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Permit V CITY OF TIGARD MECHANICAL PERMIT 3 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00246 T I G AR l? 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2012 Parcel: 2S 113AB01201 Jurisdiction: Tigard Site address: 16260 SW UPPER BOONES FERRY RD Project: Game Day Subdivision: COUNCIL VIEW ACRES (LOTS 21 -44) Lot: 30 Project Description: Install (1) 3 -ton RTU and (2) 7.5 RTU's to include ductwork and grilles. Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES LP 14505 SE HWY 212 ATTN: N PIVEN CLACKAMAS, OR 97015 15350 SE 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 05/15/2012 $601.71 Class of Work: ALT Type of Const: Ill Plan Review 05/15/2012 $150.43 Occupancy Grp: S -1 Occupancy Load: 12% State Surcharge - Mechanical 05/15/2012 $72.21 Stories: 1 Info Process /Archiving - Lg $2.00 (over 05/15/2012 $2.00 11x17) Project Valuation: $20,000.00 Info Process /Archiving - Sm $0.50 (up to 05/15/2012 $8.00 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 $834.35 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: 3 Other Desc: Duct Work: 3 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 issua or if work suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Util Notification Center. Th.: rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or . irect questions to OUNC calli 51 .232.1987 or 1.800.332.2344. '' Iss ed By: , /' a2_444.4LiC Permittee Signature: , 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. Mechanical Permit Application FOR OFFICE USE ONLY City of Tigard CE+ Y TVED Received permit No.: v ° 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: 5 / � � / [ i , / ,a• Q0. 111 Phone: 503.718.2439 Fax: 503.598.1960 MAY 1 Plan Revie , : REM a 2012 Date/By: �j Inspection pection Line: 503.639 Y 6 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard - or.gov Notified/Method: Supplemental Information CITY ''rr �� OF TIGARD ��J TYPE OF WOf'INV DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* arc 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: $ c R el (CV " 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: 16260 SW Upper Boones Ferry Rd (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: Game Day Media 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 Install (1) 3 -Ton RTU and (2) 7.5 -Ton RTU To Include Ductwork and Grilles Gas fireplace 33.39 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 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) 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 _ Fireplace E -mail: jeremy@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 Phone: (503) 658 -1892 Fax: (503) 658 -6925 Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: 119952 State surcharge (12% of permit fee) TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 Authorized signature: days after it has been accepted as complete. ----.?"--- Print name: Jeremy Hu t Date: 05/15/2012 * Fee methodology set by Tri- County Building Industry Service Board 1'\Buitding \Permits \MEC- PermitApp.doc 09/09/10 440-4617T(II /02/COM/WEB) 711 11' q Building Division Over- The - Counter (OTC) Mechanical Permit TIGARD Check List Project Description: • APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: &C — Occupancy Group: .'" 1 Type of Construction: . it,' *Type of Use: z.(Q Oregon Specialty Code: 2410 Number of Stories: i FUEL FURNACES Type: Furnace < 100K BTU Furnaces >= 100K BTU Gas Pressure: 7— L3 Roof Top Unit (RTU) `?] Tons "7, rj 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 7— Solid Fuel Fireplace/ Clothes Dryers Gas Outlets '. _ Woodstove Duct Work 3 Gas Fireplace Fire /Smoke Dampers Other Mechanical Units — Describe: Total Project Valuation: $ 2 - ©1C3c� ( FEES DUE $ k)1 71 Mechanical Permit Fee • $ i 5O.4:j Plan Review $ -7_2 .74 12% State Surcharge $ 2i') Info Proc /Arch, Lg (over 11x17 $2.00) $ «C j 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: $ 834 TOTAL FEES DUE *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS = fire protection system; NEW = new; O1R = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. 1:\Building\Forms \OTC - MEC.docx 01/13/2011