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Permit CITY OF TIGARD pp 6�® MECHANICAL PERMIT `Qx COMMUNITY DEVELOPMENT Permit #: MEC2010 -00201 i Date Issued: 05/04/2010 T I CARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 900 Subdivision: LINCOLN TOWER Lot: 0 Project: NW Mortgage Expansion Project Description: Relocate (6) supply grilles. Owner: FEES LINCOLN CENTER LLC Description Date Amount BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee 05/04/2010 $118.18 CALIFORNIA ST 49TH FL 12% State Surcharge - Mechanical 05/04/2010 $14.18 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 & 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 $132.36 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 Noti on Cen e . hose les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or dir questions to OUNC calling 3.246.6699 or 1.800.332.2344. lss ed gy: / Permittee Signature: �(4J �C1/16. C.0 4 e r 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 Application FOR OFFICE USE ONLY permitNo. : l��olQ -�G�� City of Tigard Date/By: l • 13125 SW Hall Blvd. Received �j y �� Tigard, OR 97223 Plan Review ( Q� C Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: / -. DateBy: T I G A R D Inspection Line: 503.639 Date Ready/By: Juris: RI See Page 2 for Internet: www.tigard - or.gov Notified/Method: /, Supplemental Information Y TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction 0 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: $ 2087 RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1- and 2- family dwelling EKommercial/industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION p G f • Heating/cooling Job site address: , lio,Z .4 O 50/ V/ reen b (/r ,k i Air conditioning or heat pump (requires site plan showing placement) 14.00 City/State /ZIP: • Fumace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: 760 Project name: N UV M or -/ `f V a q e 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 ee /o 4 1 //-- Gas fireplace _ 10.00 e Ct7 S VP I �� ! I s Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 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: A /CUn Hey! 1n Fuel /� piping Contact name: Bra / V ifnc hes a $5.40 for first four; $1.00 for each additional / Furnace, etc. Address: /35 5E tPt c.1 e 04 S'f Gas heat pump City/State /ZIP: , f- / _ b R 97202 Wall /suspended/unit heater Phone: ($D3 ) 23,- y&poo Fax: : (SD 3 ) 23,- 7038 Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Business name: Ar r/Cat/ //e J 7 ;, f Clothes dryer (gas) Other: Address: /33q 5E iicfeeti 3 t MECHANICAL PERMIT FEES* City/State /ZIP:: p r+ 144 U 7/Q '7202 , • Subtotal i lJ Q Minimum permit fee ($72.50) ----- Phone: ($03 ) 23 7- �l ioOO Fax: ($v3) 23 9 . 7O3 (] Plan review (25% of permit fee) CCB lie.: 33 /3.S State surcharge (12 %ofpermit fee) Vii,/, /fi TOTAL PERMIT FEE /52. 4v Authorized si ature: 5 This p ermit application expires if a permit is not obtaind within 180 gn � days after it has been accepted as complete. Print name: 13 /144,1cAes le.- Date: 5/2 /) O * Fee methodology set by Tri- County Building Industry Service Board 1:\ Building \Pcrmits\MEC- PermitApp.doc 01/19/07 4404617T(1l /02/COM/WEB)