Permit n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 00668
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2010
T E CARD Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15951 SW 72ND AVE
Project: Miller Paint Subdivision: OREGON BUSINESS PARK III Lot: 38
Project Description: Mechanical for TI.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
9788 SE 17TH AVE 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97222 PORTLAND, OR 97224
PHONE: 503 - 233 -6911 PHONE: 503 - 624 -6300
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/29/2010 $316.80
Class of Work: ALT Type of Const: VB Plan Review 12/29/2010 $79.20
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 12/29/2010 $38.02
Stories: 1
Project Valuation: $8,900.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $434.02
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 3
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 FOR OFFICE USE ONLY i
P
Other Permit: ��,,,�
City of Tigard Date/By: . t/ -. Permit No.: t • r Fic ? � f � a w` LX.)
. ° 13125 SW Hall Blvd., Tigard, OR 97223 y ' = '
�/ �� Plan Review> ,
Phone: 503.639.4171 Fax: 503.598.19 � 1, Date /By: Ai�i� � � � Q--- • r, / i
T 1 G A R D Inspection Line: 503.639.4175 , a Ready : y ® See ' age 2 for
Internet: www.tigard- or.gov v� O � � G , 1 " otified/Meth..: f 0 t1L , Supplemental Information
TYPE OF WORK CA \` COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /rep ent
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ 966
RESIDENTIAL EQUIPME / SYSTE S FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15951 SW 72 AVE • Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: Tigard Oregon 97224 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: MILLER PAINT
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 23.32
DEMO EXISTING DUCT AND REPLACE WITH SPIRAL DUCT FOR THREE Gas fireplace 33.39
EXISTING UNITS 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
, Chimney/liner /flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) • toilet compartments, utility rooms) 23.32
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Protemp Associates Fuel piping
Contact name: Bruce Butner $14.15 for first four; $4.03 for each additional
• 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 (gas)
Business name: same as above Other.
Address: MECHANICAL PERMIT FEES*
Subtotal
City/State /ZIP: ,^ l6 SO
Minimum permit fee ($90.00) —'
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) • Re
CCB lic.: 38868 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
* Fee methodology set by Tri- County Building Industry Service Board
Print name: Bruce Butner Date: 12/22//10
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