Permit CITY OF TIGARD MECHANICAL PERMIT
114
it
DEVELOPMENT Permit #: MEC2011 - 00154
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
Parcel: 2S 112 DD00200
Jurisdiction: Tigard
Site address: 15862 SW 72ND AVE 150
Project: Immunology Subdivision: PACIFIC CORPORATE CENTER Lot: 0
Project Description: Relocating ducts and grills.
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 04/12/2011 $240.93
Class of Work: ALT Type of Const: Plan Review 04/12/2011 $60.23
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 04/12/2011 $28.91
Stories:
Project Valuation: $6,200.00
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 $330.07
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / •er " - • 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
Received
City of Tigard " � Date/By: f ! Permit No.: „ — 21.
11
13125 SW Hall Blvd., Tigard, OR 97223
�� `
• Phone: 503.639.4171 Fax: 503.598. Plan Review Other Permit: •
Date/By: w• A. I . i riZ'III
1 1 , , i , Inspection Line: 503.639.4175 51N Date Ready /By: ® See ' age 2 for
Internet: www.tigard �� 1 Notified/Method: EM Supplemental Information
. .. t " � .14 t r t ,, 4 t s t ,1l '—'' E $
❑ New construction ® Addition/altera
• yl Mechanical permit fees* are based on the value of the work
ent performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. $P mechanical materials, equipment, labor, overhead, and profit.
Value: $ $6,200.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15862 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.: 15 I Project name: IMMUNOLOGY 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: I Lot 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
Gas fireplace 33.39
Relocate grills for new tenantapace 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 I ❑ 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 moms) 23.32
® APPLICANT 1 ` � . e �, Attic /crawlspace fans 2332 nloAta 23.32
Business name: Protemp Associates
Fuel piping
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 I Fax: : (503) 238 -9767 Water heater
Fireplace
E -mail: bruce(protmp.com Range
'. Barbecue
Business name: same as above Clothes dryer (gas)
Other:
Address: — PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee ($90.00) NI() . I
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee) (AO), }-
CCB lic.: 38868 State surcharge (12% of permit fee) ,_ , •
TOTAL PERMIT FEE i i, jj (J A ' ' 4 - 4 7:- This permit application expires if a permit is not obtai within 180
Authorized signature: days after it has been accepted as complete.
Print name: Bruce Butner I Date: 4/12/11 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building\Permits\MEC- PamitApp.doc 10/01 /09 440 -4617 (I 1/02/COM/WEB)