Permit CITY OF TIGARD MECHANICAL PERMIT
1111 : COMMUNITY DEVELOPMENT Permit#: MEC2015-00621
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2015
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 200
Project: CNA Insurance Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Moving heat pump and modifying duct work.
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:
FAX: 503-658-6925
l
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/21/2015 $235.31
Class of Work: ALT Type of Const: IIB Plan Review 09/21/2015 $58.83
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 09/21/2015 $28.24
Stories:
Info Process/Archiving-Lg$2.00(over 09/21/2015 $2.00
11x17)
Project Valuation: $6,000.00
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 i
Vent Fans: Vent Systems: Total $324.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: water source
Duct Work: 7 heat pump
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
issua •-, or if work uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Ur y Notification Center. ho - rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
• direct questions to OUNC b allin. 232.1987 or 1.800.332.2344.
I sued By: / Permittee Signature: k y"),_
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 Application FOR OFFICE USE ONLI'
IIICity of Tigard CENED Received • , 3i Permit No.Ad► - . _
13125 SW Hall Blvd.,Tigard,OR 9 Plan Revi ��
Phone: 503.718.2439 Fax: 503.598. 960 Plan Re: I,.„11 • er Permit:
Inspection Line: 503.639.4175 C 215 _ r'" r
T1GAk[) SCP Date Ready Ti. do �J See Page 2for
Internet: www.tigard-or.gov aRp Notified/method: 9/i,�S we: ,moo Supplemental Information Nsima
Mechanical permit fees*are based on the value of the work
❑New construction L! Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
❑ 1-and 2-family dwelling i! Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
Heating/cooling:
l Air conditioning 46.75
Job site address: ago 5 i,t/ 68th (x 141 V Furnace 100,000 BTU(ducts/vents) 46.75 _
City/State/ZIP: ;y�ctrl OA a Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: a,0 V Project name: C ,(/
Heat work 2 .32
I C/V A Tl'l s IA,��n Ce Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: 1 Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK ,' Gas fireplace/insert 33.39
p (Luc Flue vent for water heater or gas
MU lit, lII ,� and_ /'►106 Fy (Lu.c t work I o fireplace 23.32
Log lighter(gas) 23.32
(kCG 0✓n o afttfe Floor P' h Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
ROPE"‘
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater _
City/State/ZIP: Water heater
Phone:( ) I Fax::( ) Fireplace
Range
E-mail: Barbecue
Clothes dryer(gas)
Other
Business name: Go hot an JUlechcI,.nicgl
Address: 1 SOS SE tf w al z Subtotal
City/State/ZIP: C 4a(ka met s Y q 70 i$ Minimum permit fee($90.00)
V�/ Plan review(25%of permit fee)
Phone:6O3 ) G s B„ i g°id, Fax:( ) State surcharge(12%of permit fee)
CCB lic.: li Q R S',) TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
y days after it has been accepted as complete.
Authorized signature: mil, • Fee methodology set by Tri-County Building Industry Service Board
Print name: Drew 4ohma,n Date: 41/q/1,5
1:\Building\Permits UMEC_PermitApp_040113.doc 440-4617r(11/2/COM WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Famil Fee Schedule:
$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.
I:\Buildingl Permits\MEC_PermitApp_040113.doc 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
12909 SW 68TH PKWY 200, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00621
Chip Barnett
Violation Summary:
Inspector Contractor