Permit t '
CITY TIGARD MECHANICAL PERMIT
lk DEVELOPMENT SERVICES PERMIT #: MEC2003 -00734
��� I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - DATE ISSUED: 12/30/03
PARCEL: 2 S 112 DA -01400
SITE ADDRESS: 06650 SW REDWOOD LN 150
SUBDIVISION: PP1996 -048 ZONING: I -P
BLOCK: LOT: 002 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 2 DOMES. INCIN:
ELE - 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Tenant Improvement - adding (2) water source heat pumps & altering ductwork
Owner: FEES
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 -WMI
PORTLAND, OR 97224 [MECH] Permit Fee 12/30/03 $213.50
[TAX] 8% State Surchar€ 12/30/03 $17.08
[MECPLN] PJan Rev 12/30/03 $53.38
Phone: Total $283.96
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 233 - 6911
Final Inspection
Reg #: LIC 38868
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR
952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC •y c. ing
(503)246 -6699.
Issued By: _ %iii �� i Permittee Signature. 1 1■1
Call (503) 6 � 9 -4175 by 7:00 P.M. for inspections nee: ed the xt business day
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Dat la 6 /, .� , emit No.: y 73 /
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 'Q
o v �
Phone: 503.639.4171 Fax: 503.598.1960 /�,re i A. Other Permit: Date/By: ��3 -0�p p
Inspection Line: 503.639.4175 _, j, 671 I Date Ready /By: saris: ® See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit 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.
CATEGORY OF CONSTRUCTION Value: $ y� Q 19 f7
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: -
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
•
/ Air conditioning or heat pump
Job site address:
e 5 1.,.../ ?/=--"D � 7 L 4 -v E / $ (requires site plan showing placement) 14.00
City/State/ZIP: 7 , c, 7 02.o�.y Furnace 100,000 BTU (ducts/vents) 1 4.00
�' Furnace 100,000+ BTU (ducts/vents) 17.90
'Suite/bldg./apt. no.: j Y O Project name: wan T-AG L iE j4S 6 Q Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
J/ Gas fireplace 10.00
cR /I/ur- /.
s ✓ seT�2'+ .� ' nc C /,�� "TP2j» ? Flue vent for water heater or gas
4.1.- fireplace 10.00
A/VG7 2)) 1 73t/it O,0 t Log lighter (gas) 10.00
• Wood /pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner /flue/vent 10.00
❑ PROPERTY OWNER I 0 TENANT Other: _ 10.00
Name: Environmental exhaust and ventilation
Range hood /other kitchen
Address: equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: /"."0-2--e-,./1P Fuel piping
Contact name: 3 ZS' $' �! $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 9 q l 7 + LA Amf, Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater •
Phone: ( ) n Fax: : ( ) Water heater
A7 �'�� �� °� 7 G� Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
� a k C 4-5 Q eP 1. - c. A n Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signatur This permit application expires If a permit is not obtained within 180
gn h, da after it has been accepted as complete.
Print name: j ` -�„ tiY �� l „.,) Date: �26 • Fee methodology set by Tri- County Building Industry Service Board
BBuildineermits \MEC- PennitApp.doc 2/1 03 440 - 46171(1 I/0 WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\ Building \Permits\MEC- PermitAPP.doc 12/03 2