Permit A V :Y ■'1" CITY F TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00338
TtcA 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/7/2008
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 410 ZONING: C -
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT: JURISDICTION: TIG
PROJECT: EXTERRO
Project Description: TI. Relocating (5) supply grilles, (2) return grilles and (3) pneumatic thermostats. Valuation:
$3,500.00
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:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 7
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA #300
PORTLAND, OR 97258 [MECH] Permit Fee 7/7/2008 $107.00
[MECPLN] Plan Rev 7/7/2008 $26.75
[TAX] 12% State Surch 7/7/2008 $12.84
Phone: 503 -412 -4800 Total $146.59
Contractor:
MCKINSTRY COMPANY LLC
12021 NE AIRPORT WAY SUITE G
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 331 -2461
FAX 503 -331 -6906
Reg #: LIC 172811
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 direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /`L` // / `� Permittee Signatur•: `' � ��
Call 5; 7 :e - .4175 by 7:00 a.m. for inspection - at 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.
/00*- J 3c--( ). Cprre .9 _
Methanical Permit Application FOR OFFICE USE ONLY
E " City of Tigard Received 7 ? s�,,
` O
Date/By: a / o r--f , 'emit No.: piE pexiirTi _)- 3�
`
jig g ° 13125 SW Hall Blvd., Tigard, OR 972 �j ` � y /
. Plan ie ` - . -
Phone: 503.639.4171 Fax: 50 0 n Date/By: : 1 2 7/ ,
Other Permit
T 1 G A RD Inspection Line: 503.639 Date Ready / ty: Juris: ® See Page 2 for
�o
Internet: www.tigard- or.gov ��`\ $1 �•o _ Notified/Method: : Os • � 1111 �
G c►`� Supplemental Information
\� ` V 1 '
TYPE OF WO CA ON COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
(� \ Mechanical permit fees* are based on the value of the work
El New construction ®Addition /alterJCf/ment performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: s mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ $3,500.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning heat pump
Job site address: 10220 SW Greenburg Rd
(requires site plan showing placement) 14.00
City/State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: 410 I Project name: i�)CTE QR.() 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
Flue /vent for any of above 6.80
Subdivision: I Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Relocate five (5) supply grilles and two (2) return grilles. Relocate three (3) Flue vent for water heater or gas
pneumatic thermostats 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 I 0 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: McKinstry Co.
Fuel piping
Contact name: Jason Carver $5.40 for first four; $1.00 for each additional
Address: 12021 NE Airport Way, Ste G Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, OR 97220 Wall /suspended/unit heater
Phone: (503) 331 -2461 Fax: : (503) 331 -6906 Water heater
Fireplace
E -mail: jasonc @mckinstry.com Range
CONTRACTOR Barbecue
Business name: same as applicant Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 172811 State surcharge (12% of permit fee)
p , / CA (� R TOTAL PERMIT FEE
-SL" V CA I,. VE \ This permit application expires if a permit is not obtained within 180
Authorized Slgnat � -A days after it has been accepted as complete.
Print name: Date: C/2 .. o & * Fee methodology set by Tri -County Building Industry Service Board
1:\Build ' its \MEC- PermitApp.doc 01/19/07 440 -4617T I I /02 /COM/WEB)