Permit (65) CITY OF TIGARD MECHANICAL PERMIT
1r .` COMMUNITY DEVELOPMENT Permit#: MEC2016-00642
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/07/2016
Parcel: 2S 101 AD00800
Jurisdiction: Tigard
Site address: 12550 SW 68TH AVE
Project: Cache Valley Electric Company Subdivision: WEST PORTLAND HEIGHTS Lot: 26
Project Description: Exhaust fan installation.
Contractor: GOHMAN MECHANICAL Owner: CACHE VALLEY ELECTRIC CO
14505 SE HWY 212 875 NO 1000 WEST
CLACKAMAS, OR 97015 LOGAN, UT 84321
PHONE: 503-658-1892 PHONE: 503-431-6600
FAX: 503-658-6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/07/2016 $69.06
Class of Work: ALT Type of Const: Plan Review 09/07/2016 $17.27
12%State Surcharge-Mechanical 09/07/2016 $8,29
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $500.00
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: 1 Vent Systems: Total
Hoods: $94.62
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 folio the rules -uopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. ou may .. :ropy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.3 44.
Issued By:iv jermi ee Signature:40010
Call 503.6 5 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.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received 4 74
4 g Date/By: - Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 t I N/� ..I s .�,.1
Plan Review �)
S Phone: 503.718.2439 Fax: 503.598.1960 '*I i, Other Permit: b'C -
Date/B
T I GA RD Inspection Line: 503.639.4175 ,, a Date Read /B rugs: ��
Internet: www.tigard-or.gov Ready/By: Supplemental See Page for
Notified/Method: Information
'1 �1h <`-�-�'
TYPE ()F WC)� � ` , CO M> RCIAL FEIN* SCHEDULE'_ USECHECKLIST'
Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/re lac*ent'• ir`,
-1:1,
,�� .,d performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$500.00
CATEGORY OF CON .. RESIDENTIAL EQUIPMENT/SYS 1 MS IBES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND. LOCATIOi Heating/cooling:
Air conditioning 46.75
Job site address: 12550 SW 68Ih Ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Portland,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Cache Valley Electric Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Install(1)ceiling exhaust fan. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPKRTY'OWNER I TF NA N T.01 Other: 23.32
Environmental exhaust and ventilation:
Name:Cache Valley Electric Range hood/other kitchen
equipment
Address: 12550 SW 68th Ave 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Portland,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:
Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Gohman Mechanical,Inc. Other:
MECHANICAL PERMIT FEES*
Address: 14505 SE HWY 212
Subtotal
City/State/ZIP:Clackamas,OR 97015 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503-)658-1892 Fax:( ) State surcharge(12%of permit fee)
CCB lic.: 119952 TOTAL PERMIT FEE elle.0,A
This permit application expires if a permit is not obtaine within 180
A.
days after it has been accepted as complete.
Authorized signature: ' dilPr * Fee methodology set by Tri-County Building Industry Service Board
Print name:Jennifer ulsher Date:9/7/2016
1.\Building\Permits\MEC_PermitApp_0401 13.doc 440-4617T(I 1/02/COM/WEB)
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
12550 SW 68TH AVE, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00642
Chip Barnett
Violation Summary:
Inspector Contractor