Permit CITY OF TIGARD MECHANICAL PERMIT
: COMMUNITY DEVELOPMENT Permit#: MEC2021-00058
Date Issued: 2/2/2021
T t(:A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY
Project: PacTrust Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25, PT
Project Description: Remove&replace all corridor and restroom grills
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-233-6911 PHONE:
FAX: 503-238-9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/28/2021 $263.41
Class of Work: ALT Type of Const: Plan Review 01/28/2021 $65.85
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/28/2021 $31.61
Stories: Info Process/Archiving-Lg$2.00(over 01/28/2021 $6.00
11x17)
Project Valuation: $7,000.00
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 $366.87
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance; or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
.\\yIssued By: A �r1����` Aw o ` Permittee Signature: ��n
J Call 503.63v9.4175 by
7:00'a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE. USE ONLY r V
City of Tigard Received/ Z?2111// Permit Nu fs'I G C2_42/- JX 5,5
111 13125 SW Hall Blvd.,Tigard,OR 97223 Date By.
'. --,Plan Review ^
Phone: 503.718.2439 Fax: 503.598.1960(�EC DatcBy: AIM— Other Permit:
1 I(,4 It 1> Inspection Line: 503.639.4175 r� Date Ready/By: 7uris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
i a*i 1 0 2P.'-
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
T v OS- 1 ,/ ' " ' Mechanical permit fees*are based on the value of the work
0 New construction [t Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 7000,
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 12909 SW 68th Parkway Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Oregon 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Pacific parkway y Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydroni) 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: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
remove and replace all corridor and restroom grills fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ElTENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Pactrust 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
•
❑ APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Bruce Butner Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
E-mail:bruce@protmp.COm Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Protemp Associates °d1e`
MECHANICAL PERMIT FEES*
Address: 9788 SE 17th ave Subtotal
City/State/ZIP: milwaukie Oregon 97222 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503) 519-6199 Fax:(503)238-9767 State surcharge(12%of permit fee)
CCB lie.:38868 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ,,(_____y * Fee methodology set by Tri-County Building Industry Service Board
Print name: Bruce Butner Date: 1/19/21
I:1Building\Pe`mits\MEC_PermitApp_o40113.doc 4404617T(11/02/COM/WEB)