address: 15895 SW 72ND AVE 250 Project: DaVita Nephrology Subdivision: FANNO CREEK ACRE TRACTS Lot: 40 Project Description: Install (1) exhaust fan in bathroom. Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES 14505 SE HWY 212 ATTN: N PIVEN CLACKAMAS, OR 97015 15350 SW SEQUOIA PKWY #300 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 12/14/2011 $69.06 Class of Work: ALT Type of Const: Plan Review 12/14/2011 $17.27 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/14/2011 $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 $94.62 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: Fire /Smoke Dampers: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N. • a on Cen Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or dir- questions to OUN b .Ilin. 503.232.1987 or 1.800.332.2344. Issu •d By: / / e Permittee Signat , ,f{ ` r ` Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • 12/13/2011 14:59 5036586925 GOHMAN MECHANICAL PAGE 02/03 it Mechanical Permit Application i.1)1. O1 I I(t: 1 si i l�( • City of Tigard DE C 13 2 011 •1 Pullin No,: � 01.0//' 40575 13125 SW Hall Blvd., f ard, ( }R 97223 Plan Review a Phone; 503.718,2439 Fax: 501598. DtoelBy: Other Permit: /3kpi 0 ".�Q .1's/„ 1 I t i ;tt I l lnspcction Line: 503.639.4175 CITY OF TIGAn M' Date Rcady/By hriA: la See Page z for Internet: WWW.tI�+ord- or.gov BUILDING DIVISIt ehod: TT -, Suitplcmcntntlnformation TYPE. +L F .R�G11�K. ' Cxlili M el 'F F. Sc 11' 1111111.E - t7$E Carzit - List Mechanical pit 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. Value: $ $500.00 C ATEGORY' O� CONSTRUCTION R 31YtE1t137ak'I:'E o / S►" i>V11fiS wxs ❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special iafomtrttio n USE cherkiixt. 0 Multi - family 0 Master builder ❑ Ot her: Description Ea. Total , I f ' ; JOB slum 11 AND LOCATION . . Heating/cooling: . ....•. ... , .. . .. . _ _ _ _ Air conditioning Job site address: 15895 SW 72nd Ave (requires site plan showing placement) , . _ 46.75 Purnac: 100.000 BTU (ducts/vents) 46.75 CCity/State/ZIP: 3 Tigard, OR 97224 _ Furnace 100,000 +13T11 (d„ eix/venta) 54,91 Suite/bldgJapL no.: 250 1 Project name: Davits Heat pump (rescues sitcplan showingplacemcnt) 61.06 • Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 . . __ -. - Residential broiler (radiator or hydronic) 23.32 .. Unit heaters (fuel -type. not electric), in -wall, in -duct, suspended. ctc. 46,75 Subdivision: Lot no.: - Flac/vent four any of above . 23.32 . .. _ .. ..... Other: _ .. . 23,32 Tax map/parcel no.: Other fuel appliances: '11:14111 ' ,OF 'WORK Water heater 23.32 Install (1) Exhaust Fan in Bathrrom Gas fireplace 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove r 33.39 • Wood fireplace/insert 23.32 ©1'R01'E1r1 Y flNV1 Rr ' [] TENANT Chimnev/lincr /iluc/vent 23.32 W - Other: 23.32 Name: Environmental exhauaat and ventilation: Address: Range hood/ether kitchen equipment 33.39 City /State/TLP: Clothes dryer exhaust 33.39 Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms, ... ._ toilet compartments, utility teams) 23.32 [:]' APPLICANT ' , • ►.'. CONTACT PERSON . ' Attidcrawls fans 23.32 Business name: Gnhman Mechanical, Inc. Other: 23.32 -^--- Fuel piping: Contact name: Jeremy Hunt _ St4.15 far liret four, $4.03 for each addltlonnl __ Address: 14505 SE Hwy 212 Furnace, etc. -- Gas heat pump _ City /State/ZIP: Clackamas, OR 97015 Wall /suspended/unit heater Phone: (503) 658 -1392 Fax:: (503) 658 -6925 Water heater Fireplace E -mail: jeremy(lgohmanmeehanicaLcnm Range • 'CONTRAC Ora Sn'the Business name: Cabman Mechanical, Inc. Clothes dryer (gas) Other; Address: 14505 SE Hwy 212 • 1141 ANICfii: imitait Csltt:s. City /State/ZIP: Clackamas, OR 97015 _ Subtotal 09.0G • Phone: (503) 558 -1892 Minimum permit (cc ($90.00) • r Fax: (503) 658 -592.1 Plan review (25% of permit fcc) 7. .2 CCB lie.: 119952 State surcharge (12% of permit fee) Mink . TOTAI, PERMIT FEE 'mil • Authorized signature; • Ws Permit application expirta if permit is not obtained within TN days after It has been accepted aR ewaplete, Print name: Drew Cobman I Date: 12/13/2011 JJJ I ' pee methodology pct by TO.County Building industry Service FimT r r1HUiidlnft \Perniu \MEC.Pamitnpp,doe 09/09/10 440.4617T (I1 /02/COM/WI t4