Permit - n CITY OF TIGARD
MECHANICAL PERMIT
II ,'- COMMUNITY DEVELOPMENT Permit #: MEC2009 -00212
.TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/15/2009
Parcel: 2S113AB01400
N Jurisdiction:
Site address: 7358 SW DURHAM RD BLDG G
Subdivision: Lot: 0
Project: CORAM
Project Description: TI -
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY Permit Fee 05/15/2009 $674.30
#300
Plan Review 05/15/2009 $168.58
PHONE. 12% State Surcharge 05/15/2009 $80.92
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 $923.80
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 No • � ion - • -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dir questions to 0 C • -I, in. 503.246.6699 or 1.800.332.2344.
Issue By: 0 � 0 Permittee Signature:
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.
Mechanical Permit Applica • ', % CEWE �
DR FOR OFFICE ��SE O
City Of Tigard eceveate/By: id ` Permit �'� �t:T/9 �d1/
q 13125 SW Hall Blvd., Tigard, OR 97223 t
Plan Review
II - Phone: 503.639.4171 Fax: 503.598.19ttg i 5 2009 Date/By: '% j t a r" Other Permit:
Inspection Line: 503.639.4175
.T 1 K.h Internet: www. CITY OF TIGARD Date ed /Met y: Page 2 for
trgerd or.gov Notified/Method: IIMI Supplemental Information
1P1 ORK - ILD1Nr DIVISION
- - _� -- TYPE O COMMERCIA ;FEE,* SCHEDULE — USE "CHECKLIST=
❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (round -, :. : :..t dollar) of all
❑ Demolition ❑ Other: mechanical materials, e. . y , a . or, . o , aiad profit.
.CATEGORY 'OE CONSTRUCTION _ alue: $ $42,750.00
. -_ RESIDENT Pvl.. •.'I'»! `, ' TEMS.FEES* .
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building - ' -
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
' JOB SITE "INFORMATION AND - - Heating/cooling
•
Job site address: 7358 SW DURHAM RD Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: TIGARD OR 97224 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: CORAM HEALTH
Gas heat pump 14.00
Cross street/directions to job site: 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: Lot no.: Flue /vent for any of above 6.80
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
_ -• DESCRIPTION OF WORT' . -_ -- - - - Water beater 10.00
1- 6 TON PACKAGE UNIT, REDO DUCT ,GAS PIPPING,GRILLS, 8 HEPPA Gas fireplace 10.00
FILTERS Flue vent for water heater or gas
® fireplace 10.00
RESTROM EXHAUST AND CONTROLS Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
❑ PROPERTY OWNER ❑ T - Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT Attic /crawlspace fans 10.00
®- CONTACT PERSON_
' Other: 10.00
Business name: PROTEMP ASSOCIATES Fuel piping
Contact name: BRUCE BUTNER $5.40 for first four; $1.00 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) 233 -6911 Fax: : (503) 238 -9767 Fireplace
E - mail: Range
CONTRACTOR . - ' _ Barbecue
Clothes dryer (gas)
Business name: SAME AS ABOVE
Address: ' . • _ - :MECHANICAL PERMIT 'FEES,' ' _ : .-
Subtotal
City /State /ZIP: Minimum permit fee ($72.50) ( "7 9)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) f ep . 5g
CCB lie.: 38868 State surcharge (12% of permit fee) 80 • 9;
TOTAL PERMIT FEE 9 o_
This permit application expires if a permit is not obtained within 180
Authorized signature: .e�� days after it has been accepted as complete.