Permit MECHANICAL PERMIT
q CITY OF TIGARD
IN
I: COMMUNITY DEVELOPMENT Permit #: MEC2009-00328
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/15/2009
Parcel: 2S112DC00500
Jurisdiction: TIGARD
Site address: 15895 SW 72ND AVE 190
Subdivision: OREGON BUSINESS PARK III Lot: 40
Project: Truman Capitol Advisors
Project Description: HVAC TI
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
Permit Fee 07/15/2009 $157.70
#300 Plan Review 07/15/2009 $39.43
PHONE: 12% State Surcharge - Mechanical 07/15/2009 $18.92
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222
PHONE: 503 - 233 -6911
FAX: 503 - 238 -9767
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: B Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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: 2
Appliances
Vent Fans: Vent Systems: Total $216.05
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 Not ion Center. •ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dire questions to OUNC • i • 5• .246.6699 or 1.800.332.2344.
Issued y: / ' S � ! _ tL _ t 2_4 Permittee Signature: )LeI gfecte.=
Call 503.639.4175 by 7:00 a.m. for an inspection 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 AQplicatio ECEI V D -. — i;oR (Tir i(1 11 F ONI
City of Tigard Received q To Permit Pe rmitNo.:
Data
13125 SW Hall Blvd., Tigard, OR 97223 JUL 0 7 2009 Y tit e40. f 003x8
' Phone: 503.639.4171 Fax: 503.598.1960 Da y. iew 7(i% al p Permit:
-1..i G A i b Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: ( r i ' H See Page 2 for
• Internet: www.tigard- or.gov BUILDING DIVISION t°ttied/Method 7 /1/ / o / 77( Supplemental
Atod - lir 4A-
/
TYPE OF WORK 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: $ 5900.00
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building Er l lAb lyQiJLPMENT /SYSTEMS FEES*
❑ Multi - family ❑ Master builder ❑ Off: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15895 SW 72 AVE 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.: #190 I Project name: TRUMAN CAPITAL 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
Subdivision: I Lot no.: Flue/vent for any of above 6.80
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
1 -NEW 2 -TON WATER SOURCE HEAT PUMP 1 -1 -TON WATER SOURCE HEAT Gas fireplace 10.00
Flue vent for water heater or gas
PUMP WITH DUCTS & GRILLS AND RE- LOCATE DUCT FROM EXISTING fireplace 10.00
Log lighter (Ras) ( 10.00
HEAT PUMP FOR NEW FLOOR PLAN Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: _ 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00 f
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; 51.00 for each additional
Address: 9788 SE 17 AVE Furnace, etc. I I
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
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) .
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of pemut fee)
TOTAL PERMIT FEE °5
Authorized signature This p ermit application expires if a permit is not obtain w ithin 180
days after it has been accepted as complete.