Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: MEC2013-00588
T(GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/07/2013
Parcel: 2S 112 DA01400
Jurisdiction: TIGARD
Slte address: 15350 SW SEQUOIA PKWY 220
Project: Tetra Tech Subdivision: 1996-048 PARTITION PLAT Lot: 2
Project Description: Relocating Grills.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
9788 SE 17TH AVE ATTN: N PIVEN
PORTLAND, OR 97222 15350 SW 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 10/07/2013 $161.16
Class of Work: ALT Type of Const: Plan Review 10/07/2013 $40.29
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/07/2013 $19.34
Stories:
Project Valuation: $3,500.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers 8 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 $220.79
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 44.
Issued By: Permittee Signature:
--401-14111k.
Ca •39.4175 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 Application FOlt Orflcl: 1; 1: ()N1.1
City Tigard and Received 16/7
Date/By:II 1 ��� MIn• 13125 SW Hal Blvd.,Tigard,O' 1% pla /B ew II Phone: 503.718.2439 Fax: 503.5'.. '.t I 1 Date/By:
Other Permit:s/ I 1 a
T I< A R D Inspection Line: 503.639.4175 OC\ Date Ready/By: luris: See Page 2 for
Internet: www.tigard-or.gov ��� �C`O� Notified/Method: T'T�o Supplemental Information
TYPE OF W&iR l.G� COMMERCIAL FEE• SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alterktreplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$$3,500.00
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For spedal Information use checklist
❑Multi-family ❑Master builder ❑Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address:15350 SW Sequoia pkwy (requires site plan showing placement) 46.75
City/State/ZIP:Tigard Oregon 97224 Furnace 100,000 BTU(ducts/vents) 46.75
Furnace 100,000+BTU(ducts/vents) , 54.91
Suite/bldg./apt.no.:220 Project name:Tetra Tech Heat pump
(requires site plan showing placement) 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
Relcate grills for new floor plan, Gas fireplace/insert 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
Phone:( ) Fax:( ) Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
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 1716 Ave Furnace,etc.
Gas heat pump
City/State/ZIP:Milwaukie Or 97222 Wall/suspended/unit heater
Phone:(503)519-6199 Fax: :(503)238-9767 Water heater
E-mail:bruc Fireplace
bruce@protmp.com•
Range
' CONTRACTOR Barbecue
Business name:Same as above Clothes dryer(gas)
Other:
Address:
MECHANICAL PERMIT FEES'
City/State/ZIP: Subtotal %(0(. 1(a
Minimum permit fee($90.00) ---Phone:( ) Fax:( )
Plan review(25%of permit fee) yQ_j_s7
CCB lic.:38868 State surcharge(12%of permit fee) /1.3`1
TOTAL PERMIT FEEp.'7y_
'Az Authorized signature: -4," 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: 10/7/13 • Fee methodology set by Tri-County Building Industry Service Board
I:\Building\Permits\MEC-PermitApp.doc 03/07/12 440-44 ITT(I1/02/COM/WEB) �� „ 7c,