Permit • CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00537
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15875 SW 72ND AVE 200
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: CIDA
Project Description: Relocate ducts for TI, install new 1.5 ton ductless slit a/c unit.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 10/13/2009 $274.65
PORTLAND, OR 97224 Plan Review 10/13/2009 $68.66
PHONE: 503 - 624 -6300 12% State Surcharge - Mechanical 10/13/2009 $32.96
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:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers •
Fuel Types: Units < 10000 cfm: 1
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $376.27
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 6
Fire /Smoke Dampers:
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 • - - • OUNC by calling 503.246.6699 or 1.800.332.2344.
lssu • By: 0-g)162{A,C.0-4 Permittee Signature:
o e ,
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.
•
Mechanical Permit A t t IL . - -Folz o,: nc, - sr. UNI: - --
I`" t Receives! City of Tigard � v ii
V DateBy: /D Ara 9 9 PermitNo.: N r eof=a953
• 13125 SW Hall Blvd., Tigard, OR 97223
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Plan Review
Phone: 503.639.4171 Fax: 503.598A60 (� 200 Date/By: Other Permit:
�. ` , Inspection Line: 503.639.4175 Date Ready/By: Ell la See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
Bt '! D "VI" :3Ni
TYPE `�� t 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: $ $7,400.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15875 SW 72ND AVE 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
Suite/bldg. /apt. no.: #200 Project name: CIDA Furnace 100,000+ BTU (ducts/vents) 17.90
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 tLel appliances
DESCRIPTION OF WORK Water heater 10.00
RELOCATE DUCTS FOR NEW FLOOR PLAN ADD 1- NEW 1.5 TON DUCTLESS Gas fireplace 10.00
SPLIT A/C UNIT Flue vent for water heater or as
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue/vent 10.00
❑ PROPERTY OWNER ❑ 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 85.40 for first four, 81.00 for each a dditional
Furnace, etc.
Address: 9788 SE 17" AVE Gas heat pump
City/ State/ZIP: PORTLAND OREGON 97222 Wall/suspended/unit heater
Water heater
Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Fireplace
E - mail: bruce@protmp.com Range
CONTRACTOR Barbecue
Clothes dryer (Ras)
Business name: SAME AS ABOVE Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal n /
Minimum permit fee ($72.50) 0 27L/. 4S
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) (0 {C, (
CCB lic.: 38868 State surcharge (12% of permit fee) 3 a • 7
TOTAL PERMIT FEE ? .017
This permit application expires if a permit is not obtained within 180
Authorized signature: 4 days after it has been accepted as complete.