Permit CITY OF TIGARD MECHANICAL PERMIT
`•''�I n COMMUNITY DEVELOPMENT Permit#: MEC2015-00747
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/03/2015
TIGARD Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16290 SW UPPER BOONES FERRY RD
Project: PacTrust Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: Duct work modifications and relocating(2)RTU's.
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.
FAX: 503-658-6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/03/2015 $1,861.71
Class of Work: ALT Type of Const: IIIB Plan Review 11/03/2015 $465.43
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/03/2015 $223.41
Stories: Info Process/Archiving-Lg$2.00(over 11/03/2015 $4.00
11x17)
Project Valuation: $70,000.00 Info Process/Archiving-Sm$0.50(up to 11/03/2015 $10 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 52,564.55
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 f. •w the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00'• ou may • :in. a c., y of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �
•
Call .4175 by 7:00 a.m.for the next available inspe on date.
This permit card shall be kept in a conspicuous place on the job site until completion o ""e project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application / FOR OFFICE USE ONLI
City of Tigard Date/By: 3/EMU-, Permit No: Ai^ _ — ,
al 13125 SW Hall Blvd.,Tigard,OR 97223
1,11 Plan Revie �►� Other Permit:
Phone: 503.718.2439 Fax: 503.598RE E1�ED Date/By: C� �� ..4 0-0/�1 e
T 1 G A R D Inspection Line: 503.639.4175 VV Date Ready tom- funs El See Page 2 for
Internet: www.tigard-or.gov 3 2015 Notified/Method: �� Supplemental Information
NOV
TYPE OF toff? OF TIGARU COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑New construction Addition/al� �1�i�;rfA ISIQ11 Mechanical permit fees*are based on the value of the work
® ISDap performed. Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit.
Value:$ 7CtCGO`'°
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ® Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 16290 SW Upper Boones Ferry Rd (requires site plan showing placement) _ 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:Oregon State Treasury 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
Gas
Ductwork moddifications,and Unit Relocation fireplace 33.39
Flue vent for r water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER ❑ 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
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) _ 23.32
❑ APPLICANT ® CONTACT PERSON Attic/crawlspace fans 23.32
Business name:Lohman 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
Minimum permit fee($90.00)
Phone:(503)658-1892 Fax:(503)658-6925 Plan review(25%of permit fee)
CCB lie.: 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: Drew Gohman Date: 11/3/2015 * Fee methodology set by Tri-County Building Industry Service Board
t\Building\Permits\MEC-PermitApp doc 09/09/10 440-4617T(I I/02/COM/WEB)
IIIIII _ ' Building Division
Over-The-Counter (OTC) Mechanical Permit
nGnKn Check List
Project Description: T(
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: T Occupancy Group: L Type of Construction:D/
*Type of Use: COX( Oregon Specialty Code: 22/14,
Number of Stories: I
FUEL FURNACES
Type: Furnace < 100K BTU Furnaces>= 100K BTU _
Gas Pressure: Roof Top Unit(RTU) '?j Tons --t,---7
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
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work 1 Gas Fireplace
Fire/Smoke Dampers Other Mechanical Units—Describe:
Total Project Valuation: $ 70/(.4. ,,Qn FEES DUE
$ l Z1 to . 7( Mechanical Permit Fee
$ 411 Plan Review
$ A 12%State Surcharge
$ ' Cr) Info Proc/Arch,Lg(over 11x17 $2.00)
$ (nCin 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: $ 2/A,17 ---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;OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies);
REP=repair.
L\Building\Forms\OTC-MEC.docx 01/13/2011
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16290 SW UPPER BOONES FERRY RD,
TIGARD, OR, 97224
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00747
Jeff Grove
L
Violation Summary:
Inspector Contractor