Permit la �� OF MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 -00597
TIGA 13125 SW Hall Blvd., Tigard, OR 97223 503.639A171 DATE ISSUED: 12/5/2008
PARCEL: 1S135AB-01003
SITE ADDRESS: 10300 SW GREENBURG RD 200 ZONING: C - P
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
PROJECT: KPD INSURANCE
Project Description: TI - HVAC modifications, no plan review required. Project Value: $4,525
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA ST #300
PORTLAND, OR 97258 [MECH] Permit Fee 12/5/200E $132.30
[TAX] 12% State Surch 12/5/200E $15.88
Total $148.18
Phone: 503 -412 -4800
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
Reg #: LIC 33135
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or dire • uestio o OUNC by calling 503.246.6699 or 1.800.332.2344.
Issu By: �� �I ! Permittee Signature: , J /4" . C S e
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_ Mechanical Permit AD C Q FOR OFFICE USE ONLY
p ,r
City of Tigard R ece e/ ve ! � J A Permit No i 1t tL' W ,
13125 SW Hall Blvd., Tigard, OR 97 c 2��$ Plan Review
I . Phone: 503.639.4171 Fax: 503.5q 0 " Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Ions ® See Page 2 for
T I G A I(D
Internet: www.tigard or.gov op pF D 1.10 DIN ,,, Notified/Method: i ak Su pP lemental loformation
TA31
. --
TYPE OF WORK COMMERCIAL FEE *F SCHEDULE US CHECKLIST:`
ID 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 CON t It ES
Value $
,�_ .- , RESIDENTIAL EQUIPMENT /SYSTEMS FE
❑ 1- and 2- family dwelling ommercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. 1 Ea. I Total
<, t '.'' a 4 5 KJOB. SITE; INFORMATION AND ,LOCATION' „ ; ;, . _`' _ -` Heating/cooling
Job site address: /O 5 0 0 s 1^ / / / � Air conditioning or heat pump / V V Cl� /P�'/l �J v�y /�`-' (requires site plan showing placement) 14.00
City/State /ZIP: - 77;3-c , / � Furnace 100,000 BTU (ducts/vents) 14.00
p 1 �- Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 2'Vc2 Project name: / ! Y /75(/rq/) C e Gas heat pump 14.00
Cross street/directions to job site: i 4/ c a /h 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
Flue/vent for any of above 6.80
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
I' � r � "" ' S' r7 r� ` : I T ` , DESCRIPTION OF WORK ,, r r �; Water heater 10.00
t;r •. sa.: .., ',.'14.45.'
t , . . , 10.00
lit VAC Nod' i/Nc � / / 0 � 5 Gas fireplace
g
" `•• � -- -rrr / . � • - Flue vent for water heater or gas
fireplace 1000
Log lighter (gas) 10.00
Wood/pellet stove 1000
Wood fireplace /insert 10.00
P ''' � a �` t< 4V- sou ".`-»: t ' !Se ' TEI�ANT04 . - ge g, Chimney/liner /flue/vent limo
D.,-- - : ®PROPER :, OWNER ,, _.:?� Y. -� :r;�. .._.,. r � ,- .7. K„,,. Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
''' '' ''' APPLICANT -' , X g-: o z t'� µ ❑ 'CONTACT; ERSON� rw ; s At /crawls fans 10.00
�s . R-i . ,. . i ., r4,. t -t:' , 10.00
Other:
Business name: Ann e -/ Ca A q / /✓l y 2 /7 G Fuel piping
Contact name: g M ''' ' 85.40 for first four; $1.00 for each additional
Address: / 33
22 SE �/ )co &i 5 + Furnace, etc.
OR Gas heat pump
City/State /ZIP: Or - /dtrl J OR 9.7202 Wall/suspended/unit heater
Phone: (503 ) 2 3 9- '1000 Fax: : (503) 237-7 3 8 water heater
Fireplace
E -mail: Range
} if 1 s r �� L rte -' x ,dz: Barbecue
r � � �• ��� ,, CONTRACTOR .� a ., _. :. * :�. .,..�� � �..4 ..,.�;
�: Y mar � . ' "q'. : r ,3 e..Y. s -! � �c v . :nr � - :. ... ..
