Permit CITY OF TIGARD MECHANICAL PERMIT
' ;. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00063
�KK,AR,D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/02/2012
Parcel: 2S113AA00600
Jurisdiction: Tigard
Site address: 16180 SW 72ND AVE B1
Project: Ford Graphics Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Replacing RTU with (2) new fans.
Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES
14505 SE HWY 212 ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE 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 • 02/02/2012 $319.61
Class of Work: ALT Type of Const: I ll Plan Review 02/02/2012 $79.90
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 02/02/2012 $38.35
Stories: 1 Info Process /Archiving - Lg $2.00 (over 02/02/2012 $2.00
11x17)
Project Valuation: $9,000.00
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 $439.86
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 t. • low the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -00 0090. You may •.tai- a copy of the rules
or direct questions to O k C by calling 503.232.1987 or 1.800.332.2344.
� 7
Issued By: Permittee Signature: _ L
—__ Call 503. . :00_a.m.- for_ the..next.available _ inspecti•ndate.
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 �� Received
-D FOR OFFICE USE'ONLY
y
City of Tigard ^ Date/By: . V �� Permit No.., _ 'J. (,
q 13125 SW Hall Blvd., Tigard, OR 97 2 1L -
Phone: SW Hall
Fax: 503.598.1960 $ 1-� Plan Review ► .
Date/By: jilt `
T CG A R D Inspection Line: 503.639 F r� r p� l� A` Date Ready/By: ® See Page 2 for
Internet: www.tigard- or.gov `�� OG ` t � 1`i Notified/Method: / V 1 1 Supplemental Information
C1
1� � p 5 ) 1 J
TYPE 0 OF W 21� ' * COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
A / Mechanical permit fees* are based on the value of the work
—
❑ New construction ddition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, 1 Qr, overhead, and profit.
Value: $
CATEGORY CONSTRUCTION RESIDENTIAL EQUIPMENT/ SYSTEMS FEES*
❑ 1 - and 2- family dwelling ommercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: / (, / 0 - 5 Li" 7,2 Al r' A v L • (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: r/, L1D ®c , Fumace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump
J `a / k ' � ?/ 1 r✓ s (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
� _ C ' -(r I Gas fireplace ent 33.39
C�l -� � / Sr, STS r � 1 v Flue vent for water heater or gas
'M./AV 7) J'S'TI'i i3 D� fireplace 23.32
/Ai
3 U I �` Log lighter (gas) 23.32
(,-) - -r- r- Wood /pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
1 G 71-7Z. v 57-
Other: 23.32
Name: 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
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Other:
Address: /277-5- 5 A7 /,. MECHANICAL PERMIT FEES*
111, City /State /ZIP: ,,,,,e ., n g - 9 7t7 4 Subtotal
�`�3) Fax: (_ y Minimum permit fee ($90.00)
Phone:
/ oZ SI5 -C," ` i� go7'j Plan review (25% of permit -fee)
CCB lie.: v/ Q 93 State surcharge (12% of permit fee)
. TOTAL PERMIT FEE 1 , pp Authorized signature. � This p ermit application expires if a permit is not obtaiwithin 180
days after it has been accepted as complete.
-
Print name: • Air /s , � , ' Date: q7 * Fee methodology set by Tri- County Building Industry Service Board
1: \BuildingWermits \MEC- PermitApp. 08 c 09 /09/10 44 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.
L\ Buildin \Permits \MEC- PermitApp.doc 09/09/10 2