Permit RD •
CITY OF TIGA ' '� -
BUILDING DIVISION PERMIT #: Mt 0200 (16 11
13 125; SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: it i2da,(lti3 •
Phone: (503) 639 -4171 ' l�11
Inspection Requests (24 Hrs.): (503) 639 -4175 4 'II
INSPECTION' WORKSHEET FOR DATE: 1/13/2009 TIME: 7:00Am PAGE: 15
SITE ADDRESS: 15350 SW SEQUOIA PKWY 198 CLASS OF WORK:
SUBDIVISION :: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT `NAME: COMPU TERATI
DESCRIPTION: TI. ,(1) New Watersouree heat pump. Relocate floor grills, Valuatson.$5600.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PR.OTEMP ASSOCIATES INC PHONE #: 503-519 -6199
Inspection Request Scheduled For:. Date: 1/13/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 ivl :ch4 r►ical final 079631 -01 503 - 619.6199
Corrections /Comments /instructions :,
•
•
•
R PASS RTIAL APPROVAL 0 CANCEL n NO ACCESS
,
LLFOR INSPECTION
0 ADDITIONAL FEES ASSESSED
t# Inspector: �.�� Date: / / Phone #: (503) 718-
!� _ o CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00011
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/12/2009
PARCEL: 2 S 112 DA -01400
SITE ADDRESS: 15350 SW SEQUOIA PKWY 198 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: COMPUTERATION
Project Description: TI. (1) New water source heat pump. Relocate floor grills. Valuation $5500.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 1/12/200c $150.50
[MECPLN] Plan Rev 1/12/200E $37.63
[TAX] 12% State Surch 1/12/200E $18.06
Phone:
Total $206.19
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 B Permittee Signature: alt
Call 503.639.4175 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 CEpED FOR OFFICE USE ONLY
Cl of Tigard R eceived O q I Permit No 001,64C•
` g Date/By: • • • ,_� •11 •
• III 0 13125 SW Hall Blvd., Tigard, OR 97223 p lan Revi �
Phone: 503.639.4171 Fax: 503.598.1960 JAN 0 8 2009 Other Permit:
o-d te/B y: /� to • •.: .4b
TI G n It D Inspection Line: 503.639 Date Ready i y: lifffA RI See Page 2 for
Internet: www.tigard or.gov CITY OFTTGARD Notified/Method: Supplemental Information
BU11.DING DIVISIO '
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction CO 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: $ $5,500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 - family dwelling ® Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15350 SW SEQUOIA PKWY 19 Air conditioning or heat pump
I 1 c) (requires site plan showing placement) 14.00
City/State/ZIP: TIGARD OR 97224 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: #198 Project name: COMPUTERATION 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
1 -NEW 1 -TON WATER SOURCE HEST PUMP,AND RELOCATE GRILLS AND Gas fireplace 10.00
DUCT Flue vent for water heater or gas
fireplace 10.00
FOR NEW FLOOR PLAN Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
❑ PROPERTY OWNER I ❑ TENANT Other. 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT ® 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
Furnace, etc.
Address: 9788 SE 17 AVE • Gas heat pump
City/ State/ZIP: PORTLAND OR 97222 Wall/suspended/unit heater
Water heater
Phone: (503) 519 — C e i(( 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*
City/ State/ZIP: Subtotal
Minimum permit fee ($72.50) /50 • 50
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee) 3/ • (Oa
CCB lic.: 38868 State surcharge (12% of permit fee) / g. 0
TOTAL PERMIT FEE _ AD& • 1?
This permit application expires if a permit Is not obtained within 180
Authorized signature days after it has been accepted as complete.
• Fee methodology set by Tri - County Building Industry Service Board
I Print name: BRUCE BUTNER I Date: 1/8/09
1:\Building \ Permits \MEC- PermitApp.doc 01/19/07 440.4617T(I1 /02/COM/WEB)