Permit a CITY OF TIGARD MECHANICAL PERMIT
.111 > ° COMMUNITY DEVELOPMENT Permit #: MEC2009 -00449
I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/28/2009
T.
Parcel: 2S113AA00300
Jurisdiction: Tigard
Site address: 16316 SW 72ND AVE B3
Subdivision: OREGON BUSINESS PARK I Lot: 0
Project: Spec space
Project Description: Replace rooftop unit, ducts, grilles, (2) exhaust fans & (2) unit heaters.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 08/28/2009 $247.70
PORTLAND, OR 97224 Plan Review 08/28/2009 $61.93
PHONE: 503 -624 -6300 12% State Surcharge - Mechanical 08/28/2009 $29.72
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: VB
Occupancy Grp: B Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas 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: 2 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 3 Vent Systems: Total $339.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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, o ' . • . is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili .otification Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or , erect questions to OU - c. Ilin• 503.246.6699 or 1.800.332.2344.
Iss • • d By: k / /( Permittee Signature: x
Call 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.
. L PO F an/4/
Mechanical Permit Applicatio
(,,; FOR OFFICE USE ONLY
City of Tigard Ej Received ,/
�� i't Date / . acs o q � Permit No.:Hed,opeg DD7 y9
1111 C ° 13125 SW Hall Blvd., Tigard, OR 97223 - I an Phone: 503.639.4171 Fax: 503.598.1960 Date /By: 1 � ` � 7 Other Permit:
TIGARD Inspection Line: 503.639 Q LI r 2 6 2009 Date Ready/By: luris
See Page 2 for
Internet: www.tigard - or.gov Notified/Method: % a //Plait' S s Suplemntal Information
CFR' OF T?GARD ! . , MID P / - 0 .
TYPE OF ddbIJMNG DIVISION rCOMMERCIAL FEE* SCHEDULE — USE CHECKLIST
ID 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: $ 511,200.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
❑ Multi family 0 Master builder El Other: For special information use checklist.
Description I Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 16316 SW 72 AVE Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: TIGARD OREGON 97224 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: BLDG3 Project name: Gas heat pump 14.00
Cross street/directions to job site: J g e.. Q('e__S 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
1 -3 TON GAS PACK,DUCT,GRILLS GAS PIPPING,2 RESTROOM EXHAUST fireplace vent for 10.00
Flue vent for water heater or gas
2- UNIT HEATERS fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER 1 ❑ 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: ( ) I 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 55.40 for first four; $1.00 for each additional
Address: 9788 SE 17 AVE Furnace, etc.
Gas heat pump
City/State /ZIP: PORTLAND OREGON 97222 WalUsuspended/unit heater
Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: SANE AS ABOVE Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 7::, Phone: ( ) Fax: ( ) Minimum petmit fee ($72.50) / •
Plan review (25% of permit fee) Le ( • 4 3
CCB lic.: 38868 State surcharge (12% of permit fee) p.72
TOTAL PERMIT FEE _5 4%. 35`
Authorized signature: This permit application expires if a permit is not obtained within 180
�i�.fiGC_ days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 8/26/09 * Fee methodology set by Tri- County Building Industry Service Board
IlL I: \Building \Permits \MEC- PermitApp.doc 01 /19/07 440- 4617T(11 /02 /COM/WEB)