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Permit q CITY OF TIGARD MECHANICAL PERMIT 2 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00490 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/02/2011 Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 350 Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT Project Description: Relocating duct for TI. 11/17/11, reprinted permit for address correction. Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES 9788 SE 17TH AVE ATTN: N PIVEN PORTLAND, OR 97222 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE: 503 - 233 -6911 PHONE: FAX: 503 - 238 -9767 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 11/02/2011 $210.02 Class of Work: ALT Type of Const: Plan Review 11/02/2011 $52.51 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/02/2011 $25.20 Stories: Project Valuation: $5,100.00 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 $287.73 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) 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 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. 1 � � Issued By: .Permittee Signature: Call ..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 3 4 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00490 Date Issued: 11/02/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 2S101AD03200 Jurisdiction: Tigard Site address: 12909 SW 68TH PKWY 300 Project: Williston Financial Group Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT Project Description: Relocating duct for TI. Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES 9788 SE 17TH AVE ATTN: N PIVEN PORTLAND, OR 97222 15350 SE SEQUOIA PKWY #300 PORTLAND, OR 97224 PHONE. 503 - 233 -6911 PHONE: FAX: 503 - 238 -9767 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 11/02/2011 $210 02 Class of Work: ALT Type of Const: Plan Review 11/02/2011 $52 51 Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 11/02/2011 $25 20 Stories: Project Valuation: $5,100 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 $287.73 Hoods. Comm Incinerators Woodstoves Gas Fireplaces Required Items and Reports (Conditions) 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 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: d 3(2 x_dre „,_,.. G 1 Alw 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 City of Tigard <4.9 Received Date /By II Permit No • #� / e . 13125 SW Hall Blvd., Tigard, OR 97223 .. Plan Review - Phone: 503 639.4171 Fax • 503.598 1960 =I..' %., ,� Date /By Other Permit. g e. „,, -'��- TIGARD Inspection Line: 503.639.4175 �j - �Q (( Date Ready /By ® See Page 2 for - Internet: www.tigard gov �� � 1 I, rN5t1fied /Method Supplemental Information © ,., ■.Q ' i e., FM T]EPE OF WORK a =>-:y'.e' COMIYIERCIAI 300.2 SCHED =-AL1SE CHECI{1.:IST ` "' " . ;, ,.-,:,, :: :, t + � ma y ' : .rJ, ° - tcts. Mechanical permit fees* are based on the value of the work El New construction ®Addition /alteration m placeent performed Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: %� *� mechanical materials, equipment, labor, overhead, and profit „ „„, �. , Value $ $5,100.00 %` °'` ':'S” . _ .CATEGORY :OF`COIVSTII ;ION ; ;,°•, : =�i or."�._> .. :.t:3. �.,F .. •Y�. . -..�;, � .. ._ _ _ � ,,.e^w:�'y. �5 x- e a« , �,. .p �- , - _. � ,� . .�. „ "y ��1 RESIDENTI` 3 ,, STEMS FEES' , i;�,.� ID 1 - and 2 - family dwelling ® Commercial /industrial ❑ Accessory building °' " " For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total :JOB ":S��tE flI2 tTION AND LOCATION Heating/cooling Air conditioning Job site address: 12909 SW 68 Parkway (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.: #350 Project name: Williston Financial 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 electnc), 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 DESCRIitioN OFW% 67.4I{ 'i Water heater 23.32 Gas fireplace 33 39 relocate duct for tentant inprovement 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 K Chimney/liner/flue/vent 23 32 > -, - , -. A .a . ; OWNER= ; ' TEN ". 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 >" Attic /crawlspace fans 23 32 APPLICANT" �' ti' ;��� ®;; %GON'PAC'T,PERSONv Other 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 Fax: : (503) 238 -9767 Water heater Fireplace - E-mail: bruce@protmp.com Range ;,�r� %.� TOR ,E , Barbecue ,, i'; Business name: same as above Clothes dryer (gas) Other: Address: ' . =' , ' :11V - MEGH CAL I'ERMITEEES:. = City /State /ZIP: Subtotal jo, W., Minimum permit fee ($90.00) Phone: ( ) Fax: ( ) Plan review (25% of permit fee) S CCB lie.: 38868 State surcharge (12% of permit fee) TOTAL PERMIT FEE -, wit 7, •7j Authorized signature: / This permit application expires if a permit is not obta ed hin 180 " L days after it has been accepted as complete. Print name: Bruce Butner Date: 11/2/11 * Fee methodology set by Tri- County Building Industry Service Board t \Bmtdmg \Permits \MEC- PermiApp doe 10/01/09 440 -4617T (11 /02 /COM/WEB)