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Permit f :n MECHANICAL PERMIT Ar,r4 CITY OF TIGARD m a q COMMUNITY DEVELOPMENT Permit #: MEC2010 -00101 Date Issued: 03/10/2010 ,;:ti G A :k b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S112DA01400 Jurisdiction: Tigard Site address: 6650 SW REDWOOD LN 210 Subdivision: Pacific Corporate Center Lot: 0 Project: NuScale Project Description: Relocate duct for TI Owner: FEES PACIFIC REALTY ASSOCIATES Description Date Amount 15350 SW SEQUOIA PKWY #300 Permit Fee 03/10/2010 $161.16 PORTLAND, OR 97224 12% State Surcharge - Mechanical 03/10/2010 $19.34 PHONE: 503 - 624 -6300 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: Occupancy Grp: Occupancy Load: Stories: Fuel Air Handlers Fuel Types: Units < 10000 cfm: 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: Heat Pump: Appliances Vent Fans: Vent Systems: Total $180.50 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 Notifi • on Cen e . ose rules -re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or direct .uestions to OUNC b• g 50:.24.. - or 1.800.332.2344. k Issued =y: 1 / Permittee Signature: 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. Mechanical Permit Application y FOR OFFICE USE ONLY zzzggg y ' ! �' / } / City of Tigard @-I� � 4a Received Q Date /By: Vt10 IO PennitNo.: Wid,a/o0 web! ° 13125 SW Hall Blvd., Tigard, OR �3l Plan Review Q Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit: eu tPA/U_ TIGARD Inspection Line: 503.639.4175 M - AR 0 t Date Ready /By: Juris: El See Page 2 for Internet: www.tigard - or.gov ,.p Notified /Method: Supplemental Information J TYPE jt1{V ViN q� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees* are based on the value of the work New construction Yom'` ❑ El perfonned. indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ 53,500.00 1- and 2 -famil dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* El y g ® Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description p I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 6650 SW REDWOOD LN. Air conditioning or heat pump (requires site plan showing placement) 14.00 City /State /ZIP: TIGARD OREGON 97224 Fumace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite /bldg. /apt. no.: #210 Project name: NU -SCALE 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 Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas RELOCATE DUCT FOR NEW TENANT FLOOR PLAN fireplace 10.00 Flue vent vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 ❑ PROPERTY OWNER ( ❑ TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ® APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: PROTEMP ASSOCIATES ' Fuel piping Contact name: BRUCE BUTNER $5.40 for first four; $1.00 for each additional Address: 9788 SE 17 AVE Furnace, etc. Gas heat pump City/State /ZIP: PORTLAND OREGON 97222 Wall /suspended/unit heater Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Water heater Fireplace E -mail: bruce @protmp.com Range CONTRACTOR Barbecue Business name: SAME AS ABOVE Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal / /. Minimum Minimum permit fee ($72.50) 'A Phone: ( ) Fax:( ) — Plan review (25% of permit fee) 1119 CCB lic.: 38868 State surcharge (12% of permit fee) /9. % 4_ _ TOTAL PERMIT FEE / 8Q . Sv Authorized Signature: This permit application expires if a permit is not obtaineu wuntn tau ltC� -�1 days after it has been accepted as complete. Print name: BRUCE BUTNER Date: 3/10/10 * Fee methodology set by Tri- County Building Industry Service Board 1:1Building \ Permits \MEC- PermitApp.doc 01 /19/07 440- 4617T(11/02 /COM/WEB)