Permit CITY OF TIGARD MECHANICAL PERMIT
114
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00549
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/2010
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 460
Subdivision: Lot: 0
Project: Bjorklund & Montplasir
Project Description: Relocate ducts and grilles.
Owner: FEES
WISCO REAL ESTATE EQUITY Description Date Amount
FUND I LTD PARTNERSHIP, BY WYSE Permit Fee 11/02/2010 $201.07
INVESTMENT SRVS CO, 1501 SW TAYLOR ST
12% State Surcharge - Mechanical 11/02/2010 $24.13
PHONE:
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:
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 $225.20
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, 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 OUNC by calling 503.246.6699 • ::�
Issued By: /�� Permittee Signature: /2 /
Call 503. • • . • 175 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 Application L/
City of Tigard �'® D/By: // o p Permit No.: 1./e0,„_ 4d 5T J am'
° 13125 SW Hall Blvd., Tigard, OR 97223 \ \\
14
G Plan Review '/
C Phone: 503.639.4171 Fax: 503.598.19 01 D ate / B y: Other Permit: h4 am, -0�0 0237
TIGARD Inspection Line: 503.639. � j Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard or.gov k‘O � Notified /Method: Supplemental Information
G P r �
Cj
TYPE OF WORK 1 O` �\ . \
�t COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
`� Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /r performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
. CATEGORY OF CONSTRUCTION
Value: $ $4,800.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description 1 Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9020 SW WASHINGTON SQAURE RD Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: TIGARD OREGON 97223 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: #460 Project name: Bjorklund & Montplasir Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater - 23
Gas fireplace 33.39
Relocate ducts and grills to accommodate new floor plan. Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER ( ❑ TENANT Chimney /liner /flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
0 APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: PROTEMP ASSOCIATES
Fuel piping
Contact name: BRUCE BUTNER 514.15 for first four; $4.03 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 - 901.U7
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of permit fee) :2 17/ 3
TOTAL PERMIT FEE �Q.c NO
Authorized signature: This permit application expires if a permit is not obtained Wain 180
days after it has been accepted as complete.
Print name: BRUCE BUTNER I Date: 11/2/10 * Fee methodology set by Tri-County Building Industry Service Board
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