Permit CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00257
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/08/2011
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 250
Project: Spec Space Subdivision: TIGARD TRIANGLE CENTER Lot:
Project Description: Relocate duct for new floor plan.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SE SEQUOIA PKWY #300
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 06/08/2011 $145.81
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/08/2011 $17.50
Occupancy Grp: Occupancy Load: Plan Review 06/08/2011 $36.45
Stories:
Project Valuation: $3,000.00
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 $199.76
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 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 or 1.800.332.
Issued By: Permittee Signature:
C.1 1 , 5 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 FOR OFFICE USE ONLY
City of Tigard Received ��W )y , ,, -00
II ANEW No t
° 13125 SW Hall Blvd., Tigard, OR 97223 RE
I CEIV~j� Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 YY �� Date /By: Other Permit: Ijt.
Inspection Line: 503.639.4175 Date Read /B lu ris:
JUN Ready /By: ® See Page 2for
TIGARD
Internet: www.tigard - or.gov JUN 7 2011 Notified /Method: Supplemental Information
>.A>.: a•.° •:' :., .._.a aR.::.D :. ,, . �''.u�;�.,.,- i T s ��� ; �. �.-•, . *.�.m:;..:�.�'e�... :ate; �c,:.,;
-,i ,, , >.. , "W .... " COMbIERCIAI FEE* - SCHED[JLE = > °[7SE CI1E K[ IST<.:
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1 D I V ISION Mechanical pennit fees* 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.
`3
;- <;;, e,a Value: $3,00.
-'° ;;� 01x31, NT IAL ':EQUIPN� 07e,f,'15YSTEMSIkr.g. W' '
❑ I- and 2-family dwelling ® Commercial /industrial ❑ Accessory building `° ._...
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
:t •JOB., SITE INFORMA'T ,
IQN AND I�OCAlION” . ... Heating/cooling
Job site address: 12909 SW 68 pkwy Air conditioning
(requires site plan showing placement) 46.75
City /State /ZIP: Tigard Oregon 97223 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: 250 Project name: spec space 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
1 1; a =;a• g =:r Y . %.f.. Water heater 23.32 . .. .SS`r:; DESCi IWON OE WORIt• ; , -_'
Gas fireplace 33.39
Relocate duct for new floor plan
•
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
PROPER O f g. t'' T `° '" ,g, ;, Chimney/liner/flue/vent 23.32
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
-"` �" , "` "' " ` r��� Attic /crawlspace fans 23.32
® rk, ' `�= ® N'I'A P O NE- " s , "
- , , .. -- 1m ••.,. .. .a ds,.` , . � r\ .... ............. �•h >?i;:',= �_:.
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: bruce@protmp.com • Range
Igwii i i • CON TRACT: li ` °� c i Barbecue
Business " name: same as above Clothes dryer (gas)
Other: tri MECHANICAL P,E_RMTTFEE •. ,,•
Address: .,...,
City/State /ZIP: Subtotal /14; f
Phone: ( ) Fax: ( ) Minimum pennit fee ($90.00)
Plan review (25% of pennit fee) 362. gir
CCB lie.: 38868 State surcharge (12% of pennit fee) / 7. 5b
TOTAL PERMIT FEE / 99 • 76
Authorized signature This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Bruce Butner Date: 6/7/11 * 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)