Permit ;' Z fffil MECHANICAL PERMIT
CITY OF TIGARD
1 - - : a ;: COMMUNITY DEVELOPMENT Permit #: MEC2010 00179
Date Issued: 04/22/2010
T t G AR)J 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 130
Subdivision: LINCOLN ONE Lot: 0
Project: Balance Your World
Project Description: Add (2) new diffusers; relocate (2) diffusers; relocate (1) return grill; add (1) supply duct; add (2)
new return grills.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 permit Fee 04/22/2010 $115.11
CALIFORNIA ST 49TH FL 12% State Surcharge - Mechanical 04/22/2010 $13.81
PHONE:
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202
PHONE: 503 - 239 -4600
FAX: 503 - 239 -7038
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers 8 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 $128.92
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
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: lie it I Permittee Signature: g /� CI ,( C.� P 4 / � /V / �1(
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. !
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 A i s 1i , r te • €Y FOR OFFICE USE ONLY
. City of Tigard City t Date/By: 7 � � „hi Permit NoH 61• -• 0/ .7ei
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review n
C 2 Date/By: Other Perm u ,P &O /O _ �DO 6'
Phone: 503.639.4171 Fax: 503.598. 2 2 2010 Date/By:
T I G A R D Inspection Line: 503.639 i h Date Ready/By: Juris: 0 See Page 2 for
Internet: www.tigard- or.gov CITY OF TSU/1F Notified/Method: Supplemental Information
TYP OFWU) DIViG.
,� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
El New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ / 935
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
' ! For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: / o3 0 0 3 ln/ 6 ree b v r3 R d (requires site plan showing placement) 14.00
City /State /ZIP: rij a.cf O R
Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt.no.: 30 Project name: 13efinnc2 you Wer (d bookit -I Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK ' . • - Water heater 10.00
' nr � Gas fireplace 10.00
et cl c 2 n e w d t l - ru 5 er- S / re. /OC 4 "/"C 2 d t h-'rvJ e' s Flue vent for water heater or gas
/ � / fireplace 10.00
re ! OG �l > < C / r'G11 turn / / q o/ / Sop �/ C V L / q �U Log lig (gas) 10.00
2- 11et.. ( Turn 5rt 1(S Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
❑ PROPERTY OWNER ❑ TENANT Other: 10.00
• Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ' ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
• Business name: Arn e r i c 4'i he 41 ; z►f
/ Fuel piping
Contact name: grgc/ /'V a n C 4 e s el" $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: / 3 3 °/' 5 E (0 1 c / C o r1 5 ---1 '- Gas heat pump
City /State /ZIP: / - t /G1 /1 d 0 R '17202 Wall /suspended/unit heater
Phone: (503) 2 3 . 7- 5 Od Fax: : (503) 2 3 1 -7o3 8 Water heater
Fireplace
E -mail: Range _
CONTRACTOR Barbecue
Business name: A H e q 71 %i! g Clothes dryer (gas) , 7
Other:
Address: /33-, 5 E Cc, i c) e O ri 5 MECHANICAL PERMIT FEES*
City/State /ZIP: Po r -14-- /egr1 c r 0 R 9 7 2 02 Subtotal
( So3) 2 3 '7- yCoo D Fax: (5 03) 31 -7o3 Minimum permit fee ($7250)
V hone: Z 8 Plan review (25% of permit fee)
CB lic.: 33135 ✓ State surcharge (12% of permit fee)
// TOTAL PERMIT FEE /�,�Z f 9„1,
Authorized signature: /�� ,,i'�`ys CAS This permit application expires if a permit is not obtained within 180
/ l days after it has been accepted as complete.
Print name: 8r - /V/4,16 eilems' Date: 4 1/2 // / Q * Fee methodology set by Tri- County Building Industry Service Board
I :\ Building \Permits\MEC- PermitApp.doc 01/19/07 440- 46617T (11 /02 /COM/WEB)