Permit CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: MEC2013 -00001
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/02/2013
T [ G A R D g Parcel: 1S126BC01506
Jurisdiction: Tigard
Site address: 9020 SW WASHINGTON SQUARE RD 410
Project: MacDonald Environmental Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Relocate (1) duct run and install return grills as needed for this common return ceiling.
Contractor: PROTEMP ASSOCIATES INC Owner: WYSE INVESTMENT SERVICES
9788 SE 17TH AVE 1501 SW TAYLOR ST STE 100
PORTLAND, OR 97222 PORTLAND, OR 97205
PHONE: 503 - 233 -6911 PHONE: 503 - 294 -0400
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/02/2013 $78.27
Class of Work: ALT Type of Const: Plan Review 01/02/2013 $19.57
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 01/02/2013 $9.39
Stories:
Project Valuation: $800.00
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 $107.23
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Return grills
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: Perm ittee Signature: ON 870,4/ e4t7-70
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 1. ( Oyl \
Applicat' FOR OFF 1( SL
City of Tigard E C E IVE [) o-at By: j� ` o ff — Permit Ngf7�eoj0/3 — 0 ,000 /
III • 13125 SW Hall Blvd., Tigard, OR 97223
C Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 JAN 0 2 2 01 - 3 P
013 Date/By: °the` Perm Q, , a _ / 7
7 1(; n R a Inspection Line: 503.639 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard CITY OF TIGARD Notified/Method: 776- Supplemental Information
BthLDtNG DIVISIO
TYPE OF W RK • COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
N ew construction
❑ ® Addition / alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $800.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I - and 2 family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address.9e atn V Washington Square (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State/ZIP: Tigard Oregon 97224
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/b14./apt. no.: 410 Project name: One Embassy Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: ///G4604 0-/Z. Ehl/l ; /717/ C /174d_i 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 2332
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 2332
relocate one duct run and install return grills as needed this is a common Gas f replace/insert 3339
Flue veent nt for water heater or gas
return ceiling fireplace 2332
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: 2332
Name: Environmental exhaust and ventilation: _
Address: Range hood/other kitchen
equipment 3339
City/State /ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Protemp Associates Other: 23.32
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: Milwaukie Or 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)
j________ TOTAL PERMIT FEE f0 7,
n This permit application expires if a permit is not obtained within 180
Authorized signature:
zz :e ��_` -")� 2 / days after it has been accepted as complete.
Print name: Bruce Butner I Date: 12/28/12 * Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permits\MEC- PermitApp.doc 03 /07/12 440.46I7T (11 /02/COM/WEB)