Permit CITY OF TIGARD MECHANICAL PERMIT
111 a COMMUNITY DEVELOPMENT Permit#: MEC2015-00023
T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/20/2015
Parcel: 25101 DC00200
Jurisdiction: Tigard
Site address: 13535 SW 72ND AVE 200
Project: Umpqua Bank Subdivision: 72ND BUSINESS CENTER Lot: 13
Project Description: Interior office remodel.
Contractor: GOHMAN MECHANICAL Owner: PNWP LLC#2
14505 SE HWY 212 BY PACIFIC NW PROP LTD PTNSP
CLACKAMAS,OR 97015 PO BOX 2206
BEAVERTON, OR 97075
PHONE: 503-658-1892 PHONE:
FAX: 503-658-6925
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/20/2015 $601.71
Class of Work: ALT Type of Const: Plan Review 01/20/2015 $150.43
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/20/2015 $72.21
Stories:
Project Valuation: $20,000.00
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 $824.35
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans, This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adop -d by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-'10•I. You m. o. .in . .• if the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _ � ittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspecti• •ate.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application R1 cE1 I . ►I FOR OFFICE USE ONLY
1111 Received
- City of Tigard Date/By: l� — Permit No.: /tl C _Oa -17
v 13125 SW Hall Blvd.,Tigard,OR 97223 2015 Plan Review l�n1 Ai
Phone: 503.718.2439 Fax: 503.598.1960 JAN 2 0 Date/By: Other Permit:/, fJ_ taDi L 'CO;67'
TI G A R I) Inspection Line: 503.639.4175 to Ready/By: Jury Inspection Line: 503.639.4175 Ready/By: ®� v//See Page 2 for
_1
Internet: www.tigard-or.gov CITY OFTIGAK ttified/Method: G Supplemental Information
;fit r, 1A?T >,
TYPE OF WOR1 ' -+ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed. Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ rye b 6 b
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: 13535 SW 72nd Ave (requires site plan showing placement) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000 BTU(ducts/vents) 46.75
Furnace 100,000+BTU(ducts/vents) 54,91
Suite/bldg./apt.no.:Ste 2 Project name:Umpqua Bank 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
Modify Ductwork Gas fireplace 33.39
Flue vent 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 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(a?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
Phone:(503)658-1892 Fax:(503)658-6925 Minimum permit fee($90.00)
Plan review(25%of permit fee)_
CCB lic.: 119952 State surcharge(12%of permit fee)
TOTAL PERMIT FEE ip2fl 3>
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name:Drew Gohman Date:01/20/2014 * Fee methodology set by Tri-County Building Industry Service Board
I.\Building\Permits\MEC-PermitApp.doe 09/09/10 440-4617T(II/02/COM/WEB)