Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00750
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/17/2008
PARCEL: 1 S134AA -01800
SITE ADDRESS: 10180 SW NIMBUS AVE J3 ZONING: I -P
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT: 002 JURISDICTION: TIG
PROJECT: EID PASSPORT
Project Description: Install (1) 2ton ductless split system and modify existing grill locations.
Project Value: $7,500
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
ROBINSON, CONSTANCE A + Description Date Amount
ROBINSON, LYNN + BELL, KAY ET
BY INSIGNIA COMMERCIAL GROUP [MECH] Permit Fee 1/17/200E $186.50
BEAVERTON, OR 97008 [MECPLN] Plan Rev 1/17/200E $46.63
[TAX] 8% State Surcha 1/17/200E $14.92
Phone: Total $248.05
Contractor:
GOHMAN MECHANICAL INC
CLAC K A M AS, OR 212
9 7 015 REQUIRED ITEMS AND REPORTS
CLACAAS, OR 90
Contact #: PRI 503- 658 -1892
FAX 503- 658 -6925
Reg #: LIC 119952
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started withi 80 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopter in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obt copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: AteeA„, Permittee Signature: a A
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
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 (D(£ 3 'r 1 iki I1uou. 5 Received •, . . j, Permit /4 7,0075D
11 1 1 IS ' • 13125 SW Hall Blvd., Tigard, OR 97 `� Plan Review Eli Phone: 503.639.4171 Fax: 503.598 �� Date/By: fj��Ec( Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Imo' 65 See Page 2 for
Internet: www.tigard- or.gov DEC 8 2 L 00 1 Notified/Method: I e 36 /7 !C Supplemental Information
Ldhti 0 , LaiC ._ - --
r ` E .OF, woevy oFTIGf.RI) COMMERCIAL`. E ".,SCHEDULE -„USE CHECKLIST;.
EOVIS ON Mechanical permit fees' are based on the value of the work
❑ New construction Addition/alter�� performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION. , •■ • Value: $ 7� 00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ l- and 2- family dwelling D.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 or heat pump
Job site address: 0/8/7 i z)//,,,,,,....?5 (requires site plan showing placement) 14.00
City/State/ZIP: - Furnace 100,000 BTU (ducts/vcnts) 14.00
�� �� / ��� Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: J t Gas heat pump 14.00
Cross street/directions to job site: c / 1 / PA-3510021 Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
• • ' DESCRIPTION OF WORK • . ' . . • Water heater 10.00
Gas fireplace 10.00
' - P( 2 -0 v (D y 6 - D—}. ,4 � I (I vt—a -r eS5 Flue vent for water heater or gas
,, pp _ �� ( l fireplace 10.00
U ral rS e.`. J i�l f7 ► 7t �t ST, t� tJC. Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
x: - :.;. ❑ PROPERTY OWNER, - '. I ❑TENANT: Other. 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( )
Fax: ( ) toilet compartments, utility rooms) 6.80
ace fans 10.00
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace 10.00
Other:
Business name: Coltman Mechanical, Inc. Fuel piping •
Contact name: Mark Gohman • $5.40 for first four; $1.00 for each additional
• Furnace, etc.
- Address: 14505 SE Highway 212 • Gas heat pump
City/ State/ZIP: Clackamas, OR 97015 Wall/suspended/unit heater .
I Fax: (503) 658 -6925 Water heater
Phone: (503) 658 -1892 ( ) Fireplace
E -mail: mark @gohmanmechanieal.com Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Coltman Mechanical, Inc Other:
Address: 14505 SE highway 212 MECHANICAL PERMIT FEES*
City /State /ZIP: Clackamas, OR 97015 Subtotal
Minimum permit fee ($72.50)
Phone: (503) 658 -1892 ax: (50 658-6925
/ ------- . Plan review (25% of permit fee)
CCB lie.: 119952 State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE i/}1.
This permit application aspires If a permit Is not obtained within 180
Authorized si ature: // ASP `� days after It has been accepted as complete.
Date: 7 , ° � ' Fee methodology set by Tri -County Building Industry Service Board
Print name: u. ti �
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$ 50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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:\ Building \Permits\MEC- PermitApp.doc 12/30/05 2
CITY OF TIGARD -
BUILDING DIVISION PERMIT #: MEC2007 -00760
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/17/200t2
Phone: (503) 639 -4171
A 11' ,� I
Inspection Requests (24 Hrs.): (503) 639 -4175 . -,...� —
INSPECTION WORKSHEET FOR DATE: 1/24/2008 TIME: 7 :02AM PAGE: 41
SITE ADDRESS: 10160 SW NIMBUS AVE J3 CLASS OF WORK:
SUBDIVISION: SCHOLLS BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: EID PASSPORT
DESCRIPTION: Install (1) 2ton ductless split system and modify existing grill locations.
Project Value: $7,500
OWNER: ROBINSON, CONSTANCE A +, PHONE #:
CONTRACTOR: GOHMAN MECHANICAL. INC PHONE #: 503
Inspection Request Scheduled For: Date: 1f24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 063845 -02 503- 380 -8229 N
Corrections /Comments /Instructions:
l
( ij
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I/ / V ? Phone #: (503) 718 -
CITY OF TIGARD _
1 BUILDING DIVISION PERMIT #: MEC2007- 00750
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1712008
Phone: (503) 639 -4171 � ( I
' Inspection Requests (24 Hrs.): (503) 639 -4175 ` I � ..
INSPECTION WORKSHEET FOR DATE: 1/24/200 TIME: 7:02AM PAGE: 42
SITE ADDRESS: 10180 SW NIMBUS AVE J3 CLASS OF WORK:
SUBDIVISION: SCHOLL'S BUSINESS CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: EID PASSPORT
DESCRIPTION: Install (1) 2ton ductless split system and modify existing grill locations.
Project Value: $7,500
OWNER: R013INSON, CONSTANCE A +, PHONE #:
CONTRACTOR: GOHMAN MECHANICAL INC PHONE #: 503658 -1692
Inspection Request Scheduled For: Date: 1/24/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 �5 Duct work 063845-01 503 - 380.8229 N
Corrections /Comments /Instructions:
i ji/PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
\,‘: 2'— Z VLy
Inspector: Da Phone #: (503) 718-