Permit (10) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2023-00298
T I(-;A l<1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/25/2023
Parcel: 1 S 135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 500
Project: Maxim Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Relocating diffusers and ducts and adding thermostats,diffusers,ducts,return air grills,and(1)exhaust fan for
TI.
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 05/25/2023 $319.61
Class of Work: ALT Type of Const: VB Plan Review 05/25/2023 $79.90
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 05/25/2023 $38.35
Stories: Info Process/Archiving-Lg$2.00(over 05/25/2023 $2.00
11x17)
Project Valuation: $9,000.00 Info Process/Archiving-Sm$0.50(up to 05/25/2023 $3.00
Fuel Air Handlers
11x17)
Fuel Types: Electricity Units<10000 cfm: 9
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: 2 Vent Systems: Total $442.86
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 12
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 se rth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of th r les
‘17466,4___
Issued By: ' '"' Permittee Signature:
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 FOR OFFICE LSE ONLN'
RECEIVED City of Tigard Received �/ 92 'j"' 4 -wa�f' a-
.54 . J
13125 SW Hall Blvd.,Tigard,OR 97223 DateDate/By: y �W oZ3 /
� � Plan t y iew+t3, 3— �3 ' I Other Permit:
' Phone: 503.718.2439 Fax: 503.598.1960 A-- 2 li
O�;:�)z i� Inspection Line: 503.639.4175 f� Date ReadyBy. , kris: ft� See Page 2 for
Internet: www.tigard-or.gov Notified/Method: ', 4 Supplemental Information
CITY OF TIGARD r^ ,�
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
El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
g Value $9 000.00
�, r ;'••Parrt ,1. t TI
.�.[s; �...." ..z!t ;�3; � .s<,a � 'a�'.,97 ° 7 ^rFt€1.; 9 ,•` �
1-and 2-familydwelling t
❑ El 0Accessory 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 Road Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard,OR 97062 ee ea d r- Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name: Maxim Exp Suitc.sir 2L 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
-;,(, i;t, ;, • Gas fireplace/insert 33.39
Flue vent for water heater or gas
Relocate(9)existing supply diffusers and ducts,relocate(4)existing thermostats,add(1)new supply duct and diffuser to existing terminal unit. fireplace 23.32
Add(3)new return air grilles with acoustical plenums,add(1)high limit exhaust fan at the Telecom room,verify operation of existing Log lighter(gas) 23.32
Wood/pellet stove 33.39
VAV terminal units in affected areas only.Air balance and report of affected areas only. Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
y 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
Other: 23.32
Fuel piping:
Business name: American Heating
$14.15 for first four;S4.03 for each additional
Contact name: Melanie Hart Furnace,etc.
Address: 5035 SE 24th Ave. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Portland,OR 97202 Water heater
Phone: 503-239-4600 Fax:: 503-239-7038 Fireplace
Range _
E-mail: m.hart@americanheating.net Barbecue
!,'' . arc
��"� a ir .;~�" � � � ' Clothes dryer(gas)
Business name: American Heating Other ,
, ,.° 7:•"z '_::;', :;ter ;g:;a ,f Fai•',.
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: 503 239 7038
State surcharge(12%of permit fee)
CCB lie.: 33135 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
.fined by see,.Harr days after it has been accepted as complete.
Melanie Hart Er.�hn..nar,c Her
Authorized signature: zdzs.aze o�:rs:zsdrar * Fee methodology set by Tn-County Building Industry Service Board
Print name: Melanie Hart Date: 4/26/2023
I:\Building\PermitsVMEC_Pern itApp_040113.doc 440-4617T(11/02/COM/WEB)