Permit y CITY OF TIGARD MECHANICAL PERMIT
''1 3 ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00220
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/20/2015
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 190
Project: Professional Eye Care Associates of America Subdivision: WEST PORTLAND HEIGHTS Lot: 9-25,PT
Project Description: Relocate ducts&grilles for new floor plan.
Contractor: PROTEMP ASSOCIATES INC Owner: PACIFIC REALTY ASSOCIATES
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 04/20/2015 $294.32
Class of Work: ALT Type of Const: Plan Review 04/20/2015 $73.58
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 04/20/2015 $35.32
Stories: Info Process/Archiving-Lg$2.00(over 04/20/2015 $2.00
11x17)
Project Valuation: $8,100.00
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 $405.22
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuan - - . • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util . Notification Cen : . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o direct questions to OUN• cal g 3.232.1987 or 1.800.332.2344.
Issued By: /)7 41/D4 kD Permittee Signature:tXCalll 5033.639.41755 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE t!SE ONLY
Received (�av� 17 )/� -+
City of Tigard Date/By:cive T Permit No.: ri
13125 SW Flail Blvd.,Tigard OR RECEIVED Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 may: Other Permit: 64.19„90/1 6C,
•
Inspection Line: 503.639.4175 APR 0 2015 Date Ready/By. luris ® See Page 2 for
Internet: www.tigard-or.gov 2 015 Notified/Method: Supplemental Information
CITY OF TIGARD �-!111111COMITERCUM TYPE �IVI•�+IQN Mechanical permit fees*are based on the value of the work
❑New construction ®Addit ion/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$S8,100.00
CATEGORY or coNsraucnon RE AI.zoursarrrinstran FEES"
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building Forspeelol information use checklist.
❑Multi-family ❑Master builder ❑Other: Description ] Qty. I Ea. I Total
JOE RILE INFORMATION AND LOCA1 o Heating/cooling:
Air conditioning 46.75
Job site address:12909 SW 68'b Parkway Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Or 97 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:#190 Project name:Professional Eye Care Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIf7IONi OW wow Gas fireplace/insert 33.39
Flue vent for water heater or gas
Relocate grills and duct for new floor plan. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPER'rf OWNER TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
13 APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:Protemp Associates
Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:Bruce Butner Furnace,etc.
Address:9788 SE 17th ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portaland Water heater
Phone:(503)519-6199 Fax::(503)238-9767 Fireplace
Range
E-mail:bruce@protmp.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Same as above'
MECHANICAL PERMIT WEER'
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee)
CCB lic.:38868 TOTAL PERMIT FEE 5 e a I
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: 6166e_e_____ • Fee methodology set by Tri-County Building Industry Service Board
Print name:Bruce Butner Date:4/20/15
1\Building\Permits\MEC Permit App_040113.doc 440-4617x(11/02/COM/WEB)