Permit CITY OF TIGARD MECHANICAL PERMIT
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• COMMUNITY DEVELOPMENT Permit #: MEC2010 -00503
T [ G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/15/2010
Parcel: 2S101 DA00102
Jurisdiction: Tigard
Site address: 13221 SW 68TH PKWY 100
Subdivision: TRIANGLE CORPORATE PARK Lot: 2
Project: Lincoln Heritage
Project Description: Relocating grilles and VAV boxes.
Owner: FEES
GK TRIANGLE CORPORATE PARK III L Description Date Amount
BB# 73- 1771- GK1130, CBRE, PO BOX 2096
Permit Fee 10/15/2010 $423.91
WARREN, MI 48090 12% State Surcharge - Mechanical 10/15/2010 $50.87
PHONE:
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202
PHONE: 503 - 239 -4600
FAX: 503 - 239 -7038
Type of Use:
Class of Work: 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 $474.78
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 0 NC by calling 503.246.6699 or 1.800.3 _344.
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Issued By: Permittee Signature: graci /4ac / c c 4 el"
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 A p p l i c a t i o n 1 . ( )1z ) 1 : 1 : 1 ( " i : t ,, ►: O.1.1
City of Tigard
Received — -�
!`f' . r I 1 ) iU i1/ u '
, • 13125 SW Hall Blvd., Tigard, OR 972 ?� Plan Review
Phone: 503.639.4171 Fax: 503.598.1 . , ' v \ � may_ tither Permit L Li
Inspection Line: 503.639.4175 G^ • J VC� 1
T I G A It I) Phi °' Date ed/Mct Ready/By: See ' g e 2 for
Internet: www.tigard - or.gov 6 - „ k %) Notified/Method: F Supplemental Information
. TYPE OF WORK ' ��, m . 7 • COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ® Addition/alteration/r l9ce ment 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 CONSTRUCTION a Value: $ l q O O
RESIDENTIAL EQUIPMENT./ SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building For special information use check list.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
• JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 13221 SW 68 PARKWAY Air conditioning
(requires site plan showing placement) 46.75
City/ State/ZIP: TIGARD, OR ;97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 100 Project name: LINCOLN HERITAGE @ Hest pub 61.06
Cross street/directions to job site: TRIANGLE ID 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
DESCRIPTION OF WORK Water heater 23.32
HVAC MODIFICATIONS, REMOVE & RELOCATE GRILLES & VAV BOXES Gas fireplf 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
. PROPERTY OWNER . 1
Chimney/liner/flue/vent 23.32
❑
❑ TENANT - 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
Other. 23.32
Business name: AMERICAN HEATING, INC. Fuel piping
Contact name: DALE HAMMETT $14.15 for first four; 54.03 for each additional
Address: 1339 SE GIDEON STREET Furnace, etc.
Gas heat pump
City /State/ZIP: PORTLAND, OR 97202 Wall/suspended/unit heater
Phone: (503) 239-4600 Fax: : (503) 239 -7038 Water heater
Fireplace
E -mail: Range
CONTRACTOR " Barbecue _
Business name: AMERICAN HEATING, INC Clothes dryer (gas)
Other:
Address: 1339 SE GIDEON STREET MECHANICAL PERMIT FEES*
City/ State/ZIP: PORTLAND, OR 97202 Subtotal
Phone: (503) 239-4600 Fax: (503) 239 -7038 Minimum permit fee ($90.00)
_ Plan review (25% of permit fee)
CCB lic.: 33135 State surcharge (12 %ofpermit fee)
TOTAL PERMIT FEE tti 7 i/ '.
j
Authorized signature: /� �-- This permit application expires if a permit is not obtain within 180
gnature: /�.0 ` V"/(�� r - days after it has been accepted as complete.
Print name: EMMA J GORDON I Date: 10 - 15 - 10 • Fee methodology set by Tri-County Building Industry Ser Board
I:\ Building erm V its�C- PermitApp.doc 10/01/09 440-4617T(11/02/COM/WEB) .
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