Clothes dryer (gas)
Business name: A `« , e , Ccy �eG �/� y Other:
Address: /� 7 5,
/ C / p ,J S` ;` „MECHANICAL PERMQT FEE ' S `. , -:
City/State /ZIP: f , y - - /' OR 77 202 Subtotal n qq 26)
Minimum permit fee ($72.50) /OA
Phone: (so3) Z 3 / - y 6 Fax: (503) 2 3 '7- 3 8 Plan review (25% of permit fee) -
CCB lic.: 33 / 3 5 State surcharge (12% of permit fee) /I: $
TOTAL PERMIT FEE 'LW
This permit application expires if a permit is not obta,infed 180
Authorized signature fi days after it has been accepted as complete.
Print name: s /11 4c,$5 fe.-- Date: 12_ 5- O, ' Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 01 /19/07 440-4617T (1 I /02/COM/WEB)
....
CITY OF TIGARD
BUILDING DIVISION PERMIT #: i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/5
Phone: (503) 639-4171 awilo .
Inspection Requests (24 Hrs.): (503) 639-4175 ...4.4 ll .
INSPECTION WORKSHEET FOR DATE: 12/15/2008 TIME: 7 PAGE: 15
SITE ADDRESS: 10300 SW GREENBURG RD 200_ CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: WO INSURANCE
DESCRIPTION: TI - HVAC modifications, no plan review'required. Project Value: $4,625
OWNER: • SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: AMERICAN HEATING INC PHONE #: 503-239-4600
Inspection Request Scheduled For: Date: -0-16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G99 Mechanical final 079032-01 603-209-1389 N
Corrections/Comments/Instructions:
,
,
•
/ .
!41 PAS PARTIAL APPROVAL n CANCEL 0 NO ACCESS
IL CALL FOR INSPECTION [11 ADDITIONAL FEES ASSESSED
....._,
Inspector: i AIIILA.,....■._ Date: '''' ' Phone #: (503) 718 '
V r Ni,
~
. /
CITY �����~N���&���� •
�*mo m OF om�mm��um�� '
BUILDING DIVISION PERMIT #: MB2008-00597
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/512008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12 I 1U/2UD8 TIME: 7 : O1 PAGE: 23
SITE ADDRESS: 10300 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINtOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: KPD INSURANCE
DESCRIPTION: Ti - M\/ACrnndfivatioms. no plan review required. Project Value: $4,525
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 6O3-412'4800
CONTRACTOR: AlvIER|CAN HEATING INC PHONE #: 5U3-259-4600
Inspection Request Scheduled For: Date: 12110y2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough-in 07803&01 503-208'1388
Corrections/Comments/Instructions:
ts ir-- pA P PARTIAL APPROVAL Ej CANCEL NO ACCESS
F7 FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: / �mY/?1 Phone #: (5O3\718' ^�^�`
/ / ` '
‹,,c_ , • ,
. ,
CITY OF TIGARD ,
BUILDING DIVISION
A PERMIT #: MEC2008-00697
D ATE
13125 SW Hall Blvd., Tigard, OR 97223 E ISSUED: 12/5/1008
Phone: (503) 639-4171 e atvittil#
Inspection Requests (24 Hrs.): (503) 639-4175 .44. ■ 11.
INSPECTION WORKSHEET FOR DATE: 12/9/2008 TIME: 7:02AM PAGE: 24
SITE ADDRESS: 10300 SW GREENBURG RD 200 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: KPD INSURANCE
DESCRIPTION: TI - HVAC modifications, no plan review required. Project Value: $4,525
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 5W-412-480u
CONTRACTOR: AMERICAN HEATING INC PHONE #: 603-239-4600
Inspection Request Scheduled For: Date: 1219/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough-in 078873-01 503-209-1389 N
Corrections/Comments/Instructions:
1\107 r--rzrA 0.. 7 ill - t - 7 - 7,A-LeC
. ..
I I PASS ,----z- ,....„ El CANCEL 0 NO ACCESS
71 51 FOR INSPECTI0 '• 0 ADDITIONAL FEES ASSESSED
1 ■■•
Inspector: ■_■■•......._ Date:a-- '1 A / g Phone #: (503) 718- '''
L , NII