Permit (26) INICITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2017-00411
TiGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2017
Parcel: 2S112DD01601
Jurisdiction: Tigard
Site address: 15755 SW SEQUOIA PKWY
Project: Orthopedics Northwest Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Relocate ducts and interior a/c,install exhaust fan in new restroom.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES LP
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 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 06/08/2017 $352.79
Class of Work: ALT Type of Const: Plan Review 06/08/2017 $88.20
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/08/2017 $42.33
Stories: Info Process/Archiving-Lg$2.00(over 06/08/2017 $8.00
11x17)
Project Valuation: $10,191.00
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: 1
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $491.32
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
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 i ication .-nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or 'ect questions to O‘ b ca 'ng 503.232.1987 or 1.800.332.2344.
d:7_e%'Ls
ssued By: i # //,d , Permittee Signature: ?cX(*zze..._
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.
D
Mechanical Permit Applica> CEtVE FOR 01 FI( ; t SE 011.1
City of Tigard JUN 8 2017 DateBy: ((�Recei°ed /_e� M�t�
- Permit No.: e1' �� 1/
13125 SW Hall Blvd.,Tigard,OR 97223 r Plan Review
Phone: 503.718.2439 Fax: 503.598.1 \'Ili
OF IGHi3D Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 BUILDING DIVISION! Date Ready/By: jos: la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
T ' COMMERCIAL I'E or �i'OItTi "Er:RCHE>]^1131R.= I�11,IsT
Mechanical permit fees*are based on the value of the work
o New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$10,191.00
CATECOR OF CONSTRUCTION
1 EQCIt1'MT NTf f MSP .S*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist
o Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE IVFOR141(ATIONLOCATION Heating/cooling:
Air conditioning 46.75
Job site address:15755 SW Sequoia Pkwy Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Oregon 9722 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Orthopedics NW 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
OTSCHIPTION OE"WO11rR: Gas fireplace/insert 33.39
Flue vent for water heater or gas
Relocate ducts per prints and move indoor A/C and install,new restroom exhaust fireplace 23.32
shower vent Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
1 ! tENANT
-11 pJ 1'I'li` Other: 23.32
Environmental exhaust and ventilation:
Name: 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
0;APPLICANT ❑;CO TA !F .-•, Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit
heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
:CONT CTO - Clothes dryer(gas)
Business name:Protemp Associates Other:
CIL4NiCAL1 Rl H T I E .*_.. ,
Address:9788 SE 17th Ave Subtotal
City/State/ZIP:Milwaukie Or 97222 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)519-6199 Fax:(503)238-9767 State surcharge(12%of permit fee) ji'/
CCB lic.:38868 TOTAL PERMIT FEE>7 9/• 5-7—
This permit application expires if a permit is not obtain within 180
days after it has been accepted as complete.
Authorized signature: 0e3/1„a„,e_e_ * Fee methodology set by Tri-County Building Industry Service Board
Print name:Bruce Butner Date:6/8/17
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)