Permit pp CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00217
Date issued: 05/02/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113AB00101
Jurisdiction: Tigard
Site address: 16101 SW 72ND AVE 200
Project: Perlo Construction Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: Relocate grills for TI
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: 503 - 624 -6300
FAX: 503 - 238 -9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/02/2012 $69.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/02/2012 $8.29
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $500.00
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 $77.35
Hoods: Comm Incinerators: Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 or 1.800.332.2344.
Issued By: Permittee Signature: ,,, ,�^
4 , 5 ,„af",___________
Call 503.639.4175 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 Applica ' I'1 -C P r I1/ ® FOR OFFICE USE ONEY
i Lam' . tf, J R eceived •
City of Tigard , Per N
g Date /By: /� • i ll_ M� Cc A _40.2,
13125 SW Hall Blvd., Tigard, OR 97223 q
C _MAY - 2 2�� Plan Review t ^,,
Phone: 503.639.4171 Fax: 503.598.196 Date/By: Other Permi ° a04,2- -. WOO ,
TI G A It D Inspection Line: 503.639 CB I OF TIGARD Date Ready /By: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ® 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.
CATEGORY OF CONSTRUCTION Value: $ $500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building
❑ Multi- family 0 Master builder For special information use checklist.
❑ �' Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 16101 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
Suite/bldg. /apt. no.: Project name: Perlo's New Office Furnace 100,000+ BTU ( ducts/vents) 54.91
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: 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 office Gas fireplace 33.39
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 I ❑ 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: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
IS APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other
Business name: Protemp Associates 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 I Fax: : (503) 238 -9767 Water heater
Fireplace
E -mail: bruce@protmp.com Range
CONTRACTOR Barbecue
Business name: same as above Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/ State/ZIP: Subtotal tel% Oh
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 38868 State surcharge (12% of permit fee) ' , 2.
TOTAL PERMIT FEE 17, g
Authorized signature: �� This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name: Bruce Butner I Date: 5/2/12 • Fee methodology set by Tri - County Building Industry Service Board
1:\ Building \Pamits\MEC- PermitApp.doc 10/01/09 • 440- 46171' (11/02/COM/WEB)