Permit CITY OF TIGARD MECHANICAL PERMIT
7,1
e COMMUNITY DEVELOPMENT Permit #: MEC2009 -00509
,T (G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2009
Parcel: 2S113AC00101
Jurisdiction: Tigard
Site address: 16655 SW 72ND AVE 200
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Spec Space
Project Description: Replace 144 ceiling grilles. Provide plans on site for inspector.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 09/30/2009 $195.50
PORTLAND, OR 97224 12% State Surcharge - Mechanical 09/30/2009 $23.46
PHONE: 503 - 624 -6300
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 $218.96
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: ceiling grilles
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 o.tain a copy of th- rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. joe)
Issued By: (1 A \ 1 Q n1 Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that bust 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 Folz OFFICE: tisr oNt.1
IN City of Tigard Da t e e vya • Permit No.: Q So 9
° 13125 SW Hall Blvd., Tigard, OR 97223 R ECFRIF. ` d 0 q
C Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
Inspection Line: 503.639.4175 SEP 0 2009 DateBy: Other Permit
TIGARD Date Ready/By: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
E OF wo& ILDINU DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ O0
RESIDENTIAL EQUIPME / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: /�G . 1 1. 1 av D. �( /2/ Air conditioning ho or ing pump
- 2,,R, (/"�' v (requires site plan showing placement) 14.00
City /State /ZIP: j cps O� Furnace 100,000 BTU (ducts/vents) 14.00
/ /
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: s-Z /� z0
c. Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
� Gas fireplace 10.00
F GP� / 7 / cG / 5 CE/z /N r ,2 /L L L---S. Flue vent for water heater or gas
r 1 fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
JJ Wood fireplace /insert 10.00
OPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
�iPR
Other: 10.00
Name: he /F7 (�° E ,, l T y Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503 ) 6.a - 3 odt. Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT • CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
:•e0-70/19‘21+'•-/ // ��JJ,�JJ --- flx/ /"a+d - Fuel piping
Contact name: 3 y/ ,( / t $5.40 for first four; $1.00 for each additional
�` Fumace, etc.
Address: / 4/5 5 L \ � ,R/ '2
i _ Gas heat pump
�d
City /State /ZIP:. .4.eA7?/) a, .5 J 92 `- 67 7 �� Wall /suspended/unit heater
�� ° Water heater
Phone: (5 3) 79 3.- 76, i Faax�:�: ( ) Fireplace
E -mail: �e -r2,e / c14 nil/ f7Iv�-N4R/.47G Li, CV)j1 Range
CONTRACTOR Barbecue
Business name: Az..... Clothes dryer (gas)
jF1Q�t/ /� � c '4 �v f C Other:
Address: /4,6- - S` /wy 2/0 MECHANICAL PERMIT FEES*
City /State /ZIP: 4 7 / 4 5 CQ 7 p) 5 - Subtotal
Phone: J G ' a Minimum permit fee ($72.50)
��)(��. /. -c Fax: (50/ 9 S
Plan review (25% of permit fee)
CCB lic.: //9'95 ') State surcharge (12% of permit fee)
TOTAL PERMIT FEE d 8 . Q (1)
This permit application expires if a permit is not obtained within 180
Authorized signatu ' : / • d ays after it has been accepted as complete.
Print name: � ��h7 ,y2, N 1 Date: 9 � ' Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permits\ MEC- Permit App .doc 01/19/07 4400- 461 (1 I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: • Permit Fee:
$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.
l:\ Building \PermitsVvMEC - PermitApp.doc 01/19/07 2