Permit ,, r.`` )- CITY OF TIGARD f MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00718
TCG'ARD DATE ISSUED: 12/12/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101AD - 03200
SITE ADDRESS: 12909 SW 68TH PKWY 340 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: MERIDIAN TECH GROUP
Project Description: Move ducts and grilles for TI. Project Value: $12,000
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-MI
PORTLAND, OR 97224 [MECH] Permit Fee 12/12/20C $258.50
[TAX] 8% State Surchar€ 12/12/20C $20.68
Phone:
Total $279.18
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 Munidpal 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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued ::
el
/w ,` ,_ / Permittee Signature
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.
�:a'� �" y�L �� _ ,. r ^` f 1. y, . t
Mechanical Permit Application .4FOR ; K
Received� t�
City of Tigard Date/By: Permit No.: 1 I ',)
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 y4ar e Date/By: Other Permit:
Inspection Line: 503.639.4175 i b . �� .e1' I rt I • Date Read /B El See Page 2 for
Internet: www.ci.ti ard.or.us ; w - -- � Ready /By: lin g
g Notified /Method: Supplemental Information
TYPE OF. WORK . 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.
. • ,CATEGORY OF CONSTRUCTION. . • ' Value: $ $12,000.00
RESIDENTIAL .EQUIPMENT' / SYSTEMS FEES *' .
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
® Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. 1 Total
.. , JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12909 SW 68 PKWY Air conditioning or heat pump
(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.: SUITE 340 Project name: MERIDIAN TECH Gas heat pump 14.00
Cross street/directions to job site: 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
i Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION,, OF WORK
Water heater
Gas
MOVE GRILLS AND DUCT FOR NEW FLOOR PLAN fireplace f 10.00
Flue vent for for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
J PRPERTY-OWNER Chimney /liner /flue /vent 10.00
' ❑ ;TENANT .' • Other: 10.00
!!!
Name: - �(,(..�j 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 piping
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 rnrn
Minimum permit fee ($72.50) .5.V
Phone: ( ) Fax:( )
Plan review (25% of permit fee) ....e,
CCB tic.: 38868 State surcharge (8% of permit fee) go, (p
TOTAL PERMIT FEE
`���� This permit application expires if a permit is not obtai tt in 180
Authorized signature: days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 12/12//07 • Fee methodology set by Tri- County Building Industry Service Board
i:\Buitding\Permits \NEC- PermitApp.doc 12/03 440 -46I7T (I I /02/COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Mt_:C_2007- 00718
13125 SW Hall Blvd., Tigard, OR 97223 /- DATE ISSUED: 1 211;x2007
Phone: (503) 639 -4171 �1 y
Inspection Requests (24 Hrs.): (503) 639 -4175 !� 77.
INSPECTION WORKSHEET FOR DATE: 1/31120x TIME: 7 :00AM PAGE: 1
SITE ADDRESS: 12909 S W 6tfm PKWY 340 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE. CENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN TECH GROUP
DESCRIPTION: Move ducts and grilles for Ti. Project Value: $12,000
OWNER: F -V (IFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: F'ROTEMP ASSOCIATES INC PHONE #: 503 - 519 -6199
Inspection Request Scheduled For: Date: 1/31/2000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 064302 -01 503.956.6280 N
Corrections/Comments/Instructions:
A. PAS /4 PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL $ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ,_ A _ Date: lir :c C 6 7 Phone #: (503) 718- ZC
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MI:t r00f- 00718
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: .1 1/ 12/2007
Phone: (503) 639-4171 ''' Asy / ^ICI.
Inspection Requests (24 Hrs.): (503) 639 -4175 _..
INSPECTION WORKSHEET FOR DATE: 12/13/2007 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 12909 SW 68TH PKWY 340 CLASS OF WORK:
SUBDIVISION: TIGARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: MERIDIAN TECH GROUP
DESCRIPTION: Move ducts and grilles for 'fl . Project Value: $12,000
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503. 619'•6103
Inspection Request Scheduled For: Date: 12113/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa e
815 Mc=ctiariical rovgh.in 061471-01 503-519-6199 Y�
Corrections/Comments/Instructions:
diA r PA II PARTIAL APPROVAL ❑ CANCEL NO ACCESS
_ FAIL 114 .CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Date: Z-- . b Phone #: (503) 718- 24 Inspector: � _
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