Permit W ,
' W. CITY OF TIGARD MECHANICAL PERMIT
� COMMUNITY DEVELOPMENT Permit #: MEC2009 -00522
, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 10/20/2009
.TIGARD. 9 Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15495 SW SEQUOIA PKWY 190
Subdivision: Lot: 0
Project: Columbia Soft
Project Description: Relocate ducts for new floor plan, and add 2 - ton ductless split a/c unit,
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee 10/06/2009 $291.51
Plan Review 10/06/2009 $72.88
PHONE: 503- 624 -6300 12% State Surcharge - Mechanical 10/06/2009 $34.98
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222
PHONE: 503 - 233 -6911
FAX: 503 - 238 -9767
Type of Use: COM
Class of Work: ALT Type of Const: VB
Occupancy Grp: B Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 2
Gas Pressue: 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: 2
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $399.37
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 rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: T 649- l Permittee Signature: _ (j
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
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echa1iical Permit ApplicatimREC 1 VIF
Received
City Of Tigard Received
IFI �[ J`-' Date/By:
PermitNo.: 1(y�p( 7���'(� I. J2 2
• 13125 SW Hall Blvd., Tigard, OR 97223 -�
Plan Review7.1A0 0( Other Permit: q [ 12260 • Qo23
' Phone: 503.639.4171 Fax: 503.598.1960 _ Plan Re: (( !
"t I C; A R I i Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: ' /�- Jnn IZI See Page 2 for
Internet: www.tigard- or.gov BUILDING DINISiO`t{ q! Notified/Method:I0•(�• L-�/1 Its Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
' Mechanical permit fees* are based on the value of the work
N ew construction
❑ tEl performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 8!000
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
For special information use checklist.
❑ Multi - family ❑Master builder ❑Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15495 SW SEQUOIA PKWY Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: TIGARD OREGON 97224 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: #190 Project name: COLUMBIA SOFT Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
RELOCATE DUCTS FOR NEW FLOOR PLAN ADD 1- NEW 2 TON DUCTLESS Gas fireplace 10.00
SPLIT A/C UNIT Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplacefrnsert 10.00
Chimney/liner /flue/vent 10.00
❑ PROPERTY OWNER ❑ TENANT Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
Clothes dryer exhaust 10.00
City / State/ZIP: Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT ® CONTACT PERSON Attic /erawispace fans 10.00
Other: 10.00
Business name: PROTEMP ASSOCIATES Fuel piping
Contact name: BRUCE BUTNER $5.40 for first four; 51.00 for each additional
Furnace, etc.
Address: 9788 SE 17 AVE Gas heat pump
City /State/ZIP: PORTLAND OREGON 97222 Wall/suspended/unit heater
Water heater
Phone: (503) 519 -6199 I Fax: : (503) 238 -9767 Fireplace
E -mail: bruce@protmp.com Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: SAME AS ABOVE Other:
Address: MECHANICAL PERMIT FEES*
Subtotal
City/ State/ZIP: a� �,�j �
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) • +
CCB lic.: 38868 State surcharge (12% of permit fee) 31.1, (3 e
TOTAL PERMIT FEE C(
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
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