Permit CITY OF TIGARD MECHANICAL PERMIT
Il COMMUNITY DEVELOPMENT Permit#: MEC2014-00013
T IGAR.L) 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 01/14/2014
Parcel: 2 S 113AA00400
Jurisdiction: Tigard
Site address: 16200 SW 72ND AVE B2
Project: Spec Space Subdivision: ROSEWOOD ACRE TRACTS Lot: C
Project Description: Mechanical for TI Installing(1)new RTU and(3)unit heaters with duct work and gas piping
Contractor: GOHMAN MECHANICAL Owner: PACIFIC REALTY ASSOCIATES
14505 SE HWY 212 ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-658-1892 PHONE: 503-624-6300
FAX: 503-658-6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/14/2014 $550.91
Class of Work: ALT Type of Const: IIIB Plan Review 01/14/2014 $137.73
Occupancy Grp: S-1 Occupancy Load: 12%State Surcharge-Mechanical 01/14/2014 $66 11
Stories: 1 Info Process/Archiving-Lg$2.00(over 01/14/2014 $2.00
11x17)
Project Valuation: $18,000.00 Info Process/Archiving-Sm$0.50(up to 01/14/2014 $10.00
11x17)
Fuel Air Handlers
Fuel Types Natural Gas 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: 2 Vent Systems: Total $766 75
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 follow the rul- adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•%n You m. o•tai a copy of the rules
or direct questions to OUNC by calling 503 232.1987 or 1 800.332.2344.
4441FA
Issued By: Signature:
Cal .639.4175 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 Annhic il
EIVED FOR OFFICE USE ONLY
City of Tigard DDat/BByd ihninimermegme
114 13125 SW Hall Blvd.,Tigard,OR 9722�f y
g , Phone: 503.718.2439 Fax: '503.598.19 Plan 14 2014 Pla 0= � f Date/By.Review
r t t;,1)<n Inspection Line: 503.639.4175 Date Read r. . 111 VI See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method. Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit Leese 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.
Value:$$18,000.00
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. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:Air conditioning
Job site address: 16200 SW 72nd Ave., (requires site plan showing placement) 46.75 ,
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224
Furnace 100,000+BTU(ducts/ven(s) 54.91
Suite/bldg./apt.no.: Project name: 1 OBP-16200 Spec T1 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: t�; 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 i
Install New Rooftop Unit and 3 New Unit Heaters Gas fireplace 33.39
p Flue vent for water heater or gas
To Include Ductwork and Gas Piping fireplace 23.32
Log lighter(gas) 23.32 _
Wood/pellet stove 33.39
Wood fireplace/insen 23.32
❑ PROPERTY OWNER J Chimney/liner/tlue/vent 23.32
❑ TENANT Other 23.32 I
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
Other 23.32
Business name:Lohman Mechanical,Inc.
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:Lohman Mechanical,Inc. Clothes dryer(gas) ,
Other:
Address: 14505 SE Hwy 212 MECHANICAL PERMIT FEES*
City/State/ZIP:Clackamas,OR 97015 Subtotal
Minimum permit tee($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: •))...,,.. .......7.....„..---- days after it has been accepted as complete.
Print name: Drew Gohman I Date: 1-13-2014 . Fee methodology set by Tri-County Building Industry Service Board
1\Building\Permits\MEC-PermitApp doe 09/09/10 440-4617T(I 1/02/COM/WEB)
III • Building Division
Over-The-Counter (OTC) Mechanical Permit
T l c n lz° Check List
Project Description: y f 1-
APPLICATION SPECIFIC INFORMATION
GENERAL INFORMATION
*Class of Work: Occupancy Group: "ji Type of Construction:
*Type of Use: (�t.T1i(1� Oregon Specialty Code: 2
Number of Stories: 1
FUEL FURNACES
Type: Furnace< 100K BTU Furnaces>= 100K BTU
Gas Pressure: Roof Top Unit(RTU) 1 Tons
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 (Q^)
Solid Fuel Fireplace/ Clothes Dryers Gas Outlets
Woodstove Duct Work Gas Fireplace
Fire/Smoke Dampers Other Mechanical Units—Describe:
Total Project Valuation: $ (8 JO 9O, FEES DUE
$ 650,4e( Mechanical Permit Fee
$ ( 7. Plan Review
$ b i 12%State Surcharge
$ Z 2 Info Proc/Arch,Lg(over 11x17 $2.00)
$ fib, QC) 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: $ 766,75-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;O'IR=other(use for fences,decks,retaining walls,signs,awnings or canopies);
REP=repair.
I:\Building\Forms\OTC-MEC.docx 01/13/2011
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16200 SW 72ND AVE B2, TIGARD, OR, 97224
Commercial - Mechanical
699 Mechanical final
2014-02-10 00:00:00
MEC2014-00013
PASS - No C of O
Violation Summary:
Inspector Contractor