Permit T !a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 -00427
DATE ISSUED: 8/14/2008
,ricA.Itb! 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112 DD -00701
SITE ADDRESS: 15800 SW UPPER BOONES FERRY RD A -120 ZONING: I -
SUBDIVISION: OREGON BUSINESS PARK II LOT: JURISDICTION: TIG
PROJECT: BRODERICK GALLERY
Project Description: Replacing all grills. Valuation: $1,200.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 8/14/200E $72.50
[MECPLN] Plan Rev 8/14/2001 $18.13
[TAX] 12% State Surch 8/14/2001 $8.70
Phone: Total $99.33
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -519 -6199
FAX 503- 238 -9767
Reg #: LIC 38868
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By / i i' / ���� Permittee Signature:
Call !9. • .4175 by 7:00 a.m. for inspections 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 - FOR OFFICE LSE ONLY
City of Tigard O Rece
�E it No.:
• I)atrr A `� k— t) ,z
III 13125 SW Hall Blvd., Tigard OR 97223
C
Plan Revie
Phone: 5 Fax: 503. ��1 D� , 8v _ Other Permit:
TIGARD Inspection Line: 503.639 Q Date Ready. By H See Page 2 for
Internet: www.tigard or.gov rr 1 4 7.0 Ntfe•Metho4, Supplemental Information
TYPE OF WOR`. OF�0 t3N COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ® Addition/altera ' f 1 , f'.- �M[� 51 Mechanical permit fees* are based on the value of the wort
''i performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ S1,200.00
❑ 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
y g ® Commercial/industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating'
Job site address: 15800 SW UPPER BOONES FERRY RD Air c.taiditioning o heat P
(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 (ductsivents) 17.90
Suite/bldg. /apt. no.: Project name: BRODRICK GALLERY
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hvdronic 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:
Flue/ vent for any of above 6.80
Other 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.0()
Cris fireplace ALL GRILLS AND ARRANGE FOR NEW FLOOR PLAN Flue vii for 10.0(1
or avater heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fueplacchnsert 10.00
❑ PROPERTY OWNER ( ❑ TENANT Chimney/liner/flue/vent 10.()0
C)dter. 10.00
Name: Ens-irontnental 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 cemprutmems, utility rooms) 6.80
❑ APPLICANT i ❑ CONTACT PERSON Atii✓iaaw1s'pece fans 10 -00
Otlnr. 10 -()0
Business name: PROTEMP ASSOCIATES
Fuel piping
Contact name: BRUCE BUTNER 55.40 for first four, 51.00 for each additional
Address: 9788 SE 17 AVE Furnace, ``
Cias heat pimp
City/State/ZIP: PORTLAND OREGON 97222 Wall/suspended/unit heater
Phone: (5503) 519 -6199 Fax: : (503) 238 -9767 Water heater
Fireplace
E -mail: bruce(ajpr'otmp.com Range
CONTRACTOR Barbecue
Business name: same as above
Clothes dryer (gas)
Other.
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Mini m m permit fee ($72.50) 7 -.
Phone: ( ) Fax: ( ) Phan review (25% of permit fee) / Si; /3
CCB lic.: 38868 State surcharge (I2% of permit fee) 1 7p
TOTAL PERMIT FEE 141, 3?
Authorized signature: IY_6 � t it appfiatiou expires ifa permit a not obtained within 1
IAA{ ,..• f Q r days alter it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IVIEC20O8-OO427
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: °14(20013
Phone: (503) 639 -4171 • ` ° °. ,, °5- :Itil �s;
Inspection Requests (24 Hrs.): (503) 639 -4175 .4;' ".�.
INSPECTION WORKSHEET FOR DATE: 8!19!20 TIM E: 7:OOAM PAGE 15
SITE ADDRESS: 15000 SW UPPER I300NES FERRY RD A - 120 CLASS OF WORK:
SUBDIVISION: OREGON BUSINESS PARK II LOT #: TYPE OF USE:
PROJECT NAME: BRODE }TICK GALLERY
DESCRIPTION: Replacing all grills. Va!uation: $1,200.00
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTFMP ASSOCIATES INC PHONE #: 503519 - 6199
Inspection Request Scheduled For: Date: B/19/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Mess -
64_#GC
699 Mecha!iical final 0743313 -01 503-519-6199 \WA
Corrections /Comments/ Instructions:
00 PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 8 / A /cog Phone #: (503) 718- Z( .74/