Permit CITY OF TIGARD MECHANICAL PERMIT
a
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00158
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/31/2008
PARCEL: 2 S 112 DA - 00800
SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
PROJECT: CAMBRIDGE INTEGRATED SERVICES
Project Description: TI - Relocating ducts and grilles. Project Value: $4,500
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 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
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 3/31/200E $130.00
[TAX] 12% State Surch 3/31/200E $15.60
Phone: Total $145.60
Contractor:
GOHMAN MECHANICAL INC
14505 SE HIGHWAY 212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
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 within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct • - ' • ns to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B / / % " (/ Permittee Signature: y
Call 503.639.4175 by 7:00 a.m. for inspections that usiness d
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.
.' Mgchanical Permit Application FOR OFFICE USE ONLY
'4. . — City of Tigard Received y . P e g 0 Permit No.: li a,/a/�8'�U /!
71 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review v�� ! _
_ • Phone: 503.639.4171 Fax: 503.598.1960 Da�By. Other Permit:
TI GARD Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard -or.gov Notified/Method: i 6 Supplemental Information
l
- r, . , TYPE ;OF, WORK - -s,. a.; , COMMERCIAL}: FEE* SCHEDULE = ,-0 SE CHECKLISZ
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 rofP tt.
CATEGORY OF .CONSTRUCTION Value: $ , 9S120
RESIDENTIAL EQUIPMENT / SYSTEMS FEES":
❑ l- 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 or heat pump
lob site address: is /i Eb 5/_ j/cy jA PKIV/ (requires site plan showing placement) 14.00
City/State /ZIP: Jj._76,0,0 C2 . pay Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: e2 cp Project name:CA sp/ Cy ,.Z /7 1 Gas heat pump 14.00
Cross street/directions to job site: 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
• , ,-..;fr.',.."' - Gas fireplace 10.00
,: C 1 T NCr eMeleggP 14 / /lektw Flue vent for water heater or gas
,�, fireplace 10.00
` e/ �
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
` <,� PROPERTY OWNER l . _I O TENANT 10.00
a Other.
Name: ` C27 .C/! Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
h' Singleduct exhaust (bathrooms,
Fax: ( ) toilet compartments, utility rooms) 6.80
Phone: ( ) Attic/crawlspace fans 10.00 • ❑ APPLICANT ❑CONTACT PERSON Other: 10.00
Business name: Gohman 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 .
503 658 6925 Water heater
Fax: Phone: (503) 658-1892 (503) Fireplace
E -mail: mark @gohmanmechanical.com Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Coltman Mechanical, Inc Other:
Address: 14505 SE Highway 212 MECHANICAL PERMIT FEES*
Subtotal
City/State/ZIP: Clackamas, OR 97015 Minimum permit fee ($72.50)
Phone: (503) 658 -1892 Fax: (503) 658 -6925 Plan review (25% of permit fee)
CCB lie.: 119952 State surcharge (8% of permit fee) 7
TOTAL PERMIT FEE
This permit application expires If a permit Is not obtained wit In 180
Authorized signature: days after It has been accepted as complete.
J
• Fee methodology set by Tri County Building Industry Service Board
Print name: > Jg � 1' /w1" Datc:3 dr
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.
•
I: \Building\Permits \NEC- PermitApp.doc 12/30/05 2 - -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00156
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/31/2008
Phone: (503) 639-4171 o�liI
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_'
INSPECTION WORKSHEET FOR DATE: 4/17/2008 TIME: 7:02AM PAGE: 11
SITE ADDRESS: 15'115 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: CAMBRIDGE INTEGRATED SERVICES
DESCRIPTION: TI - Relocating ducts and grilles. Project Value: $4,500
No Plan Review Required.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: GOHMAN MECHANICAL INC PHONE #: 503 658.1892
Inspection Request Scheduled For: Date: 4117/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 068557 -01 503-830-9691 N •
Corrections /Comments /Instructions:
•
`. PAS A ' ' RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL 2 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ . L
Inspector: Date: / Phone #: (503) 718- 7
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008.00156
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/31/2000
Phone: (503) 639 -4171 , 4 0,
Inspection Requests (24 Hrs.): (503) 639 -4175 - P:_..
INSPECTION WORKSHEET FOR DATE: 4/7/2008 TIME: 7:01AM PAGE: 34
SITE ADDRESS: 15115 SW SEQUOIA PKWY 100 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: TYPE OF USE:
PROJECT NAME: CAMBRIDGE INTEGRATED SERVICES
DESCRIPTION: TI - Relocating ducts and grilles. Project Value: $4,500
No Plan Review Required.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: GOHMAN MECHANICAL INC PHONE #: 503 - 1892
Inspection Request Scheduled For: Date: 4/712008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 067949.02 5038309691 Y
Corrections /Comments /Instructions:
•
•
L PASS / TIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
t❑ FAIL ' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
//,
Inspector: Date: 7 7 og Phone #: (503) 7187`