Permit r 4° CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00224
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 05/18/2010
x „ Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 710
Subdivision: LINCOLN TOWER Lot: 0
Project: Axiom EPM
Project Description: HVAC modifications for TI
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee 05/18/2010 $500.11
12% State Surcharge - Mechanical 05/18/2010 $60.01
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 $560.12
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 i work s for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility tification 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 dir ct questions to OUNC by c• •ng 503.246.6699 or 1.800.332.2344.
Issue By: V 1 ; / Permittee Signature:
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
City of Tigard • 1 V ED Received _/
Date/By: � �
I g ID Permit No.: e Ql Q ',C�QO�,
14 • 13125 SW HaII Blvd., Tigard, OR 97223 i
Plan Review
Phone: 503.639.4171 Fax: 503.5/.1960 1S 201 �y OtherPe
41 tn& /
Inspection Line: 503.639.4175 M T 0 Dat Ke v" `+
T I G A R D p Date Ready/By: Ruts. 0 See Page 2 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
Cl ; Y Jr TIGARD
Tyi , v'I IVISIOIV. COMMERCIAL . FEE * - . SCHEDULE,- =:USE CHECKLIST
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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
. - .
-. CATEGORY OF -CONSTRUCTION. Value: $ / G, 000 . '
RESIDENTIAL EQUIPMENT / FEES*
❑ 1- and 2- family dwelling 14Commercial/industrial El Accessory building .
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
, .: JOB 'SITE', INFORM AN_ D' LOCATION Heating/cooling
Job site address: /020'0 SVI/ � Q (€ '7 6t, ,�
Air conditioning
J (requires site plan showing placement) 46.75
City /State/ZIP: OR Furnace 100,000 BTU (ducts/vents) 46.75
• Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 7 /0 Project name: A X 1 0 /77 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
JDESCRIPTION'OF WOR 1C Water heater 23.32
t Gas fireplace 33.39
rl IM V tnOc/ I - f / G q 7L, h j - / - 0 T -Z• Flue vent for water heater or gas
, AG C' fireplace 23.32
p Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent -
0 PROPERTY • OWNER ' I -; [ ] ?TENANT
Other. 23.32
r
Name: Environmental exhaust and ventilation
I••!V• •� - -,
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
b• AP1'LICANT'' ti ., 0 'CONTACT ' PERSON ' Attic /crawlspace fans 23.32
Other: 23.32
Business name:
mYrer / CG//f ., ff eq--/-7n -
Contact name: B/ 'c/ e ',,c ` c54 e Fuel piping
/ ' 514.15 for first four; 54.03 for each additional
Address: / 33 D .5 E 6p , e n S '�'— Furnace, etc.
�7 Gas heat pump
City/State /ZIP: l e - -f la (i d OR 972 O Z Wall/suspended/unit heater
Phone: (5Q3) 239- 4/(000 Fax:: (503) 23e1-703 8 Water heater
Fireplace
E -mail: Range
CON TRACTOR ' Barbecue
Business name: A fi heat -tin Clothes dryer (gas)
Other
Address: /33q S ► e0 �? --1- MECHANICAL:PERMIT FEES *'
City /State/ZIP: fo,/'- f- /a,w O 97202_ Subtotal 560. ii
Phone: (503) 239- 116,00 Fax: (5 ) 23 1 7o3 0 Minimum permit fee )
Plan review (25% of permit rmit fee fee) —e1
CCB lic.: 3313 , State surcharge (12% of permit fee) 60,
TOTAL PERMIT FEE Sc4.0. ii, e_ This permit application expires if a permit is not obtained ed within 180
Authorized signature: ] days after it has been accepted as complete.
Print name: . C/ / .,9,1C h e s 7 C.- Date: 5 - -17 -10 * Fee methodology set by Tri- County Building Industry Service Board
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