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Permit CITY OF TIGARD MECHANICAL PERMIT II COMMUNITY DEVELOPMENT Permit#: MEC2014-00313 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/24/2014 TIGARD 9 Parcel: 25113AC00101 Jurisdiction: Tigard Site address: 16655 SW 72ND AVE 800 Project: Microlnterconnects Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 37 Project Description: Modification of grilles for TI 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 06/24/2014 $201.07 Class of Work: ALT Type of Const: Plan Review 06/24/2014 $50.27 Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/24/2014 $24.13 Stories: Project Valuation: $4,800.00 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: Vent Systems: Total $275.47 Hoods: 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 issuan.- • work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon U'' Notification : ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to O C • ca g 503.232.1987 or 1.800.332.2344. ]/ Issued By: �! �I Lid-Ft.0 n / Permittee Signature: Call 503.639.4175 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 Appli 'o aciurp FOR OFFICE USE ONLY 1,1 Received 3 • City of Tigard \UP Date/By: / (f1 / f;� �J PermitNo.: i+ 3i 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review Phone: 503.718.2439 Fax: 503.598.10* 2 4 2014 Date/By: Permit: y: &6/1.4:)/..95 T I C A R a Inspection Line: 503.639.4175 _ Date Ready/By: Juris. See Page 2 for Internet: www.tigard-or.gov Ci 1 YU1=i iGARD Notified/Method: Supplemental Information 11'1t ,,”,, 1°0 ``,f COMMERCIAL FEE* SCHEDULE — USE CHECKLIST TYPE OF FORK 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. Value:$$4,800.00 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist. ❑ Multi-family ❑ Master builder ❑Other: Description I Qty. Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning Job site address: 16655 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/vents) 54.91 Suite/bldg./apt.no.: WI Project name: Micro Interconnects 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 vent Gas fireplace Grilles to accomodate new floor plan Flue vent v f 33.39 for for 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:Gohman 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 Fumace,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 aZQI.402 Phone:(503)658-1892 Fax:(503)658-6925 Minimum permit fee($90.00) 7 Plan review(25%of permit fee) �. CCB lic.: 119952 State surcharge(12%of permit fee) 2(././3 `X_ TOTAL PERMIT FEE _0/7 ,� Authorized signature:. ` This permit application expires if a permit is not obtained within 180 g '( days after it has been accepted as complete. Print name:Drew Gohman I Date:6/24/14 " Fee methodology set by Tri-County Building Industry Service Board I\Building\Permits\MEC-PermitApp dot 09/09/10 440-4617T(I I/02/COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi-Family Fee Schedule: Total Valuation: Permit Fee: $0.00 to$500.00 Minimum fee$69.06 $500.01 to$5,000.00 $69.06 for the first$500.00 and $3.07 for each additional$100.00 or fraction thereof,to and including $5,000.00. $5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and $2.81 for each additional$100.00 or fraction thereof,to and including $10,000.00. $10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and $2.54 for each additional $100.00 or fraction thereof,to and including $50,000.00. $50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and $2.49 for each additional $100.00 or fraction thereof,to and including $100,000.00. $100,000.01 and up $2,608.71 for the first$100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1:\Building\Permits\MEC-PermitApp.doc 09/09/10 2 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 16655 SW 72ND AVE 800, TIGARD, OR, 97224 Commercial - Mechanical 699 Mechanical final PASS - No C of O July 7, 2014 at 8:21:24 AM MEC2014-00313 Jeff Grove Violation Summary: Inspector Contractor