Permit v CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00617
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/29/2008
PARCEL: 2 S 101 A D -032 00
SITE ADDRESS: 12909 SW 68TH PKWY 190 ZONING: MUE
SUBDIVISION: TIGARD TRIANGLE CENTER LOT: JURISDICTION: TIG
PROJECT: BENEFICIAL
Project Description: Relocate grilles for TI. Project Value: $1,100
NO PLAN REVIEW REQUIRED.
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:
WO
GAS PRESSURE: 50 + HP: CL DSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS LO 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 -WMI
PORTLAND, OR 97224 [TAX] 12% State Surch 12/29/20C $8.70
[MECH] Permit Fee 12/29/20C $72.50
Total $81.20
Phone:
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 Municipal 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 OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue By: Permittee Signature: k'gg Z s
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.
Mechanical Permit Application, Foli (wrier: usl� °N�l_�
City of Tigard CE D Received
Date/By: q 08 A, !)
Permit No.:Atite) /. ,
II
0
13125 SW Hall Blvd., Tigard, O 97223
Q
Phone: 503.639.4171 Fax: 503•598•1nspec rQ�E1c 2 9 ZOO8 Date/By: Other Permit:
Plan Review / �,
TIGARD
Inspection Line: 503.639 UU C Date Ready /By: gli See Page 2 for
Internet: www.tigard ocgov
a TIGARD Notified/Method: Supplemental Information
d �OD I V ISION
TYPE COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ® 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: $ 1100.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 - family dwelling ® Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family 0 Master builder 0 Other:
Description I Qty. 1 Ea. I 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 OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 190 Project name: BENEFICIAL FINANCE Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Flue/vent for any of above 6.80
Subdivision: I Lot no.:
Other _ 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
RELOCATE GRILLS FOR T.I.
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER 0 TENANT Chimney/liner /flue/vent 10.00
Other 10.00
Name: 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
Business name: PROTEMP ASSOCIATES Other 10.00
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 OR 97222 Wall/suspended/unit heater
Phone: (503) 519 -6199 I Fax: : (503) 238 -9767 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: SAME AS ABOVE Clothes dryer (gas)
Other
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum pert fee ($72.50) 7 '
Phone: ( ) Fax: ( )
Plan review (25% of permit fee) .9'
CCB lic.: 38868 State surcharge (12% of permit fee) 1.10
TOTAL PERMIT FEE g/. Rp
Authorized signature: atn This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name:.BRUCE BUTNER I Date: 12/10/08 • Fee methodology set by Tri-County Building Industry Service Board
1:\Building \Permits \MEC- PermitApp.doc 01 /19/07 440- 4617T(11 /02/COM/WEB)
CITY OF TIGARD •
„ _ . .,
BUILDING DIVISION PERMIT #: MEC2008-00617
13125 SW Hall Blvd Tigard OR 97223 . ,- DATE ISSUED: 12/29p006
Phone: (503) 639-4171 ikatio # 7
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/30/20013 d' TIME: 7:00AM _ PAGE: 10
SITE ADDRESS: 12909 SW 68TH PKWY 190 CLASS. OF WORK:
SUBDIVISION: -
f I ARD TRIANGLE CENTER LOT #: TYPE OF USE:
PROJECT NAME: BENEFICIAL
DESCRIPTION: Relocate grilles for TI. Project Value: $1,100
NO PLAN REVIEW REQUIRED. .
OWNER: PACIFIC REALTY ASSOCIATES, PHONE #:
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519.6199
. ,
Inspection Request Scheduled For: Date: 12/3W2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
699 Mechanical final 07924&01 503-519-6199 011P
Corrections/Comments/Instructions:
• .
•
. • .
4 1 so parl 1 PARTIAL APPROVAL 0 CANCEL E] NO ACCESS
• FAIL MI CALL FOR INSPECTION 11 ADDITIONAL FEES ASSESSED
Inspector: A
1 Date: / &°1 Phone #: (503) 718-Z--C.