Permit CITY OF TIGARD MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: MEC2012 -00104
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/23/2012
Parcel: 2S113AA00700
Jurisdiction: Tigard
Site address: 16444 SW 72ND AVE B5
Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Ducts and grills for TI and replacing existing 2.5 -ton RTU.
Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY TRUST
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 02/23/2012 $305.56
Class of Work: ALT Type of Const: IIIB Plan Review 02/23/2012 $76.39
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/23/2012 $36.67
Stories: 1 Info Process /Archiving - Lg $2.00 (over 02/23/2012 $2.00
11x17)
Project Valuation: $8,500.00 Info Process /Archiving - Sm $0.50 (up to 02/23/2012 $13.50
11x17)
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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: 2 Vent Systems: Total $434.12
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 • .w the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952-001-0:•0 You may •.•tain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ �'` + `� • ittee ignature: a
Call 503.639.41 • .; a.m. for the next available inspe•.'on 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 1 Received o lagyMilliMillm
71 C 13125 SW Hall Blvd., Tigard, OR R ^ `' Plan Review - - t�p��,
Phone: 503.718.2439 Fax: 503.598.1960 O h •ermit:
Inspection Line: 503.639.4175 201 Date/By:
Ins Awie ` /L P • ,_
T I G A R D p FEB 2 3 Date Rea WT.' El See Page 2 for
Internet: www.tigard Notified/Method:
Igil Supplemental Information
L C � ITY OF T:GA D A,
TYPE OFD Ibk G U{ViSION 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.
Value: $ ` r ,s-To
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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 16444 SW 72 Ave (requires site plan showing placement) 46.75
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Pie dmont Vgc us 9k, Q �� Heat pump
CJY ZS !n (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
Push and pull 2.5 ton RTU with new 2.5 -ton RTU. To include ductwork and grilles. Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue /vent 23.32
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: Gohman Mechanical, Inc. Other: 23.32
Fuel piping:
Contact name: Jeremy Hunt $14.15 for first four; $4.03 for each additional
Address: 14505 SE Hwy 212 Furnace, etc.
Gas heat pump
City /State /ZIP: Clackamas, OR 97015 Wall /suspended/unit heater
Phone: (503) 658 -1892 Fax: : (503) 658-6925 Water heater
jeremy@gohmanmechanical.com Range
E -mail:
J y @gohmanmechanical.com 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 36; s-G,
Phone: (503) 658 -1892 Fax: (503) 658 -6925 Minimum permit fee ($90.00)
Plan review (25% of permit fee) -- x e ,3 /l
CCB lic.: 119952 ' / State surcharge (12% of permit fee) t G 7
TOTAL PERMIT FEE tf ,3y, 4 J.,
This permit application expires if a permit is not obtain d within 180
Authorized signature:
days after it has been accepted as complete.
Print name: Jeremy Hun Date: 02/23/12 ' Fee methodology set by Tri- County Building Industry Service Board
I :Building\Permits\MEC- PermitApp.doc 09/09/10 4404617T(II /02/COM/WEB)