Permit 7 � CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00218
Date Issued: 05/20/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112DD00200
Jurisdiction: Tigard
Site address: 15862 SW 72ND AVE 150
Project: Immunology Subdivision: PACIFIC CORPORATE CENTER Lot:
Project Description: Unit heater with 150 ft. of gas line for generator.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES LP
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 233 -6911 PHONE:
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/20/2011 $124.32
Class of Work: ALT Type of Const: Plan Review 05/20/2011 $31.08
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/20/2011 $14.92
Stories: Info Process /Archiving - Lg Sheet (over 05/20/2011 $2.00
11x17)
Project Valuation: $2,300.00 Info Process /Archiving - Sm Sheet (up to 05/20/2011 $3.50
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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 $175.82
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: generator
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 OU■ by calling 503.232.1987 • ?!I
Issued By: .. Permittee Signature:
di
Call 51 '•.4175 by 7:00 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
'..-,.-.5)1 .
• FOR OFFICE-USE ONLY
Received
City of Tigard ,
, fire Permit No.: --,
v -
q 1 3125 SW Hall Blvd., Tigard, OR -1
III Date/By: Adiv r _..4. • el:
. 0\ Plan Reviewnfirtin
26 Other Permit:
' - '''..: ' Phone: 503.639.4171 Fax: 503. ;IP . C Z1 1 Date/By: Ailkee.
Inspection Line: 503.639.4175 —
‘76) Date Rea.) ll y: Juris: 10 See Page 2 for
r■t' (P\ Notified/Method: 776. Supplemental Information
TIGARD Internet: www.tigard-or.gov \\\\ 41j
1 0 . 1 0
; "‘0 4 11•VISNOW,,LT , ,arEVOF.4 ,,,, laiell'':.*::git„;. ,, : ,, ii MMEREITALIkt
4
El New construction Addition/altera replacement
Mechanical permit fees* are based on the value of the work
E la
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
41Eiia Value: $ $2,300.00
„ 'A , ;.:,::4-i 4%
'' l ''' " ''''''' "'"' '' ' '''" ' " -"'" '"' "" '''''''"''''' ' "'''' ' " ' -'- ' 4- '' '''"‘ '. ' " ' - ' —1 qr -: RESHIEKTIAI:AkiDifikENT i S YSTEMS ES* --
0 I- and 2-family dwelling CEI Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder El Other:
Description Qty. I Ea. I Total
"'"MWIM;
"IfWV--3AW-1,14613'grfilii45iiii , e ''' 4 Heating/cooling
Job site address: 15862 SW 72" 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.: Project name: IMMUNOLOGY
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
Flue/vent for any of above 23.32
Subdivision: Lot no.: .
Other: 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF ,WORIC;-: ; ',1 ',.',,.V : jr t.:-; „ Water heater 23.32
INSTALL OWNERS UNIT HEATER,UNDER GROUND GAS LINE FOR Gas fireplace 33.39
GENERATOR 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
Chimney/liner/flue/vent 23.32
*RF =', --:---i ' ', 0 TENANT - :- ' ' - ' ' ,- ,'A -
Other: 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
Attic/crawispace fans 23.32
C,#k'; ;;',ViiillitaictlYEAC4IMERRnaiga Other: 23.32
Business name: Protemp Associates Fuel piping
Contact name: Bruce Butner $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: 9788 SE 17 Ave Gas heat pump
City/State/ZIP: Portland Oregon 97222 Wall/suspended/unit heater
Water heater
Phone: (503) 519-6199 Fax: : (503) 238-9767
Fireplace
E bruce@protmp.com Range
166fiXtfOli: - - ... .::sc!; '-'rrt Barbecue
'''''' - "II'- ' ' " I- '—'-'-''''''' Clothes dryer (gas)
Business name: same as above
Other:
Address: :., ,, „ 4/**01.5k4c710kili4IT'f4t;:;;iliii;1M-
Subtotal
. City/State/ZIP:
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 38868 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtain d within 180
Authorized signature: .. days after it has been accepted as complete. '
* Fee methodology set by Tri-County Building Industry S ice Board
Print name: Bruce Butner Date: 5/20/11
I: \ Building \ Permits \ MEC-PermitApp doc t0/O1/09 440-4617T (1 1 /02/COM/WEB) S • F:,1