Permit li ,- . - - 4 CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00719
TIGARD DATE ISSUED: 12/12/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY497 /OO ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: BENEFICIAL FINANCIAL
Project Description: Move ducts and grilles for TI. Project Value: $7,000
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: 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 12/12/20( $177.50
[TAX] 8% State Surchar€ 12/12/20( $14.20 .
Phone: Total $191.70
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17T1-I 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 / � I ! ,a. Permittee Signature: 6,,,,,,,,A,,,,,
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.
f
Meclnical Permit Application FOR OFFICE USE ONLY
City- Tigard Received permit No.:
Date/By: Q xi f / 7l
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /tn , ,0 � •t� D a t e /B y: Other Permit:
Inspection Line: 503.639.4175 , iJ.. ' Date Ready /By: la See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: WI Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ $7,000.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
® Multi- family ❑ Master builder ❑ Other: Description
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 9722 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: SUITE).91 0 Project name: BENEFICAL Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
MOVE GRILLS AND DUCT 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
6 RO ERTY OWNER. ❑ TENANT Chimney/liner/flue/vent 10.00
I � ' /c . Other: 10.00
Name. �� A,c, r 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: _
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: BRUCE @PROTMP.COM Range
CONTRACTOR Barbecue
Business name: SAME AS ABOVE Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Minimum permit fee ($72.50) i . ,
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB Iic.: 38868 State surcharge (8% of permit fee) 1 .A0
TOTAL PERMIT FEE /9/. ?O
Authorized signature: This permit application expires if a permit is not obtained within 180
g days after it has been accepted as complete.
Print name: BRUCE B TNER I Date: 12/12//07 • Fee methodology set by Tri-County Building Industry Service Board
i:\ Building \PermitsUMEC- PermitApp.doc 12/03 440 -461 Tr (1I /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: h1F C2i107 007'i9
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 177 i ?./2007
Phone: (503) 639 -4171 r d g i`�
Inspection Requests (24 Hrs.): (503) 639 -4175 % 1 I
INSPECTION WORKSHEET FOR DATE: 111 % , 008 TIME: 7 :OOAM PAGE: 49
7O
SITE ADDRESS: 12909 SW 68TH PKWY VT — CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: BENEFICIAL LIFE INSURANCE
DESCRIPTION: Move ducts and grilles for TI. Project Value: $7,000
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519-6199
Inspection Request Scheduled For: Date: 1/18/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess- ■ -
G39 Mechanical final 063269 -01 503.519.6199
ill
Corrections /Comments /Instructions:
!i PAS II PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
II FAIL %, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 Inspector: Date: / 6 , et Phone #: (503) 718- 06
�
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2001.00719
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
Phone: (503) 639 -4171 A � i Inspection Requests (24 Hrs.): (503) 639 4175 _' oli
INSPECTION WORKSHEET FOR DATE: 12/18f2g07 TIME: 7 :01AM PAGE: 72
/.e)v
SITE ADDRESS: 12909 SW 68TH PKWY 490 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: BENEFICIAL LIFE INSURANCE
DESCRIPTION: Move ducts and grilles for TI. Project Value: $7,000
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519-6199
Inspection Request Scheduled For: Date: 12/18/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 061672 -01 503.519 -6199
Corrections /Comments /Instructions:
(elg: a PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ F IL /A 1 LL FOR INSPECTION ❑ ADDITION' L FEES ASSESSED
R
Inspector: _ ��_ Date: E V • Phone #: (503) 718- 1
40