Permit f ti
i
CITY OF TIGARD WHIM MECHANICAL PERMIT
; COMMUNITY DEVELOPMENT Permit #: MEC2011 00013
T t G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011
Parcel: 1 S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 430
Project: Farmers Insurance Subdivision: Lot: 0
Project Description: Relocate ducts and grills for TI. 2/3/11, reprint to correct project name.
Contractor: PROTEMP ASSOCIATES INC Owner: WISCO REAL ESTATE EQUITY
9788 SE 17TH AVE 1501 SW TAYLOR STREET, SUITE 100
PORTLAND, OR 97222 PORTLAND, OR 97205
PHONE: 503 - 233 -6911 PHONE: 503 - 294 -0400
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/05/2011 $81.34
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 01/05/2011 $9.76
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $900.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $91.10
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 -0090. You may obtain a copy of the rules
or direct qu- • 9 UNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: A /, 4 Permittee Signatu Ai ,Ar.-
1
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.
CITY OF TIGARD MECHANICAL PERMIT
li 2 ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00013
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011
Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 430
Project: State Farm Subdivision: Lot: 0
Project Description: Relocate ducts and grills for TI.
Contractor: PROTEMP ASSOCIATES INC Owner: WISCO REAL ESTATE EQUITY
9788 SE 17TH AVE 1501 SW TAYLOR STREET, SUITE 100
PORTLAND, OR 97222 PORTLAND, OR 97205
PHONE: 503 - 233 -6911 PHONE: 503 - 294 -0400
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/05/2011 $81.34
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 01/05/2011 $9.76
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $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 $91.10
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 N • tion 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 dir t questions to OU C alli 503.232.1987 or 1.800.332.2344.
Issue By: . r 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
7
City of Tigard C 1 �/ Et� Received
Date/By: / Permit No.: ee` / Q
13125 SW Hall Blvd., Tigard, OR 97 lJ1 •
Phone: 503.639.4171 Fax: 503.598.1960 Plan Review
II � ., Date /By: Other Permit: L /,,,,,, OelOa JAN / �l , �
TI G A R D Inspection Line: 503.639 1 A N ®� 201 I Date Ready /By: • kris: El See Page 2 for
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
CITY OF T GGARD
•
TYPE OF �G D 1\1 ' o~ COMMERCIAL FEE* SCHEDULE L USE CHECKLIST
El 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: $ $900.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
Multi-family Master builder For special information use checklist.
El y ❑ ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9020 SW WASHINGTON SQUARE 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.: 490 y30 Project name: STATE FARM INSURANCE 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
RELOCATE GRILLS FOR TENANT INPROVEMENT Gas fireplace 33.39
•
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
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: .23.32
Business name: Protemp Associates Fuel r m
Pp >;
Contact name: Bruce Butner - $14.15 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 t ( • 3 `/
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) _�
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of permit fee) 9 w
TOTAL PERMIT FEE 9l . IO
Authorized signature: �� This permit application expires if a permit is not obtains within 180
days after it has been accepted as complete.
Print name: Bruce Butner I Date: 1/5/11 * Fee methodology set by Tri -County Building Industry Service Board
I:\ Building /Permits \MEC- PermitApp.doc 10/01/09 440- 4617T(II /02 /COM/WEB)