Permit (141) MECHANICAL PERMIT
u CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit#: MEC2017-00139
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2017
Parcel: 2S 112 DA01400
Site address: 15350 SW SEQUOIA PKWY Jurisdiction: Tigard
Project: PacTrust Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Building 241 -Common area update:Install(2)WSPH replace with all new ducts/grills in hallways.
Contractor: PROTEMP ASSOCIATES INC Owner:
9788 SE 17TH AVE PACIFIC REALTY ASSOCIATES
PORTLAND, OR 97222 ATTN: N PIVEN
15350 SW 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 03/02/2017 $589.01
Class of Work: ALT Type of Const: IIB Plan Review 03/02/2017 $147.25
12%State Surcharge-Mechanical 03/02/2017 $70.68
Occupancy Grp: B Occupancy Load:
Stories: 3 Info Process/Archiving-Lg$2.00(over 03/02/2017 $8.00
Project Valuation: $19,500.00 11x17)
Info Process/Archiving-Sm$0.50(up to 03/02/2017 $1.00
11x17)
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 Fumaces: 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:
Hoods: Total $815.94
Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: 2 water
Duct Work: 1 source heat
Fire/Smoke Dampers: 4
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:
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 A lication
City of Tigard h i ; FOR of I�lc> SE o���l.�
s Received
13125 SW Hall Blvd.,Tigard,OR 97223
S I)ateBy: Permit No.: M�A r1•� /,OO j3q
Phone: 503.718.2439 Fax: 503.59 404
.1 �) a; { P1anRevie� t� fig Cr4`t;)
i'I C A K D Inspection Line: 503.639.4175 2 . /e t)1 i Date/By: y ,' 1 �n Other Permit: p� //
Internet: Line:g 03.63 .41gov Date Read B 11 0277
(_ a <� Date Ready/B,
3II��G��� 0 See Page 2 for
:i a i, ® Supplemental Information
TYPE OF WORK ,.
❑New construction COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
®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
0 Demolition ❑Other:
mechanical materials,el ui s ment,labor,overhead,and.rofit.
CATEGORY OF CONSTRUCTION Value:$$19,500.00
❑ 1-and 2-family dwelling 11 Commercial/industrial 0 Accessory building L EQUIPMENT/S
Multi-family
0 Other: RESIDENTIAXSe'EMS FEES
0 Master builderFor special information use checklist.
El Description
JOB""S� FORMATION AND LOCATION Heatin_coolin l: Ea Total
11111 46.75
Job site address:15350 SW Sequoia Pkwy
Air conditionin_ _
City/State/ZIP:Tigard Or Furnace 100,000 BTU(ducts/vents) 467
97224 . 5
Furnace 100,000+BTU(ducts/vents) 11111 54.91
willimmilim
Suite/bldg./apt.no.: Project name:241 Building /1,,
Cross street/directions to job site: / i5� _ 61.06 _
Duct work _
23.32
Hydropic hot waters stem 11111 23.32
Residential boiler(radiator or
h Ironic)
Unit heaters(fuel-type,not electric),
in-wall,in-duct,sus.•nded,etc.
Flue/vent for an of above 46.75
Subdivision: _®_
Lot no.: Other: _®_
Tax map/parcel no.: Other fuel a..fiances:
O1EMIIIPI10N OF WORK _ 23.32
Install 2-WSHP replace with all new duc � _ 33.39
t,grills in hallways Flue vent for water heater or gas
fireplace
Lo_li_ ter :as) • 23.32
Wood/a ellet stove =®_
33.39
Wood fire.lace/insert
_ 23.32
0 PROPERTY OWNER ❑ TENANT Other: 11111 23.32
_ 23.32 11111111111
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
e.ui.mentIIII
City/State/ZIP: Clothes d er exhaust 33.39
Single-duct exhaust(bathrooms, 33.39
Phone:( ) toilet com.artrnents,utility rooms
. 23.32
❑ APP ANT ' Attic/crawlspace fans
23.3211111111 23.32
} CONTACT PERSON
113111111111111111111111111111
Business name:Protemp Associates
1RsON
Other: _
Fuel hi.in!:
Contact name:Bruce Butner $14.15 for first four;$4.03 for each additional
IMEMAddress:9788 SE 17th ave ___
City/State/ZIP:Portaland Wall/sus ended/unit heater IRTMEEmillim ■ __
Phone:(503)519-6199 ===
Fax::(503)238-9767 __
E-mail:bruce@protmp.com
wad
CONTRACTOR Barbecue ���
Business name:Same as above Clothes d er :as _=_
Other: 111111
Address: MECHANICAI PE
City/State/ZIP: Subtotal 11111111111111
Phone:( ) Minimum permit fee($90.00) —
Plan review(25%of permit fee) —
CCB lic.:38868 State surcharge(12%of permit fee) —
TOTAL PERMIT FEE 1111111111111111Authorized signature: ."/ _ .. This permit application expires if a
permit is not complete. within 180
days after it has been accepted as comp
` Fee methodology set by Tri-County Building Industry Service Board
Print name:Bruce Butner
Date:2/8/17
I:\Bui1ding\Permits\ EC_PermitApp_040113,doc
440-4617T(11/02/COM/WEB)