Permit CITY OF TIGARD MECHANICAL PERMIT
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''1 = COMMUNITY DEVELOPMENT Permit#: MEC2021-01021
Date Issued: 1/13/2022
T I G A R.II) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 545
Project: Gallagher Bassett Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Relocate(1)existing supply diffuser. Relocate(1)existing return air grilled.Add(1)fan power box.
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
5035 SE 24TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97202-4765 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/30/2021 $254.98
Class of Work: ALT Type of Const: VB Plan Review 12/30/2021 $63.75
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 12/30/2021 $30.60
Stories: 5 Info Process/Archiving-Lg$2.00(over 12/30/2021 $2.00
11x17)
Project Valuation: $6,668.00 Info Process/Archiving-Sm$0.50(up to 12/30/2021 $3.00
11x17)
Fuel Air Handlers
Fuel Types: Electricity Units< 10000 cfm: 1
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 $354.33
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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
Issued By: Ho-U,y Vaw De, Weg� Permittee Signature: 0vt,A t ' t c -
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.
451
Mechanical Permit ApplicationRECEIVE FOR OFFI.E USE ONLY
City of Tigard DateBy: / �/ZOZ/ ��� Permit No.:it Received -IEC207-0102.1
13125 SW Hall Blvd.,Tigard,OR 97223
a DEC 15 2021 Phone: 503.718.2439 Fax: 503.598.1960 Plan Riew a-
Other ether Permit:
Inspection Line: 503.639.4175 L.ITY OF TIGARD DateBy:
T I G A R D Date Ready/By: / Juris: HI See Page 2 for
Internet: www.tigard-or.gov 3UIl.DING DIVISIO ed/Metbod:2 I �I ( /4 'r"tey Supplemental Information
• ! l i+ '£ I ll :: UL
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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 0 Other: mechanical materials,equipment,labor,overhead,and profit.
6668
tsa;s�ref 3 t i p 8 i s >' ONSTR ICI ` �� R t S*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
Heating/cooling:
� Air conditioning 46.75
Job site address: 10220 SW Greenburg Rd Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Ste 545 I Project name: Gallagher Bassett Suite 545 3L(121456) Heat pump 61.06Duct 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
t s !1 or fir Gas fireplace/insert 33.39
>.. a.
` ' """ "' Flue vent for water heater or gas
Relocate(1)existing supply diffuser Relocate(1)existing return air grille Add(1)fan powered box fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
FilE r ... 3 . , Other: 23.32
tOpty
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
23.32
'+ di xi . , +o*.ka-lix. Other.
a .` Z. �.. " +,aka......
Business name: American Heating Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Melina Vaca Furnace,etc.
Address: 5035 SE 24th Ave Gas heat pump
WalUsuspended/unit heater
City/State/ZIP: Portland,OR 97202 Water heater
Phone: 503-519-1337 Fax:: Fireplace
Range
E-mail: m.vaca@americanheating.net Barbecue
sy Clothes dryer(gas)
Business name: American Heating Other
1t9T+ 1 6 x si `T
Address: 5035 SE 24th Ave Subtotal
City/State/ZIP: Portland,OR 97202 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone: 503-239-4600 Fax: State surcharge(12%of permit fee)
CCB tic.: 33135 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
iy signed by Melina Vaca days after it has been accepted as complete.
Melina Vaca -u r� 74Iama.�aaaa'.g.r''''
Authorized signature: zos+.,zsm:+s:m-ogoo * Fee methodology set by Tri-County Building Industry Service Board
Print name: Melina Vaca Date: 12/15/21
1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(1 1/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Vi otal V*at on ,.'
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Pemuts\MEC_PermitApp_040113.doc 2