Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00573
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2010
Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 601
Project: Matrix Absence Management Subdivision: LINCOLN THREE Lot: 0
Project Description: Relocating existing diffusers, grilles and one sensor.
Contractor: MCKINSTRY COMPANY Owner: LINCOLN CENTER LLC
12021 NE AIRPORT WAY SUITE G BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 331 -2461 PHONE:
FAX: 503 - 331 -6906
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/10/2010 $246.55
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/10/2010 $29.59
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $6,314.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $276.14
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 ado :. by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 95 s i -090. You may obtai • copy of the rules
or direct questions to OUNC by calling I = . 1.800.332.2344.
Issued By: / • ermittee Signatur • : / . / ` i _Le
C '" 1 : by 7:00 a.m. for the next availabl- inspection date.
This permit card shall be kept in a conspicuous place on the job site • .til completion of the project.
Approved plans are required on the job site at the time of each inspection.
7
Mechanical Application ‘` "S) l o OFFICE USE ONLY
City of Tigard ��j � p Date/By: Received �! 10 Permit No.: iU UQ 3
° 13125 SW Hall Blvd., Tigard, OR 98.1960 ° �.p Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 y \ Q o Date / Other Permit: 0 di O — p L.) T I G A R D Inspection Line: 503.639 �� G ec ,,, ; ate Ready /By: ice: El See Page 2 for
Internet: www.tigard -ocgov �l �,�15 Notified/Method: & Supplemental Information
TYPE OF WORK $ p 9 COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical 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, la r. r. errheead d rofit.
CATEGORY OF CONSTRUCTION Value: $ / �'' —
RESIDENTIAL EQUIPMENT, / SYSTEMS FEES*
❑ 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building
• For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
,JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 10220 SW Greenburg Road, Suite 601 Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: Tigard, Oregon 97233 Fumace 100.000 BTU (ducts/vents) 46.75
Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 610 Project name: Matrix Expansion 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),
McKinstry Project #9406 in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: 01004 Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: 1S135AB Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Relocate existing diffusers and grilles, relocate (1) existing zone sensor, Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
McKinstry Job #9406 Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
❑';PROPERTY OWNER 0 "TENANT
Other: 23.32
Name: Matrix 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
0 APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: McKinstry Company, LLC Fuel piping
Contact name: Diane Parke, Project Coordinator 514.15 for first four; $4.03 for each additional
Address: 16790 NE Mason Street, Suite 100 Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, OR 97230 Wall/suspended/unit heater
Phone: (503) 331.2465 Fax: : (503) 331.6907 Water heater
Fireplace
E -mail: dianep @mckinstry.com Range
CONTRACTOR Barbecue
Business name: Same as above
Clothes dryer (gas)
Other: 1 ❑ ❑
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 21.1,4/, 5
Minimum permit fee ($90.00)
Phone: ( ) Fax:( )
Plan review (25% of permit fee)
CCBIic.:172811 State surcharge (12 %ofpermitfee) 1 1,5--q TOTAL PERMIT FEE L , / E
This permit application expires if a permit is not obtain within 180
W
Authorized signatu : L la4 days after it has been accepted as complete.
Print name: Diane P Date: 11/9/10 * Fee methodology set by Tri -County Building Industry Service Board
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