Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00259
Date Issued: 06/09/2010
T E O ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S 112 DA00700
Jurisdiction: Tigard
Site address: 15333 SW SEQUOIA PKWY, STE# 150
Subdivision: PACIFIC CORP CENTER Lot: 0
Project: OnOne Software
Project Description: Relocate ducts & grilles.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 06/09/2010 $277.46
PORTLAND, OR 97224 12% State Surcharge - Mechanical 06/09/2010 $33.30
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 - 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 $310.76
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 wor. spended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notific. '.n Center. •.se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct q - stions to OUNC b calli = 1 .246.6699 or 1.800.332.2344.
Issued B : %� ' / Permittee Signature: r_ r2
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 - - - -vela or_ufc.f-t_se _ - _
1114 City 25 W Tigard Da y; , ' Permit SW Hall Blv Tiga rd, OR 97223 y / d rte,vo/o -
' C Phone: 503.639.4171 Fax: 503.598.1960 Plan R few Other Permit: /• oe,f0't�l
/ � Q
Date/By:
I l i \ K L' kspection Line; 503.639.4175 Date Rea _furls: and -or. ov �'�' H See Page 2 for
Internet: www.ti
8 8 Notified/Method: Supplementallnformadon
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit:
CATEGORY OF CONSTRUCTION Value: $ $7,500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling ►,/ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15333 SW SEQUOIA PKWY Ah conditioning
(requires site plan showing Placement) 46.75
City /State/ZIP: Tigard Oregon 97224 Furnace 100,000 BTU (duets/vents) 46.75
Furnace 100,000+ BTU (dugts/vants) 54.91
Suite/bldg. /apt. no #150 Project name: ON ONE SOFTWARE Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential bailer (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
Gas fireplace 33.39
Relocate Duct For new tentant space 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 1 ❑ TENANT Chimney/liner /flue /vent 23.32
Other: l 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City / State/ZIP: Clotho dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
0 APPLICANT CI CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Protemp Associates
Fuel piping
Contact name: Bruce Butner $14.15 -for first four, $4.03 for each additional
Address: 9788 SE 17 Ave Furnace, etc I
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 protmpsom Ran:e
CONTRACTOR Barbecue
Business name: same as above
Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
•
City /State/ZIP: Subtotal
Mi .
Phon ( ) Fax; ( ) ni�rrum permit fee ($90.00) ��
Plan review (25% of permit fee) Q _
CCB lip,; 38868 State surcharge (12% of permit fee) 33 . 30
TOTAL PERMIT FEE /d, ? ,
Authorized Signature: Thi p ermit a expires if a peraut is not obtained within 150
!i days after it has been accepted as complete.