Permit CITY OF TIGARD MECHANICAL PERMIT
t r �t Permit #: MEC2011 -00572
ip
: COMMUNITY DEVELOPMENT
I1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/20/2011
Parcel: 2S112DC01400
Jurisdiction: Tigard
Site address: 15865 SW 74TH AVE 105
Project: Cognex Subdivision: FANNO CREEK ACRE TRACTS Lot: 4
Project Description: Install (2) rooftop gas packs, ducts, grills, hook -up gas to existing.
Contractor: PROTEMP ASSOCIATES INC Owner: JDS LLC
9788 SE 17TH AVE CRITERION CREEKVIEW LLC
PORTLAND, OR 97222 ATTN JAMES A MEYER
PO BOX 6525
BEAVERTON, OR 97007
PHONE: 503 - 233 -6911 PHONE:
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/20/2011 $627.11
Class of Work: ALT Type of Const: VB Plan Review 12/20/2011 $156.78
Occupancy Grp: B Occupancy Load: Info Process /Archiving - Lg $2.00 (over 12/20/2011 $4.00
11x17)
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 12/20/2011 $8.50
Project Valuation: $21,000.00 11x17)
12% State Surcharge - Mechanical 12/20/2011 $75.25
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 $871.64
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 Notificatio - s er. 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 que ons to OU by calling 503.232.1987 or 1.800.332.2344.
Issued By 1 � s %i — ♦ Permitte• ignature: 1 ° /A (e---.. J
Call 503.639.4175 by 7:00 a.m. for the next available • • - section 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 OF F I CE USE ONLY
City of Tigard RE ReceiDate /By: ved i / / // rah Permit No.: IN .. a 13125 SW Hall Blvd., Tigard, OR 9722
Phone: 503.639.4171 Fax: 503.598.1960 Plan Date /By: Revie j 1 ( k (���/
q l // Juris: S (f Other Permit: IA
TIGARD Inspection Line: 503.639.4175 DEC 13 2011 Date Ready /By: / / See Page 2 for A • Internet: www.tigard - or.gov Notified /Method: /.7,-///6// / /lp / Supplemental Information •
CITY OF TIGARD 6tt -(
''''7.1:7:'.77%.a, '' ;, ;,>; ; 17,1* OE' �V CO .1 140CIAL:R 10,. SGHE6 - ECKLIST
T <.
- r.�,,, � ,, . ,.,,..., �� , Rl�yl�} #� � =1�1�11� � giJE° , ��usE-c
❑ New construction El 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.
„ -: � -�a ��.. ;`sue �H.�,;,,�,
,,, _ " O CO UGTIOIV
1 - an d 2 dwelling SI ENTIiaiL EQUIPME Y `M •F E * ~'
❑ y g ® Commercial /industrial ❑ Accessory building `' ` " "'' °� •
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
`JOB SITE INF ORMATI ON AND-LOGATION- Heating/cooling
Job site address: 15865 SW 74 ave Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: Tigard Oregon 97224 Fumace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: #105 I Project name: Cognex
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
` , , `' ° "' '" Water heater 23.32
i O FV1'O ' "I' i-
�: =., 'r�'' %.rac��"J `�,�• .a .: �' �:� � e..aut- A.�.a. >�u nt���,. , ., - ,...n ,. e .. - . , ,..
Gas fireplace 33.39
install 2 roof top gas packs,duct,grills,hook up gas to existing 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
7 'W - '' s ''
.::: � - :,. ®'.Y "I'ItOI',ERTY O,WNER� ° -M<��. � -; r;;: . ❑ .TEllIA1V1'` - A=" :
:M " ...: . ..:... . . ..:,.. -.:.. �- , ,..::. - 23.32
Other
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
` x' Attic/crawlspace fans 23.32
has, ' ; :. APPI?ICANT %% : ►� GOI+ITAGT ,PERSON 4i: `:. P
- - w... .. .� � : � • :�a4 � ,,. ,�
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
.,v,°\SM ..CONTRACI"OR a £r ::: <, Barbecue ,
Business name: same as above
Clothes dryer (gas)
Other:
Address: Al * fig' �y,.;,�;- �:���,`.,_. -a: `.°
*. : - 1,
MEC ' CAL' >PERM1T � ' �
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum pennit fee ($90.00)
Plan review (25% of pennit fee)
CCB lie.: 38868 State surcharge (12% of pennit fee) `,,�
TOTAL PERMIT FEE ? f. `e
Authorized signature: i �3 %L`A - This permit application expires if a permit is not obtained within 180
�LCdGt_ days after it has been accepted as complete.
Print name: Bruce Butner Date: 12/9/11 * Fee methodology set by Tri- County Building Industry Service Board
I: \Building \Permits \MEC- PermitApp.doc 10/01/09 440 -4617T (11/02 /COM/WEB)