Permit CITY OF TIGARD MECHANICAL PERMIT
IS • COMMUNITY DEVELOPMENT Permit#: MEC2014-00007
Data Issued: 01/1612014
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Parcel: 1 S135QD01800
Jurisdiction: TIGARD
Site address: 11565 SW HALL BLVD 180
Project: Bella Institute Subdivision: METZGER ACRE TRACTS Lot: 32
Project Description: Removing existing split systems, and installing(4)new gas packs. duct grills and gas piping
Contractor: PROTEMP ASSOCIATES INC Owner: BKB PROPERTIES LLC
9788 SE 17TH AVE 11255 SW DAVIES RD, APT 1014
PORTLAND, OR 97222 BEAVERTON, OR 97007
PHONE: 503-233-6911 PHONE
FAX: 503-238-9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/16/2014 $957 31
Class of Work: ALT Type of Const: VB Plan Review 01/16/2014 $239.33
Occupancy Grp: Occupancy Load: 12% State Surcharge-Mechanical 01/16/2014 $114.88
Stories: 2 Info Process/Archiving-Lg$2.00(over 01/16/2014 $6.00
11x17)
Project Valuation: $34,000.00 Info Process/Archiving-Sm$0 50(up to 01/16/2014 $5 00
11x17)
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 9 Vent Systems Total $1,322 52
Hoods: Comm Incinerators
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers Other Mech Units-
Gas Outlets. Other Desc-
Duct Work 4
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.if1 44
Issued By: r/ Permittee Signature: /ice
JJJ
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 Application , , , w , 11 1 1 t 1 1 1 .1 0.I ,,
City of Tigard '�� � Received / �� Permit No.: J - .
Illq
13125 SW Hall Blvd.,Tigard,OR���j�
Phone: 503.718.2439 Fax: 503.5 °r/� ��i�
Other Permit:
Inspection Line: 503.639.4175 ^ ` Se P r�
I �I'I Internet: www.li dux. ov w1 t,��� Date Ready/By: (uric 0 Sec P .: 2 Sr
g A1� 0 " Notified/Method: i7,,i Supplemental Information
_ TYPE or W ; s % COItO I.FM SCHEDULE– USE 41ST
['17z Mechanical permit fees'are based on the value of the work
❑New construction ®Addition/ait��tnent performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$34.000.00
CATEGORY OF CONSTRUCTION RkBIZMTAL KQIIISMTINT/6YSIDfB FEU"
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty.1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Headng/cooliag:
Air conditioning
Job site address: 11565 SW Hall Blvd (requires site plan showing placement) 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Oregon 97223 Furnace 100,000+BTU(ducts/vems) , 54.91
Suite/bldg./apt.no.:1i Project name:Bella Xv5-1,-h... r:. (requires H eat pump 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: l 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
Demo existing split system,4 anew gas packs,duct grills and gas pipping, Gas f Flue vent ntice/insert 33.39
for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
0 morn= OWNER I 0 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
0 APFUCANT 0 CONTACT urns M 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 176 Ave Furnace,etc.
— Gas heat pump
City/State/ZIP:Mitwaukie Or 97222 Wall/suspended/unit heater
Phone:(503)519-6199 Fax: :(503)238-9767 Water heater
E-mail:brucer*protmp.com Fireplace
Range
CONTRACTOR Barbecue
Business name:Same as above Clothes dryer(gas)
Other:
Address:
[IDIANICAL PERMIT REW
City/State/ZIP: Subtotal
Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
CCB lie.:38868 State surcharge(12%of permit fee)
����� TOTAL PERMIT FEE
Authorized signature: � This permit applicatiaa expires it a permit is oat obtained within l80
days after it has been accepted as complete.
Print name:Bruce Butner Date: 1/9/14 • Fee methodology set by Td-County Building Industry Service Board
I'Su ilding\Pe nits\MEC-Permit App.doc 03/07/12 440.46177(11/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11565 SW HALL BLVD 180, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
2014-02-21 (null)
MEC2014-00007
PASS - No C of O
Violation Summary:
Inspector Contractor