Permit CITY OF TIGARD MECHANICAL PERMIT
1
COMMUNITY DEVELOPMENT COMMUNITY MEC2010 00002
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/05/2010
Z 1GARD, Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 590
Subdivision: Lot: 0
Project: ID Expert
Project Description: HVAC modifications to TI space for new and relocating grills and (1) new VAV box.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee 01/05/2010 $263.41
CALIFORNIA ST 49TH FL 12% State Surcharge - Mechanical 01/05/2010 $31.61
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 Fumaces: 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 $295.02
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: h Permittee Signature: ( i Ji tI4ci es J e .---
Cali 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.
'� � Ate¢ tl� } ■-
1VI c hanical Permit A licatio ` ' . = 1'' `7't,`'`N Q w "�` `
DECEIVED I b A ,
_� i .,. ... F Ial`t) i. UsI 0 .• 1 � i 3 1 4 , -; t = �z : c : . y
R ece i ve d i� r
City of Tigard Date/By: 4 lI F Permit No. : — aoe7oZ
V 13125 SW Hall Blvd., Tigard, OR 97223 P lan Revi -.v �-o2461/0
.i Phone: 503.639.4171 Fax: 503.598.1960 JAN 05 2010
Date/By: Other Permit:
,Ti C A K' l) I nspection Line: 503.639.4175 Date Ready/By: Juris: 0 See Page 2 for
.,,-r,..__:.z.si 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 construction ddition /alteration replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION , •
Value:$ 678 (.0
RESIDENTIAL EQUIPMENT /SYSTEMS FEES* •
❑ I- and 2- family dwelling ommercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /03 0O Co r 5VV e e n bur R cI Ai conditioning
y (requires site plan showing placement) 46.75
City /State /ZIP: 779Ar o ci 72 23 Furnace 100,000 BTU (ducts /vents) 46.75
,� Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: S7 (/ Project name: rip E x P e r• -t-
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
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
VA ' /J DESCRIPTION OF WORK • Ti- ater heater 23.32
Gas firep
H (/ m0ci) 1 ► ; cq.boll S / o -L- ..5pq ee Flue vent lace
for water heater or gas 33.39
,
n 7t- re �D c 4I �1 y q r t � 1 $ fireplace 23.32
a �/ / Log lighter (gas) 23.32
O h e r I e i-✓ V /} tL b 'O 7S Wood/pellet stove 33.39
Wood fireplace /insert 23.32 •
' ❑ PROPERTY OWNER Chimney /liner /flue /vent 23.32
❑ T 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: A m e I r CAii N eGi I ! h Other: 23.32
Fuel piping
Contact name: DA l e HOYrlm e 1 't $14.15 for first four; $4.03 for each additional
339 5 E . _ 5 Fumace, etc.
Address: , c C O h
Gas heat pump
City/State/ZIP: P f /(^rt d OR °/7202. Wall/suspended/unit heater
q
Phone: (Cp7 239- y( Fax: : (503 ) 23 ! - 7D38 Water heater Fireplace
E -mail: Range
' CONTRACTOR .. Barbecue
1 4 Clothes dryer (gas) _
Business name: A lc 44 C TO rn L Other:
Address: /33 e7 5 E Gideon e MECHANICAL PERMIT FEES*
City /State /ZIP: F -j-1 On cl Og '97ZQZ Subtotal ;26 3, 1!
Minimum permit fee ($90.00)
Phone: (503) 239- 1/6e2O Fax: (5c3) 2 31- 7038 Plan review (25% of permit fee)
CCB lic.: 33 13 5 , , State surcharge (12% of permit fee) If t
TOTAL PERMIT FEE R9,5:
Authorized signature: ��g" a This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete.
Print name: g - M4, h es. e/- Date: / 2/30/0 9 • Fee methodology set by Tri- County Building Industry Service Board
1:\Building\Permits\MEC- Permit App doc 10/01/09 440- 4617T(11 /02/COM/WEB)
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.
C\ Building \Permits\MEC- PermitApp.doc 10/01/09 2