Permit Abdo CTYOFT
- •• .
TIGARD MECHANICAL PERMIT / C21-4 y 1 ". DEVELOPMENT SERVICES PERMIT #: MEC2005 -00089
r�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/4/2005
PARCEL: 1 S135BA -00102
SITE ADDRESS: 10104 SW WASHINGTON SQUARE RD A -2A
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Remarks: Mechanical TI, adding (2) returns. Project Value: $600
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA #300 [MECH] Permit Fee 3/4/2005 $72.50
PORTLAND, OR 97258 [TAX] 8% State Surchar€ 3/4/2005 $5.80
Phone: Total $78.30
Contractor:
GOHMAN MECHANICAL INC
412 S BEAVERCREEK RD., STE 602 REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 650 - 1588
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 questions to OUNC by calling (503)246 -6699.
Issued = � '' ��� =-' -� - Permittee Signatur -
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next b ess 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 ot Tigard
A Received 3 v 4:5
Date/By.
iew Permit No
Plan Rev Hiciae49.5-,-.e22.227
13125 SW Hall Blvd , Tigard, OR 97223
Phone 503 639 4171 Fax 503 598.1960 Date/By* Other Permit
Inspection Line. 503 639 4175 lit
i". A. --..
Date Ready/By luas„...--- 0 See Page 2 for
A
Internet www.ci tigard or us Notified/tvlethod. '7'7 , Supplemental Information
' '; -.... :-..-4- J%C '2. : ":i'5 44 . 11-k-filt*.I'Fi4.7.t."40.1:Df;Fi:''`..1-13C--P i' — USE CHECKLIST
0 New construction ddition/alteration/replacement
Mechanical permit fees* are based on the value of the work
A
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
e
.. t ir f;;Wl 2 ,..0 6 40 9 e,304trat t glliTet i r,44 : 44: 41 4. 4: wo-i---- , - -. 4; .. - - - V%lu: $
:::, ,..- "--41,;-,E0,,i / SYSTE MS FEES*
0 1 and 2 dwelling fUCommercial/industrial 0 Accessory building
For special information use checklist
ID Multi 0 Master builder 0 Other Description I QtY I Ea I Total
r., Heating/cooling
Job site address: 1 t9 / 4:72.- ...1■,/ iii/A6 e..er)rbil Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project nameite i / A ..... 1 ,. -
- 0 611(42 Gas heat pump 14.00
Cross street/directions to job site: ta i ,,b Aje 11 . 00 ,.. r 1e 7--- Duct work 14 00
Hydronic hot water system 14.00
0 . 41 eta (7 /;,./ 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
:' •. !'.. Water heater 10 00
'..- , 'J. -- *...•'f'"4 ,,, •,_ ... ,-,.:-...,—.t-r-- , ..-,-...2 '7-.. :...., '...-..rif A...:..-. :,-• ,,- -, .
Gas fireplace 10.00
//ti 6ritit 1.- 74/7/741/ GL/W..- 74th f Flue vent for water heater or gas
fireplace 10.00
( hi -ete /1./5 Log lighter (gas) 10 00
Wood/pellet stove 10 00
Wood fireplace/insert 10 00
Chimney/liner/flue/vent 10 00
'-,- .... Ci :. '- "- ' -,
i. k EN ANT - - - - , - , --- Other 1000
00
Name: _, a . n .,.... 7idc Environmental exhaust and ventilation
Range hood/other kitchen
Address /600 v ti A A l , equipment 10.00
City/State/ZEP r" 1 C:>2- Clothes dryer exhaust 10 00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax ( ) toilet compartments, utility rooms) 6 80
;',....';',..•;. 113'.• ,' •--.. iik:-4,-;:.,:., Attic/crawlspace fans 10 00
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: 412 S. Beavercreek Rd. #602 Gas heat pump
City/State/ZIP: Oregon City, OR 97045 Wall/suspended/unit heater
Water heater
Phone: ( 503 650-1588 Fax: : ( 503 655-0514 Fireplace
E mgohman@gohmanmechanical.com Range
1 _,i,; : ' ; 00' 4 =- • '. .,:.-":-,..-':?,;.':'- Barbecue
Clothes dryer (gas)
Business name: Gohman Mechanical, Inc
Other
Address: 412 S. Beavercreek Rd. #602 ,:zthirs,..:.,..ivikc:EafiidkiiiRM1Ti,ti§-11'
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($72 50) 72
Phone: ( 503) 650-1588 Fax ( 503) 655 Pl
-0514 , 6
an review (25% of permit fee)
CCB lic.: Oregon 119 52 State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7%. sa
Authorized signature zt 410/4/14: Thas permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name /./e4ril ,niafgrP5rr72-- I Date.0305-- • Fee methodology set by Tri-County Building Industry Service Board
■ N.13uddIng\Permtts\ MEC-PcrrrutApp dot 12/03 440-4617T (11/02/COM./WEB)
. .
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
$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.
osuildmeermits\MEC-PermitApp doc 12/03 2
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2005 -00089 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/4/2005
Phone: (503) 639 -4171 A Inspection Requests (24 Hrs.): (503) 639 -4175 _._,It
INSPECTION WORKSHEET FOR DATE: 3/1512005 TIME 7:13AM PAGE: 80
SITE ADDRESS: 10104 SW WASHINGTON SQUARE RD A -2A CLASS OF WORK:
SUBDIVISION: OAKBURG LOT #: 001 TYPE OF USE:
PROJECT NAME: ACTIVATE CELLULAR 167 0
DESCRIPTION: Mechanical TI, adding (2) returns. Project Value: $600 0
OWNER: EQUITY OFFICE PROPERTIES TRUST, PHONE #:
CONTRACTOR: GOHMAN MECHANICAL INC PHONE #: 503- 650.1688
Inspection Request Scheduled For: Date: 3/1512005 Pour Time:
Code # ' Inspection Description Confirm # Contact # Message ,,.-- -
699 Mechanical final 001650-01 503-650.1588 N '
./ , ,
Corrections /Comments /Instructions:
(PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 i 3�l S'� (503) Date: Phone #: (503 718-