Permit CITY OF TIGARD MECHANICAL PERMIT
11
s COMMUNITY DEVELOPMENT Permit #: MEC2012 00569
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/31/2012
Parcel: 2S112AD01000
Jurisdiction: Tigard
Site address: 14945 SW SEQUOIA PKWY 150
Project: RTM Investments Subdivision: PACIFIC CORPORATE CENTER Lot: 1
Project Description: TI
Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES LP
14505 SE HWY 212 ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SW 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: Permit Fee 10/31/2012 $347.71
Class of Work: Type of Const: Plan Review 10/31/2012 $86.93
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 10/31/2012 $41.73
Stories:
Project Valuation: $10,000.00
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 $476.37
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. M , r
Issued By: o' ! /r Permittee Signature: O ki 4 PPLIg 1 D�1.
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.
1 0/31 /2012 10:29 5036586925 GOHMAN MECHANICAL PAGE 03/03
Mechanical Permit Application
City of Tigard OCT 31 2012 eey to 1 all l.>- Pertn4 No.: R6e.,../.0 /a,• DO Slogs
13125 SW Hall Blvd., Tigard, OR 97223
Atm ' I Phone: 503.718.2439 Fax; 503.598.1960 �� D1te/B Review Other Permit: tQ�/r �Q� �� . bD t g y
T ( � ; 1i c) Inspection L ine: 503.639.4175 tc Ready/By:
I m, r
Internet www.tigard- or.gov B ILDtNG 55 Sec Page 2 for
DUI UlfYla ohfied/Mclhod; no
Supplemental information
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❑ New Construction Mechanical permit fees arc based on t value of the work "
® Addition /alterattOn /replacement' pmforrned. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
rA —'" -, �, ,s t :7,' w,p7� , r �;. t ,5. Value: $ $10,000 00
* 4 1' r .k ttN Slt� r 1 (r' - i M�f �`7� l,ta� (RJ "�1� 7. �i'!r" T �`,� :1 Y+l �y -..am5
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YL4 ■ q vt ..:. 44 .'.' 4 J 4� S ` cx , ^ , 1 r s l { � r � -7 � 1^n � �1et., . Wx -
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special infnrmer use checldttl.
❑ Multi - family ❑ Master builder ❑ Other: Descript
7 i .w .'� ' pF r �'7 q Z J 1 01 I Ti' y z j ,.. , .a Heating/cooling:
� Q tY• Fa Total
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Acr.. - •8.: .r .d :di .. Jr„ -4. fit•!", . ,, S t d �-L4 . . ¢ t \tj f .�' % .'r' - ,r.sT... Air cco i rdii
• -� .i ..,.a _s� r��ti.��:- AirwndiGlming
Job site address: 14945 SW Sequoia Pkwy (requires site plan allowing placement) 46.75
City /State /ZIP; Tigard, OR 7232
Furnace 100,000 BTU (duets/vents) 46.75
Furnace 100,000+ BTU (ducts/vent) 54,91
Suite/bldg./apt. no.: / 50 Project name: RTM Investments Neat pump
wires site tan ahowin keemcnt 61,06
Cross street/directions to job site: Duct work ) 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or "
h dmnic 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
Tax map /parcel no
Other- 23 32
g
G S � Other fuel appliances:
i wl] ..“ M 4 �-z z n�,lea:f $ Gi36 e7.. k v f;14 R rIA; wf . ° •if 1i Water heater 2332
r y. - .i ,tr ,...n r,.., :rr. ^,: _ ....1' ++ .4744,g.t.i.fe. 1 f :
Modifications to ductwork Gas fireplace/insert 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
G,',. nti�r: ✓" hc 1."9.2 ;A: „:: ° `i� 7.-,L7,77%,.-7,„..,.....,1.;,4-5.., s s `a rl ^.tr ?,Ia ot imney/lincr /ftue/vent W
23.32
.._ ...... ..-, .,w l.� ;s�z � • � .,'}�..j.:r+....a +t- i;,, Otltcr; �
Name: - 23.32 ,
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State/ZTP: Clothes d ex haust 33.39
Phone: ( ) Fax ( ) Single -duct exhaust (bathrooms,
toilet utility .32
X :
� may _.�„ �, T ,,., , compartment, utili rooms) 23
uy rs" 7 - '' hq 2 i.p.,i7f -:.7.17.-::1-17,470%.,
1'�t c C;'3 a4 i:; 0 i i rt- 9 ace flans
:;',4) : � 1 rf ..7 . 1 4. 'i%r ii . °. ,Z5A+ 1:'? AttiC/Ctawf p 23.32
Business name: Gohman Mechanial, line. Other, 23.32_
Fuel piping:
Contact name: Jeremy Hunt _ 514.15 fbr first four; $4.03 for each additional
Address: 14505 SE Hwy 212 Furnace, etc, _
City /State/ZIP: Clackamas, OR 97015 Gas heat Dump
Wall/suspended/unit heater
Phone: (503) 658 -1892 Fax:: (503) 658 -6925 Water heater
E -mail: jerenly @gohmanmechanicaLeom
Rang ax
Range
;i- fi ,-t , . t ufr^"' 1 r 7; e. J r" !t Barbecue
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Business name: Gohman Mechanical, Inc. Clothes d er as
—
Address: 14505 SE Hwy 212 Other
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City /State/ZIP: Clackamas, OR 97015 _ Subtotal
Phone: (503) 658 -1892 Fax: (503) 658 -6925 Minimum permit fee ($90.00)
Plan review (25 %ofpermit tbc)
CCB lie.: 119952 State su (12% of permit fee)
7, TOTAL PERMIT FEE 1 -}np . 37 ,
Authorized signature: + This permtt application expires if a permit is not obtained within 180
impA
1 days after It tuts been accepted as complete
Date: 10/31/12 • Fee methodology act by Tri- County Blrittting Industry Service Board
t:lattildoodnerrniti1wc- arm,itnpp. 0107/12 440.4017T (1 T /02/COM/Wes)
10/31/2012 10:29 5036586925 GOHMAN MECHANICAL PAGE 01/03
ohrnan
Wei — OW
echanical, Inc.
14505 SE Highway 212
Clackamas, Oregon 97015
Phone: 503-658-1892
Fax: S03-658-6925
wwwyohmanmechanlgl.com
DATE: OCTOBER 31, 2012
Send to: City of Tigard From:
Attention: Building Department Angie Gohman
Fax Number: 503 - 598 -1960 Administrative Assistant
Phone Number: 503 - 718 -2439 Service@gohmanmedJanIcal.com
Regarding: Mechanical Permit Number of Pages, Including Cover. 34(7--
❑ URGENT ❑ PLEASE REPLY ASAP ❑ PLEASE COMMENT RI PLEASE REVIE O FOR YOUR INFORMATION
COMMENTS:
Building Department Personnel,
Enclosed is the Permit Application for ductwork modifications being completed t 14945 SW Sequoia Pkwy along with
the Payment Authorization Form. Please review and process the permit. When complete please fax us back a copy of
the permit and payment for it.
Please let me know If you have any questions or concerns at your convenience.
Th - you,
Angle cohman
fax cover