Permit /A ,1 ` / / ` — "J— . tc„,( .:1 -"Leif .
n CITY OF TIGARD MECHANICAL PERMIT
71 m ` CO MMUNITY DEVELOPMENT Permit #: MEC2009-00652
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T I G AA [7 1 3 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/10/2009
Parcel: 2S113AD01900
Jurisdiction: Tigard
Site address: 16640 SW 72ND AVE B10
Subdivision: OREGON BUSINESS PARK I Lot: 9
Project: Veris
Project Description: Install (3) gas packs, ducts, grilles & gas piping.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Permit Fee 12/10/2009 $1,988.70
PORTLAND, OR 97224
Plan Review 12/10/2009 $497.18
PHONE: 503 - 624 -6300 12% State Surcharge - Mechanical 12/10/2009 $238.64
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: IIIB
Occupancy Grp: S -1 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas 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: 1 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $2,724.52
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 3
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 Notificatio Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct que ons to OUNC •y callirTtj 503.246.6699 or 1.800.332.2344.
Issued B : ..- I ' / ' Permittee Signature:
Cali 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.
a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00652
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/10/2009
T I G r1 R D 9 Parcel: 2S 113AD01900
Jurisdiction: Tigard
Site address: 16640 SW 72ND AVE B10
Subdivision: OREGON BUSINESS PARK I Lot: 9
Project: Veris
Project Description: Install (3) gas packs, ducts, grilles & gas piping.
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300
Permit Fee 12/10/2009 $1,988.70
PORTLAND, OR 97224
Plan Review 12/10/2009 $497.18
PHONE: 503 - 624 -6300 12% State Surcharge - Mechanical 12/10/2009 $238.64
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: IIIB
Occupancy Grp: S -1 Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: 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: Total $2,724.52
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 3
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 No ' • • ion - - . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dir questions to OU C b 01 1 g 50. or 1.800.332.2344.
Issu d By: . I / I 1 Permittee Signature: l c 1 ,
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.
r _ M echanical Permit Application. T � — _ FOR I (I 1 S I O N L 1
City of Tigard CE�E1.> Received �
a 13125 SW Hall Blvd, OR 97223 Datc/9y: /o< C7 � .l , .._r Pcrmrt No.: / y',.406
p Plan Revie - 1 .
' C Phone: 503.639.4171 Fax: 503.598.190E C 0 8 2009 Date/By: WA A201 0 ° Other Permit:
�. �. t �. Inspection Line: 503.639.4175 Date Ready/By: June: Page 2 for
- Internet: www.tigard- or.gov Notifie / „ii, Su pple
CITY O F TIGARD ([[
mental Information
BUILDING DIVISION i
TYPE OF WORK C RCIAL 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: $ $75,100.00
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea- I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 16640 SW 72ND AVE Air conditioning
(requires site plan showing placement) 46.75
City / State/ZIP: TIGARD OREGON 97224 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: VERLS NORTH ANNEX Heat Pump 61.06
Cross street/directions to job site: Duct work 23.32
_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
Subdivision: I Lot no.:
Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
3- LENNOX GAS PACKS,DUCT,GRILLS ,GAS PIPPING, Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
• Wood fireplace/insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney liner /[lue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
CO APPLICANT ® CONTACT PERSON Attic/crawlspace fans 23.32
Business name: PROTEMP ASSOCIATES Other: 23.32
Fuel piping
Contact name: BRUCE BUTNER $14.15 for first four, $4.03 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
Bneinegs name: SAME AS ABOVE Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/ State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum.pemti1. fee ($90.00) / ?g 70
Plan review (25% of permit fee) d{ 7. /Q
CCB lic.: 38868 State surcharge (12% of permit fee) a 3 g . 4
TOTAL PERMIT FEE A17VO".
Authorized signature e_ �/ � 2 � — 0 c This permit application expires if a pe is complete.
obtained within 180
days ys after h
it has been accepted as s wniptete.