Permit CITY OF TIGARD MECHANICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00153
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
Parcel: 2S112DA00800
Jurisdiction: Tigard
Site address: 15055 SW SEQUOIA PKWY 130
Project: Yecuris Subdivision: Lot: 0
Project Description: Relocating ducts and grills.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
9788 SE 17TH AVE 15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97222 PORTLAND, OR 97224
PHONE: 503 - 233 -6911 PHONE: 503 - 624 -6300
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/12/2011 $297.13
Class of Work: ALT Type of Const: Plan Review 04/12 /2011 $74.28
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 04/12/2011 $35.66
Stories:
Project Valuation: $8,200.00
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:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $407.07
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 0 : I I _ .2344. j
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Issued By: �/- •ermittee Signature: i-a
Call 503.639.• • • :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.
Mechanical Permit Application i�+, FOR OFFICE USE ONLY
City of Tigard 6 Dat
/t f ♦' - Permit No.: —
• 13125 SW Hall Blvd., Tigard, OR 97223 !II 1
111 I \, Plan Review i
Phone: 503.639.4171 Fax: 503.598.1960 I+ Other Permit: • , �� ,
I l G A ti D Inspection Line: 503.639 1 to Re ady/By: lu g: See Page 2 for
Q�
Internet: www.tigard or.gov p, ,�G' i fied/Method: '7 Supplemental Information
, �!\‘
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit lees* 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: S 58,200.00
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. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 15055 SW SEQUOIA PKWY 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.: #130 Project name: YECURIS Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydmnic 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: 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
Relocate grills for new tenant ace Gas fireplace 33.39
g � 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 ❑ TENANT Chimney/liner /flue/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: ( ) Fa\: ( ) toilet compartments, utility rooms) 23.32
®_ APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32 _
Business name: Protemp Associates 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: brucenprotmp.com Range
CONTRACTOR Barbecue
Business name: same as above
Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/ State/ZIP: Subtotal ,
Phone: ( ) Fax: ( ) 1
Minimum permit fee ($90.00)P 7, 7
Plan review (25% of permit fee) ,
CCB lie.: 38868 State surcharge (12% of permit fee) t (
TOTAL PERMIT FE fl '7. a 7
Authorized signature' /j This permit application expires if a permit is not obtai d thin 180
days after it has been accepted as complete.
Print name: Bruce Butner I Date: 4/12/11 * Fee methodology set by Tri -County Building Industry Service Board
1: \Building ■Permits \MEC- PermitApp.doc 10/01/09 440.4617T(11/02/COM/WEB)