Permit a CITY OF TIGARD MECHANICAL PERMIT
o • COMMUNITY DEVELOPMENT Permit #: MEC2010 -00455
T l G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/17/2010
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 600
Subdivision: LINCOLN CENTER/FIVE LINCOLN Lot: 0
Project: Axium
Project Description: Mechanical for TI. Adding and relocating ducts, diffusers and grilles.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
Permit Fee 09/17/2010 $873.49
CALIFORNIA ST 49TH FL 12% State Surcharge - Mechanical 09/17/2010 $104.82
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 $978.31
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC ' calling 503.246.6699 or 1.800.332.2344.
Issued By: i Permittee Signature: ? f'2A/ A4A, C C S e
Call 503.6 -. by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Auulicati `v
`` FOIZ OFFICI•: USI.: ONI,Y
. - �� R
CI of Tigard � � •
• �' g '1 1 010 Received eiv r : Ci r
13125 SW Hall Blvd., Tigard, OR 97223 Qc? 1 Plan Review Other Petmit: l4..) _
Phone: 503.639.4171 Fax: 503.598.1960 c GPO Date/13y: . i
i 1 i ; A ii 1 Inspection Line: 503.639.4175 O` �\ `1 \ c \O e ate Ready/By: See Page 2 for
Internet: www.tigard - or.gov v∎ D,. ` Notified/Method: EilliSupplementallnformation
- ' TYPE; O F :WORx . , ; S ULE y USE.CHE15T!:
Mechanical permit fees' are based on the value of the work
❑ New construction 2 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
s CA'FPGORY OF CONSI`RIICTION
. _.
Value: 3 •
RFSI11<)rNT1fAf.. , - • . T /'SXSTE11i$ '.�*
❑ 1 - and 2- family dwelling in C ommercial/industrial ❑ Accessory building For special informat use checkl
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
Y JOB S1TE `IT ORMAT16N ANI$ i1OCATION Heating/cooling
s :..: / 0 2 0 0 S V �/ 6 Iree n b Vf R ci
Air conditioning
Job site address: (requires site plan showing placement) 46.75
City/State /ZIP: 77 died o R °1 2 2 Furnace 100,000 BTU (ducts/vents) 46.75
9 Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 600 Project name: A X 1U W 1 T Z 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
Water heater 2332
DE5CR1pTION OF' R!OR]K s t 33.39
Gas fireplace
r'e //o c a f e 3 0 svp 1 y di f' f. s e r 5 Flue vent for water heater or gas
1 fireplace 23.32
re / c 91 e /0 re t%e ^ j 1 1 C S Log Tighter (gas) 23.32
i 1 2. new SuP Iziy civ GfS t d1 •P- usee 5 Wood/pellet stove 33.39
Wood fireplace/insert 23.32
qdc1 / 5/ view re��•� `f 1. I l 5
Chimney/liner /flue/vent 23.32 •
:; . D. , FROPERTY OR'NERl „ . I: � ,. '..•:1':_'•.:-':..: D',ONANT ` Other: 23.32
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
D AP LICA11 �� �,<,' - `' d P tSON a Attic/crawlspace fans
GON FA CP
......,. . .... , . Other: 23.32
Business name: / 9 me r i t iof h H e a r II? y Fuel piping
Contact name: BrA tJ p/1 f 1 A'1 c. h e .s - 1- cc- $14.15 for first four; $4.03 for each additional
// Furnace, etc.
�O
Address: / 33 9 5 E ' devil S G as heat pttmp
City/State /ZIP: For.* /a of? 97 2 0 2. Wall/suspended/unit heater
Fax: (5 239 -7C'3 6 Water heater
Phone: (503)23 1/6,00 Fireplace
E -mail: Range .
` ' 1 i` CONTAOR
� - RCT ; s 4 s ' ' Barbecue
Clothes dryer (gas)
Business name: A rn e r 1 C or "7 H Cm +I rl I Other:
a
Address: /33 '3' 5E �O.f cJ C o o S CHANIcsAL p }R Mr' EES• -
City/State /ZIP: / l arl d 0 R '17202 Subtotal
Minimum permit fee ($90.00)
Phone: (5503 ) 239- 1./600 Fax: (5o3 ) 23/-703 $ Plan review (25% of permit fee)
CCB lic.: 33 13.6 _ State surcharge (12% of permit fee) 5
TOTAL PERMIT FEE C --7 g;3 I
�fJQ This permit application expires if a permit is not obtained within 180
Authorized signature: / "' � n days after it has been accepted as complete.
Print name: gilsid A/40 A e s -f Gee- Date: 9 /15/ 0 • Fee methodology set by Tri-County Building Industry Service Board
I 1Building \Permits\MEC- PermitApp.doc 10/01/09 440.4617T(11 /O2JCOM/WEB)