Permit CITY OF TIGARD MECHANICAL PERMIT
1 1 a COMMUNITY DEVELOPMENT Permit MEC2009 -00402
t Date Issued: 08/05/2009
T i G ARD 13125 SW Hall Blvd., Tigard OR 97223 503 639 4171 Parcel: 2S112DD00701
Jurisdiction:
Site address: 15800 SW UPPER BOONES FERRY RD 120
Subdivision: Lot:
Project: Jonathan Plant DVM
Project Description: Install (3) exhaust fans, relocate ducts, grilles and t- stats. No plan review required
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN N PIVEN, 15350 SW SEQUOIA PKWY
Permit Fee 08/05/2009 $170 30
#300
12% State Surcharge - Mechanical 08/05/2009 $20 44
PHONE
Contractor:
GOHMAN MECHANICAL
14505 SE HWY 212
CLACKAMAS, OR 97015
PHONE 503 - 658 -1892
FAX: 503 - 658 -6925
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm
Gas Pressue 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 $190 74
Hoods: Comm Incinerators:
Woodstoves Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers' Other Mech Units:
Gas Outlets Other Desc
Duct Work
Fire /Smoke Dampers
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100 You may obtain a copy of the rules
or direct . - ons tcrei. NC b = - ling 503.246 6699 or 1.800.332.2344.
Issue. By: /, Permittee Signature: \ \ ��
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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,.........e,, Mechanical Permit Applicatio
City oft-dice-eswego RE
PO Box 369 • 380 A Ave
Picj
kw; 0 zon PERMIT #
DATE RCVD f
Lake Oswego, OR 97034 5 l'
RCVD BY ellb i .
Ph k e: (503) 635-0390 • Fax: (503) 697-6574 I , DATE ISSUED
Website: www.ci.oswego.or.p
, OF 'wtoikk:. :,-...:::;', V,::':zi$*'- , ''.-" , ' bit:163 - 31\ 1143 ,L%MgitclApKt*,;.tcH04LE , L'aspiECKLipi-;, , ,
Mechanical permit fees* are based on the value of the work
12 New construction El Addition/alteration/replacement
performed. Indicate the value (rounded to nearest dollar) of all
0 Demolition 0 Other: mechanical materials equipment, labor, overhead, and profit.
tATEGORY,:OF 'tONSTRUD:TITD r,,'. ::T -..:J : Valuation: $ 6 b no . 00
,k,00):ENtig:t:OulOMEi3rt./OsTOWS,0*.',':
0 I- and 2-family dwelling l Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
: ' % - . '-' • 2 ; '1.' •:' ', "7.0:0'-`';$11-ftfOrtf-k—M-Atf01.' AND 0:440A ' ' . HEATING/COOLING
Job site address 15800 SW Upper Boones Ferry #120 Fumace 36.00
AIC — Heat Pump
City/State/ZIP: Lake Oswego, OR 97035 SITE PLAN REQUIRED 50.00
Suite/bIdglapt no.. 120 _ Project name. John D Plant Gas heat pump 50.00
Duct work 20.00
Cross street/directions to job site: Hydronic hot water system 50.00
Residential boiler (radiator
or hydronic) 29 00
Unit heaters (fuel-type, not
electric), in-wall, in-duct,
suspended, etc. 29.00
Subdivision: I Lot no.: Flue/vent for any of above 20.00
Other: 21.00
Tax map/parcel no.: ' i', ; !" .' :OTHEWFUEL APPLIANCES
OES,C:Ikki,tiON10F Gas fireplace 36.00
Flue vent for water heater
Install (3) Firhaust Farts and relocate ductwork A rd or gas fireplace 20.00
T—St
, Log lighter (gas) 36 00
_
Wood/pellet stove 36.00
Wood fireplace/insert 36.00
4::; ', ',:1; O - 0 : .- ' f.', .;,%-::'-',;';, gli: tONA
Chimney/liner/flue/vent 20.00
Name: Other: 21.00
'ENVIRONMENTAL EXHAUST. ANOVENTILATION
Address: Range hood/other kitchen
City/State/ZIP: equipment 22.00
Clothes dryer exhaust 13.00
Phone: ( ) Fax: ( ) Single-duct exhaust
Er ; ''':::::si CONTACT l,,,r (bathrooms, toilet
compartments, utility rooms) 1400
Business name: Gohman Mechanical, Inc. Attic/crawlspace fans 14.00
Contact name: Mark Gohman Other: 14.00
Fuel piping: (first four) 14.00
Address. SE Highway 212 Each additional outlet: 2.20 _
City/State/ZIP: Clackamas, OR 97015 CHECK FOR EACH GAS OUTLET USED '
Fumace 0 Gas heat pump •- 0
Phone: ( 503) 658-1892 I Fax. (503) 658-6925 Range 0 Watcr hcatcr 0
E-mail. mark@gohmanmechanical.com Fireplace El Wall/unit heaters - 0
. , • ' CONTRAtT013, .' -- ' , . ,,‘-,. "T`f, ' Barbecue 0 Clothes dryer (gas) 0
„ .
Other: 0
Business name: Gohman Mechanical, Inc. . . CANCELLED PERMIT NOTICE
Address: 14505 SE Highway 212 Cancellation of Permit must be at Owner's request; In
event of any fee refund, check will be Issued to Owner.
City/State/ZIP: Clackamas , OR 97015
MECHANICAL PERMIT FEES*
Phone. (503) 658-1892 Fax: (503) 658-6925 Subtotal /70 • 5
E-mail: mark@gohmanmechanical.com Minimum permit fcc Aaser
Plan review if Required (25% of permit
CCB lie.. 1 1 9952 I Metro/City lie. # 4788 fcc) e-
i x-i Statc surchargcierof permit fcc) - a gf
Authorized signature:
X - ) 1 1,--rt TOTAL PERMIT FEE
This permit application expires if permit is not obtained within
180 days after it has been accepted as complete
Print name.rt 0 rec., &Ohrela.ri Date: 0 g/5 61 • • Fee methodology set by Tn-County Building Industry Scrme Board
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