Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00587
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/22/2006
PARCEL: 2 S 112 D D -01600
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160 ZONING: I -P
SUBDIVISION: PACIFIC CORPORATE CENTER LOT: JURISDICTION: TIG
Project Description: PETROCARD. Install split system A/C for server room. Valuation: $5,100.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 11/22/20C $143.30
[TAX] 8% State Surcha 11/22/20C $11.46
Total $154.76
Phone:
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -519 -6199
FAX 503- 238 -9767
Reg #: LIC 38868
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: fn w Permittee Signature: � c
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Call 503.639.4175 by 7:00 a.m. for inspections 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.
Mecha>rical.Permit A WE FOR OFFICE USE ONLY
Rece ived
Ci of Tigard Permit
h' g 2 2�i , Receive -Air 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 ® ..ilyl� Date/By: Other Permit:
Inspection Line: 503.639.4175 G1 rYQF1� j• DateReady /By: Juris: See Page 2 for
Internet: www.ci.tigard.or.us gV`i.04G D i Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ 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: $ S� 1 0 • C `
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
Multi -famil
❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heatinp/cooling
Air conditioning or heat pump
Job site address: 15575 SW SEQUOIA PKWY (requires site plan showing placement) 14.00
City/State /ZIP: TIGARD OREGON 97224 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: #160 Project name: PETROCARD. Gas heat pump 14.00 •
Cross street/directions to job ste: Duct work 14.00
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. 10.00
• Subdivision: Lot no.:
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
INSTALL SPLIT SYTEM A/C UNIT FORSERVER ROOM Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
Other: _ 10.00 _
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans • 10.00
Other: 10.00
Business name: PROTEMP ASSOCIATES Fuel t to
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Contact name: BRUCE BUTNER $5.40 for first four; $1.00 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 ($72.50)
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (8% of permit fee)
TOTAL PERMIT FEE j'C�, 7(
This permit application expires if a permit is not obtained within 180
Authorized signature: 5� days after it has been accepted as complete.
Print name: BRUCE BUTNER 'vet Date: 9/12/06 • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (11 /02/COM /WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200S- 005137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/22/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 I e ..
INSPECTION WORKSHEET FOR DATE: 12/5/2006 TIME: 7 :00AM PAGE: 4
SITE ADDRESS: 15575 SW SEQUOIA PKWY 160 CLASS OF WORK:
SUBDIVISION: PACIFIC CORPORATE CENTER LOT #: • TYPE OF USE:
PROJECT NAME: PETROCARD
DESCRIPTION: PETROCARD. Install split system NC for server room. Valuation: $5,100.
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519.6199
Inspection Request Scheduled For: Date: 12/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 040678-01 503-519-6199 V
Corrections /Comments /Instructions:
11 i ni ��,
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.....-
L _F--/pAss ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FA ft ❑ CALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED
Inspector: Date: CJ6 Phone #: (503) 718 - Z �