Permit CITY OF TIGARD MECHANICAL PERMIT
: 0 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00051
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/04/2010
T f C„'�R. - 9 Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 180
Subdivision: TIGARD TRIANGLE CENTER Lot: 0
Project: Spec Space
Project Description: Turn existing water source hat pump and re duct per TI.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 Permit Fee 02/04/2010 $151.95
Plan Review 02/04/2010 $37.99
PHONE: 503 - 624 -6300 12% State Surcharge - Mechanical 02/04/2010 $18.23
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222
PHONE: 503 - 233 -6911
FAX: 503 - 238 -9767
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: B Occupancy Load:
Stories: 3
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
•
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $208.17
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire /Smoke Dampers: 1
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OU C by calling 503.246.6699 or 1.800.332.2344.
Issued By: (� a ria \1� 1 Permittee Signature: � get
1�1
Cali 503.639.4175 by 7:00 a.m. for an inspection 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.
• + Ir.
Mechanical Permit Application RECEIVE FOR OFFICE USE O \'1.1'
City of Tigard Received „ Permit 0 ' 0
514
111 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ,r
2 2010 1
tJ
Phone: 503.639.4171 Fax: 503.598.1960 pate /By: i� (� 1I' Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /By: ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: .1 • , E Supplemental Information
BUILDING DIVISIO
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El 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: $ $3,200.011
❑ 1- 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ® C ommercial /industrial ❑ Ac cessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 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.: 180 Project name: TIGARD TRIANGLE SPEC CORR 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
TURN EXISTING WATER SOUCE HEAT PUMP AND RE DUCT PER TI
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 ( ❑ 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 0 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 a dditional
Address: 9788 SE 17 AVE Furnace, etc.
Gas heat pump
City/State /ZIP: PORTLAND OREGON 97222 WalVsuspended/unit heater
Phone: (503) 519 -6199 I 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)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of permit fee)
TOTAL PERMIT FEE Ol
Authorized signature: This permit application expires if a permit is not obtained with IV �,L�c� days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 2/1/10 * Fee methodology set by Tri -County Building Industry Service Board
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