Permit n CITY OF TIGARD MECHANICAL PERMIT
`"7 2 COMMUNITY DEVELOPMENT Permit#: MEC2012 -00112
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/08/2012
Parcel: 1S126CA01000
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 115
Project: Sport Clips Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: New 4 ton rooftop unit, ducts, grills, (1) restroom exhaust fan, (1) rooftop exhaust, gas piping & venting for (1) water
heater.
Contractor: PROTEMP ASSOCIATES INC Owner: CAFARO NORTHWEST PARTNERSHIP
9788 SE 17TH AVE PO BOX 422
PORTLAND, OR 97222 FLORHAM PARK, NJ 07932
PHONE: 503 - 233 -6911 PHONE:
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/08/2012 $398.51
Class of Work: ALT Type of Const: VB Plan Review 03/08/2012 $99.63
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/08/2012 $47.82
Stories: 1 Info Process /Archiving - Lg $2.00 (over 03/08/2012 $4.00
11x17)
Project Valuation: $12,000.00 • Info Process /Archiving - Sm $0.50 (up to 03/08/2012 $11.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 1 50 or Greater HP:
Air Conditioning: •
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $561.46
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 Notifica ' • • - • . 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 • •estions to OUN c- ' • 50 32.1987 or 1.800.332.2344.
Issued By: / (10 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
Receiv a Ha� H A A _ 0 _co-.,
/
City of Tigard Date/By: Permit No.: GL�(J
13125 SW Hall Blvd., Tigard, OR 97223
111 Phone: Review
Phone: 503.639.4171 Fax: 503.598.1960 ��l YED Date /By: dio'.' 0 MIN Other Permit: hap/
TI G A R D Inspection Line: 503.639 Date Ready /By: � ruris ® See Page 2 for
Internet: www.tigard or.gov MAR 1 2 012 Notified/Method:_ ', �� Supplemental information
TYPE OF AR 0 14 Tu COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ® Addition /alteration/rep 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: $ $12,000.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building
❑ Multi- family 0 Master builder For special information use checklist.
❑ �' Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9009 SW Hall Blvd 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.: #115 Project name: Sports Clips 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
Gas fireplace 33.39
new 4 -ton RTU,duct,grills, 1- restroom exhaust,l- rooftop exhaust,gas pipping, Flue vent for water heater or gas
vent 1 water heater 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 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
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
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1 7561. ifk
Authorized signature: This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Bruce Butner I Date: 3/1/12 • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \PermasVMEC- PermitApp.doc 10/01/09 440.4617T(II /02/COM/WEB)