Permit „ CITY OF TIGARD MECHANICAL PERMIT
III COMMUNITY DEVELOPMENT Permit#: MEC2015-00662
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2015
Parcel: 25101 BA00101
Jurisdiction: TIGARD
Site address: 7500 SW DARTMOUTH ST 120
Project: Great Clips Subdivision: WEST PORTLAND HEIGHTS Lot:
Project Description: Installing(1)RTU,curb,duct work,grills,exhaust fan,and booster fan.
Contractor: PROTEMP ASSOCIATES INC Owner: WAL-MART REAL ESTATE BUSINESS TR
9788 SE 17TH AVE BY PROPERTY TAX DEPT STORE 5935-00
PORTLAND, OR 97222 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 503-233-6911 PHONE:
FAX: 503-238-9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/01/2015 $548.37
Class of Work: ALT Type of Const: VB Plan Review 10/01/2015 $137.09
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 10/01/2015 $65.80
Stories: 1 Info Process/Archiving-Lg$2.00(over 10/01/2015 $8.00
11x17)
Project Valuation: $17,850.00 Info Process/Archiving-Sm$0.50(up to 10/01/2015 $2.50
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: Vent Systems: Total $761.76
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 503.232.19 . .2344. 1
Issued By: Permittee Signature: ✓ 4,401
Cal . 9.4175 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 FOR OFF IC F 1 SF Om,‘
City of Tigard EI ED Received
1111 •. r V �./ f /. Permit No.: ,
RE Date/By: 1 .�� 5 h1/ V!� i ��, . r.
13125 SW Hall Blvd.,Tigard,OR 9722111 ��` Plan Revi- 'T
Phone: 503.718.2439 Fax: 503.598.1960 Plan Re: �`a Other Permit: = ��1�'/►•f •
TIGARD Inspection Line: 503.639.4175 S E p 2 8 2015 Date Ready luris: H See Page 2 for
Internet: www.tigard-ocgov OF TIGARD Notified/Method: ��/`y �Q Supplemental Information
C�1 1 t ! ,Q/C/
TYPE OF RCIAL 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.
Value:$$7,850.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:7500 SW Dartmouth Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Oregon 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump _ 61.06
Suite/bldg./apt.no.:220 1 Project name:Great clips 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
Other: 23.32
Subdivision: I Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Install RTU,curb,duct,grills,exshaust fan,booster fan fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY 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
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) I Fax::( ) Fireplace
Range
E-mail:bruce@protmp.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Protemp Associates Inc. Other:
MECHANICAL PERMIT FEES*
Address:9788 SE 17th Ave Subtotal
City/State/ZIP:Portland Oregon 97222 Minimum permit fee($90.00)
Phone:(503)519-6199 Fax:(503)238-9767 Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lie.:38868 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Fee metho
Authorized signature: -L methodology set by Tri-County Building Industry Service Board
Print name:Bruce Butner Date:9/28/2015
I:\Building\Permits\MEC_PermitApp_040113.doe 440-4617T(1 I/02/COM/WEB)