Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00255
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 140
Project: OMEP Subdivision: TIGARD TRIANGLE CENTER Lot:
Project Description: Relocate duct for new tenant.
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 $124.32
Class of Work: ALT Type of Const: Plan Review 06/08/2011 $31.08
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/08/2011 $14.92
Stories:
Project Valuation: $2,300.00
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 $170.32
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 503.23 . .800.332.2344.
Issued By: f_/ - Permittee Signature:
Call .:.• 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 RECE FOR OFFICE USE ONLY
Rec eived
2Q � 1 Dale/By: : 4e���
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Ci ty of Ti JUN ° Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 C Other Permit: • Inspection Line: 503.639.4175 1 a of TIG �RD Date /By: ag
TI GARD BUILDING DID Noti fied /Metho Date ied/Meth d hns: S See Page for
Internet: www.tigard- or.gov ISIQ�y : See
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=:GOM ERCIAL,FE SGH DU E'`' ilSECI(EC IST
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.
,.. .,�......,•,�. - _;, • „q Value: $ $2 ' 300.00
ate' �. �.� E.'ATEGOItI',A CONSTRUCTIONS � � �'°
...::... - -,yam_ -- . >. .�.w,. ..,.::a,,,�.•��.ti.,: .., .... ".- :,::,..;. >.,- ,.,,�.;.: -- . ",_.,.....:. >ai»i�.� �,;.:DE.. .�,�,�, -" ,
”' <'RE� [ NTIAL EQU7PiVIE- .,'ISYSTEMSFEES
❑ 1-and 2- family dwelling ® Commercial /industrial ❑ Accessory building ��" • e .,, ,- _.. - , -
❑ Multi- family ❑ Master builder El Other: Other: For special in u checkli
Description Qty. I Ea. Total
:IQB Sft INFQRMr TION =AND LOCATION
` , Heating/cooling
Air conditioning
Job site address: 12909 SW 68 pkwy
(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.: #140 Project name: Oregon Manufacturing Heat pump 61.06
/
Cross street /directions to job site: aM p 1 Ductwork 23.32
111 JJ 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
k ' 1)FSCRIPTION of woi % r h
Water Wat eater 23.32
-' �. <� Gas fireplace 33.39
Relocate duct for new tentant space 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
.�•� j Chimney /liner /flue /vent 23.32
>I'Rgf RTY O`... R y ; ;' ' c TENANT:
F`w_ x 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
%< , ®sAPPC IEAN I ®,G{pNTACT `•PERSON:. " Attic /crawlspace fans 23.32
Other: 23.32
Business name: Protemp Associates Fucl t to
p g
Contact name: Bruce Butner $14.15 for first four; $4.03 for each additional
Address: 9788 SE 17 Ave Furnace, etc.
Gas heat pump
City /State /ZIP: Portland Oregon 97222 Wall/suspended/unit heater
Phone: (503) 519 -6199 Fax:: (503) 238 -9767 Water heater
Fireplace
E -mail: brute @protmp.com Range
4 OONTItAGTOR ` Barbecue
Business name: same as above Clothes dryer (gas)
Other:
Address: - ,.: �, �� • ��_ �� a� <" ,
;; ✓ MEGIiANICALPE1tMIT FEE$* , ° .� E• *FN .
r
City/State /ZIP: - Subtotal /4'4/
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee) .fl/, O$
CCB lie.: 38868 _ State surcharge (12% of permit fee) /4. ?2
TOTAL PERMIT FEE / , 3�
Authorized si g 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 metltodology set by Tr-County Building Industry Service Board
I: \Buitding \Permits \MEC- PermitApp.doc to /01/09 440- 4617T(1 t /02 /COM /WEB)