Permit il 4
CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00042
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/27/2009
PARCEL: 25101 AD -03200
SITE ADDRESS: 12909 SW 68TH PKWY 430 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Relocate grilles for TI. Project Value: $950
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODDRYERS:
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 1/27/200c $72.50
[TAX] 12% State Surch 1/27/200c $8.70
Phone:
Total $81.20
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 • I // , J, ... , Permittee Signature: l
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 Applicatio tE CENED FOR OF I ICI USE ONLY
City of Tigard Received
Date/By:
� Permit No.: M�/t � ,�9 „Oa) 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review "v
• Phone: 503.639.4171 Fax: 503.598.1960 JAN 2 7 2009 Date /By: Other Permit:
T 1 G A R D inspection Line: 503.639 Date Ready /By: 1' Hi See Page 2 for
Internet: www.tigard CITY OF TIGARD Notified/Method: (O. Supplemental Information
BUILDING DIVISION
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: $ $950.00
1- and 2 -famil dwelling Commercial /industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
El y g ® ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12909 SW 68 PKWY Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: TIGARD OREGON 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 430 Project name: TIGARD TRIANGEL SPEC SPAC
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 fireplace 10.00
MOVE GRILLS FOR NEW FLOOR PLAN
Flue 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 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
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: Range
CONTRACTOR Barbecue
Business name: SAME AS ABOVE
Clothes dryer (gas)
Other
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Phone: ( ) I Fax: ( ) Minimum permit fee ($72.50) ljiie5
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of pemtit fee) 1 0
TOTAL PERMIT FEE g' ,
Authorized Si afore' This permit application expires if a permit is not obtained within 180
1'� days after it has been accepted as complete.
I Print name: BRUCE BUTNER I Date: 1/27/09 • Fee methodology set by Tri-County Building Industry Service Board
1:\ Building \Pamits\MEC- PamitApp.doc 01 /19/07 440 - 46171(11 /02/COM/WEB)
CITY OF TIGARD di
BUILDING DIVISION PERMIT #: N1E:C2009-00042
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: -1/27000,
• Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/20/20 9 • TIME: •oiAlvi PAGE: . 6
• •
SITE ADDRESS: 12909 SW 68TH WAY 430 . CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER 'LOT #: TYPE OF USE:
• PROJECT NAME: SPEC SPACE •
DESCRIPTION: Relocate grilles for TI. Project Value: $960
OWNER: PACIFIC REALTY ASSOCIATES, • • PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503
Inspection Request Scheduled For: Date: 1/28/2009 Pour Time:
Code # Inspection Description Confirm #- .Contact # Message
• 699 IVIechanical final ,080068-02 503-619-'6199
Corrections/Comments/Instructions:
•
•
El CANCEL-
I A PAS FA ". APPROVAL
fr •
IL ALL FOR INSPECTION
A ' ADDITIONAL FEES ASSESSED n NO ACCESS
Inspector: • Date: 1 i Phone #: (503) 718-