Permit C ITY OF T I GA R D MECHANICAL PERMIT
I^c DEVELOPMENT SERVICES PERMIT #: MEC2003 -00678
.II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/26/03
PARCEL: 1 S 134BC -00300
SITE ADDRESS: 12282 SW SCHOLLS FERRY RD
SUBDIVISION: • ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000'cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Remove existing duct, install new spiral pipe above ceiling, new grills throught
Valuation $7800
Owner: FEES
BPP RETAIL LLC Description Date Amount
BY BURNHAM PACIFIC PROPERTIES
ATTN: JOHN WATERS [MECH] Permit Fee 11/26/03 $147.10
SAN DIEGO, CA 92101 • [TAX] 8% State Surchart 11/26/03 $11.77
Phone: Total $158.87
Contractor:
GOHMAN MECHANICAL INC
412 S BEAVERCREEK RD., STE 602
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 503- 650 -1588 Duct Inspection
Reg #: LIC 119952 Final Inspection
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 -00
I
Issued By: • Permittee Signature: /
Call (5 ) 639 -4175 by 7:00 P.M. for inspections needed e next business day
1 FOR OFFICE USE ONLY
Permit Application Received Mechanical
Date/By: I ( -0 3 (, a Permit No.:� CO3—OA to — 7e •
Planning Approval vv Building
City of Tigard T est Form A Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
4"1:111 r Date/By: Case No.:
Internet: www.ci.tigard.or.us _./1 . i Contact Juris.: ® Sec Page 2 for
W
24 -hour Inspection Request: 503- 639 -4175 '"' Name/Method: Supplemental Information.
TYPE OF WORK . COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
akddition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
• CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2 - Family dwelling Commercial/Industrial Value: $ 7 6.3(:)c_.) C°— See Page 2 for Fee Schedule
Accesso Multi RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
El rY Building Mu amy Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add - on air conditioning 14.00
Job site address: azt 2 -6.0 �lti 11S rFCRP-t, ' Gas heat pump 14.00
Suite #: I Bldg. /Apt. #: Duct work 14.00
: Hydronic hot water system 14.00
Project Name
I�r 2'Z A A-1 co %Z-Z A Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue/vent (for any of above) 10.00
Repair units 12.15
Subdivision: Lot #: Other Fuel Appliances
Tax map /parcel #: • Water heater 10.00
• DESCRIPTION OF WORK Gas fireplace 10.00
r7 _ �� lb%) �C t•�r iJ� tc� � I L . Flue vent (water heater /gas fireplace) 10.00
� Log lighter (gas) _ 10.00
Q cz+N \ E Bibb e--t l .6 . Wood/Pellet stove 10.00
t J G •t (1.4.11 c-› C ain in i Sr e Wood fireplace/insert 10.00
Chimney /liner /flue/vent 10.00
❑ PROPERTY OWNER 1 ❑ TENANT Other: 10.00
Environmental Exhaust & Ventilation
Name: Range hood/other kitchen equipment 10.00
Address: Clothes dryer exhaust 10.00
City /State /Zip: Single duct exhaust
Phone: Fax (bathrooms, toilet compartments,
❑ APPLICANT [a'CONTACT PERSON utility rooms) 6.80
Name: Mark Gohman Attic /crawl space fans 10.00
Other: 10.00
Address: 412 S. Beavercreek Rd. #602 Fuel Piping
City /State /Zip: Or e gon City, OR 97045 ($5.40 for first 4, $1.00 each additional) **
Phone: 503 - 650 -1588 I Fax: 503 - 655 -0514 Furnace, etc.
Gas heat pump **
E -mail: mgohman@gohmanmechanical.com Wall/suspended/unit heater *'
. CONTRACTOR Water heater
Business Name: Gohman Mechanical, Inc. Fireplace "
Address: 412 S. Beavercreek Rd. #602 Range *„
City /State /Zip: Oregon City, OR 97045 Clothes dryer (gas) `*
Phone: 503- 650 -1588 _ Fax: 503- 655 -0514 • Other:
CCB Lie. #: 119952 Total:
Mechanical Permit Fees*
Subtotal: $
Authorized / Minimum Permit Fee $72.50 $
Signature: 11/....,_,- / larl - Date: Plan Review Fee (25% of Permit Fee) $
State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
(Please print name) Notice: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
r CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 75
INSPECTION DIVISION Business Line: (5 6 71 MST
3' e BUP
Received / C ` Date Requested / z //6 /03 AM PM BUP -
Location /Z-1 5 -e o Suite dr. 3 —d 6 l 77
Contact Person fatoa Ph ( 1 ) 7 93 - 3 7/ ? PLM
Contractor /� _ Ph ��� ) SWR
BUILDING Tenant/Owner -/'' Z-e-YI - • ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear JI¼L Int Sheath/Shear C - 5 Framing ci
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING I M _
Post & Beam 4,1! Vir,
Under Slab
Rough -In ,
Water Service
6, / 4
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS FAIL
ECHANO
o earn
ough- n
as ine
•. • _ Dampers
Fina ...
PART FAIL
EL TRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line / {` iLt
ADA Approach/Sidewalk Date ' � i � V 3 Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL