Permit =; CITY OF TIGARD MECHANICAL PERMIT
' : * :. COMMUNITY DEVELOPMENT Permit#: MEC2014-00580
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/22/2014
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 160
Project: Michael O'Brien Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Relcoate grills for new floor plan,add(1)exhaust fan in IT room and(1)exhaust fan in breakroom.
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 10/22/2014 $311.18
Class of Work: ALT Type of Const: Plan Review 10/22/2014 $77.80
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/22/2014 $37.34
Stories:
Project Valuation: $8,695.00
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: 2 Vent Systems: Total $426.32
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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 Noti . .ii 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 di - questions to •UNC s calling 503.232.1987 or 1.800.332.2344.
•
sued By:
d •
y: 40 //� j Permittee �� ��
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 ►;OR O1 FIC use ONLY
a City of Tigard •1 Received e� Cn, if/ �y5p 7• "d g 'r :r Date/By: /rf Ot' Permit No.: C l �1�(/JOV
13125 SW W Hall Blvd.,Tigard,O'„9 f Plan Review �^ l`
° ?','".' • Phone: 503.718.2439 Fax: 503.598.1960 Date/By. Other Permit: 41-el Y —619,23`
•T I G A R D Inspection Line: 503.639.4175 OCT' 2 2 ?.l,LI Date Read/B _furls:
Internet: www.tigard-or.gov Notified/Method: Supplemental See Page l Information
CITY•�I /�� Supplemental Information
TYPE 5� ���It ro . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New 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:$$8,695.00
. ,CATEGORY OF'CONSTRUCTION 'R ESIDENTIAL EQUIPMENT/SYSTEMS FEES* '
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total
.,,.,.. .", ,',,.,„,a.,,.: JOB.'SITE„1NFORMATION AND LOCATION 1
Heating/cooling:
Air conditioning 46.75
Job site address: 12909 SW 68th PKWY Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Or 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:160 Project name:O'Brien Associates Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
. , DESCRIPTION OF WORK Gas fireplace/insert 33.39
' Flue vent for water heater or gas
Move grills to new floor plan 1-new exhaust fa for./,room,1-new exhaust fan fireplace 23.32
for break room Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
Q.PROPERTY OWNER TENANT Environmental exhaust and ventilation:
Name: Pp, -1-46,t_. 7"-- Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT , :❑ ,CONTACT,PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name:Bruce Butner Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/Z1P: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
"" " =CONTRACTOR- . . ,` . .' Clothes dryer(gas)
Business name:Protemp Associates Other:
' MECHANICAL PERMIT FEES*
Address:9788 SE 17th Ave Subtotal 8",1 S
City/State/ZIP:Milwaukie Or 97222 Minimum permit fee($90.00)
Plan review(25%of permit fee) '77,80
Phone:(503)519-6199 Fax:(503)238-9767 State surcharge(12%of permit fee) 3 7, 39
CCB lie.:38868 TOTAL PERMIT FEE y�,9
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:)6i _ * Fee methodology set by Tri-County Building Industry Service Board
Print name:Bruce Butner Date: 10/22/14
1:\Building'.Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)