Permit CITY OF TIGAR® MECHANICAL PERMIT
a
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00162
} Date Issued: 04/13/2010
4.1'6 AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 380
Subdivision: LINCOLN CENTER/TWO LINCOLN Lot: 0
Project: Waldron Co.
Project Description: Relocation of air distribution in TI space.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee 04/13/2010 $145.81
12% State Surcharge - Mechanical 04/13/2010 $17.50
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 $163.31
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: ,41 W-41 , • Permittee Signature:
CaII 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.
r� i f," i * . ' "i t^ fi n' . P �z i"� ` t r y "+ 9 , c
Mechanical Permit Applic i � I . . > t � olzbl I IcH u5N o� � ' ' s �' ' ``
City of Tigard R eceived V P ermit No.'
'' ;, ' i .1 ': ,. - ,c 13125 SW Hall Blvd., Tigard, OR 97223 P �' 3 2010 Date/By: 7 /3 /0 4 61w _ /`7t -��/ i da /6 -
C ' Plan Revie r
:. Pho ne: 503.639.4171 Fax: 503.598.1960 D a t eBy: Other Permit: � CC t� oto - 'o/
...Ti c , I Inspection Line: 503.639.4175 Date Ready /By: luris. See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD ®
Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New constructionddition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value:$ 31
• CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ) ommercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. Total
• . JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /0220 SW loree n b ieCJ Air conditioning
(requires site plan showing placement) 46.75
City /State /ZIP: Tigard 0g 9 7 2 y Furnace 100,000 BTU (ducts /vents) 46.75
� w Id r0 /'1 Co Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
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: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
1 Gas fireplace 33.39
re /0 C.. 7 r� o� /r c/,S`/ /1 b.i/ 0 r Flue vent for water heater or gas
I1') T= s p' C ° Log lighter 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
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT - ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: /` -) rymer /c-6-4 ea r Other 23.32
i n Q
J Fuel piping
Contact name: Brad / //aaC h es--1 e ✓' $14.15 for first four; $4.03 for each additional
Address: / 3 3 c7 5E 6/ U e pn S --/— Furnace, etc.
Gas heat pump
City /State /ZIP: . - -/-/ 69 /". "7720 2 Wall /suspended/unit heater
Phone: (5t x)23 9_ LA0,00 Fax: : (5o3) 2 3°I - - 703 4E3 Water heater .
Fireplace
E -mail: Range
• CONTRACTOR Barbecue
Business name: A ', - � C ',. 7 I--- H e q - f /n Clothes dryer (gas)
Other:
Address: X33 9 5 F' 6 , eon MECHANICAL PERMIT FEES* •
City /State /ZIP: Po J at, d O R °17242 Subtotal /
( 0 ) 2 3Cf - / 60 Fax: (503) 23 - 703 8 Minimum permit fee r mit fee
Phone:
,� "] (/ O Plan review (25% of permit fee)
CCB lic.: SS J3 5 State surcharge (12% of permit fee) / Sa
TOTAL PERMIT FEE /62, ' /
A'. This permit application expires if a permit is not obtained within 180
Authorized signature: - days after it has been accepted as complete.
Print name: T�l�� /1/47c 4 c .25- . 7 l C,-- Date: y'-/3 - /Q * Fee methodology set by Tri- County Building Industry Service Board
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Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$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.
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