Permit 71 4
CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00012
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 190 ZONING: I -
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: 002 JURISDICTION: TIG
PROJECT: DIANA HARRISON CPA
Project Description: TI. Relocate floor grills. Value $4,500
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: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 1001( BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 1/12/200c $130.00
[MECPLN] Plan Rev 1/12/200 $32.50
[TAX] 12% State Surch 1/12/200C. $15.60
Phone: Total $178.10
Contractor:
PROTEMP ASSOCIATES INC
17TH
PORTLAND, OR 9 7222
REQUIRED ITEMS AND REPORTS
POR 97222
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 6 : � - ,1 I: r �� i Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that usiness 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 roll OFFICE USE. O `1_,
Received (y � �y�
City of Tigard Date/B • • a 'CA 0 Permit No.: 1 t 1 41% • 0 W ,.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie ' w
' Phone: 503.639.4171 Fax: 503.598.1960 JAN 0 8 2009 Date im Other Permit: ` Bkt P2.00g ., -
T I G A R D Inspection Line: 503.639 Date Rea 7y :y: ® See Page 2 for t
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISIO .
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: $ $4,500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling (0 Commercial/industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AM) LOCATION Heating/cooling yt
Job site address: 15350 SW SEQUOIA PKWY I q O Air conditioning or heat pump
(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.: #190 Project name: DIANA HARRISON CPA 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: I 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 fireplace 10.00
RELOCATE GRILLS FOR NEW FLOOR PLAN
Flue vent for r water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ 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 ® CONTACT PERSON Attic /crawlspace fans 10.00
Business name: PROTEMP ASSOCIATES �' 10.00
Fuel piping
Contact name: BRUCE BUTNER $5.40 for first four; $1.00 for each additional
Address: 9788 SE I7 AVE • Furnace, etc.
Gas heat pump
City/ State/ZIP: PORTLAND OR 97222 Wall/suspended/unit heater
Phone: (503) 519-6.1.1)9-- (,4 (( 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
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) /AO •
Plan review (25% of permit fee) 3a•°
CCB lic.: 38868 State surcharge (12% of permit fee) /6 4'O
TOTAL PERMIT FEE I/7 Q• /
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after It has been accepted as complete.
I Print name: BRUCE BUTNER I Date: 1/8/09 • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 440- 46I7T(I1 /02/COM/WEB)
•
CITY OF TIGARD
BUILDING DIVISION • PERMIT #:
MEC 2809-00012
13125 SW Hall Blvd., Tigard, OR .97223 DATE ISSUED: 1/12/2003
Phone: (503) 639-4171 ityptli
Inspection Requests (24 His.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/132009 TIME: 7 00AM PAGE: 13
SITE ADDRESS: 15350 SW SEQUOIA PKWY 190 CLASS OF WORK: •
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: 002 TYPE OF USE:
PROJECT NAME: DIANA HARRISON CPA
,DESCRIPTION: Ti Rc loc; to floor grills. Value $4,500
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: Pr OTEMP. ASSOCIATES INC PHONE #: 5O3 -519 -6199
Inspection Request Scheduled For: Date: 1/13/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Messa.e
699 Mechanical final 079631.03 503-619-6199
Corrections /Comments / Instructions:
C1-7 diP
•
•
,! F,.' I� PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
I FAIL " ; ALL FOR INSPECTION - U ADDITIONAL FEES ASSESSED
Inspector: Date: _ ,. Phone #: (503) 718 - Z "