Permit CITY OF TIGARD MECHANICAL PERMIT
s , COMMUNITY DEVELOPMENT Permit #: MEC2010 -00698
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/30/2010
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 360
Project: Ameriprise Subdivision: LINCOLN CENTER /FIVE LINCOLN Lot: 0
Project Description: Mechanical TI
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
1339 SE GIDEON ST BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97202 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 239 -4600 PHONE:
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/30/2010 $576.31
Class of Work: ALT Type of Const: Plan Review 12/30!2010 $144.08
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 12/30/2010 $69.16
Stories: 6
Project Valuation: $19,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8, 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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $789.55
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 • rk is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'cation Cente Th. e rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir t questions to OUN ; calling .232.1987 or 1.800.332.2344.
14 AcS Issu d By: K /‘ � � Permittee Signature: k �6i G <l"
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 Application FOR OFFICE USE ONLY
City of Tigard Received / , /D S ► Permit No.: W , 0
Ill u e 13125 SW Hall Blvd., Tigard, OR 97223 plan Review ►'�1��t�
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: 4.i, Other Permit: Q / , 4.,40 I , I
FIG A R D Inspection Line: 503.639.4175 Date Ready Ty: y: kris: ® See Page 2 for
Internet: www.tigard Notified/Method: Supplemental Information
TYPE OF WORK , COQ]�CIAIt')? : GIi�EI?ULEs,. .0.4:0 ..01,IST '.
Mechanical permit fees* are based on the value of the work
El New construction [9 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
r Value $ / DoO
' . , - r N : ' CA T (G,OR ' . ?;.;';4;i',.;',-.).,;.4,-; I RUC
k'SIII � NT a46 Pkkorls*sTF, ot' c ,
❑ 1- and 2- family dwelling i ] Commercial/industrial El Accessory building
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. 1 Ea. 1 Total
' n , ,JOB: S1T ` 1 A AN]) L O CATION, 4 : , � 4 , Heating/cooling .
. °' .., ' . / ' ` f - Air conditioning
Job site address: 10200 5 w 6 ✓ e h b v ri R iJ (requires site plan showing placement) 46.75
City/State/ZIP: 7 Q�d OR Furnace 100,000 BTU ( ducts/vents) _ 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
• Suite/bldg. /apt. no.: 3 60 Project name:A e v 1 P 1 -- 1 S t°O 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 .
u `s Water heater 23.32
,. A)ESCRIPTION OI! : RORK v ° Gas fireplace 33.39
re /OG fe 7 Vfl ply d ()G -I- s Flue vent for water heater or gas 23.32
/ / fireplace J r e. Ur r • 1 I t $ 23.32
('e I Jo G q � e 5 L o g li (gas) -
add 2 net., 5 rP 1 y Jo G+ 5 Wood/pellet stove 33.39
Ad ci 2 new Wall modsi4ed Co.1t.. t,.,; 4. Wood fireplace/insert 23.32
.� Chimney/liner /flue/vent 23.32
lul` OWNER r ❑,`TEN Other:
fI ' ❑PROPER -. .: K r .. 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 -
®� O
CNTACT PERS'''ON ` : r Attic/crawlspace fans —
23.32
/•' .," ... . , . i1.. AP -:-.; C:- .',r} ,..a ..-. ,o- .` ... ,..- ..�,, . ,,..._ Other: 23.32
` Business name: A me r f c' r7 H e el ' t / e ✓ q Fuel piping
Contact name: gr of ci M '3 r'7 c. h e S f GC"' GC"' $14.15 for first four; $4.03 for each additional
/ I 1 Furnace; etc.
Address: / 33 (p S E , U � D rl S r G as heat pump
City/State /ZIP: P r -t- Ian U 0 g 97202_ Wall/suspended/unit heater
Phone: ($03 )Z3 '7 — '/(o 0 0 Fax: : (503)23'7-7(23 S Water heater
Fireplace _
E -mail: Range
; -. ! r ,_ .. .. jo..i . ` ` y i p 1 .+ A - s a . i h
e .{ . � i - . y _t I n Barbecue
{a t w s ,n o ,. CQ1VT> ACTOR : . e , .. ., ;',>.. - l . ..
�(f a: Clothes dryer (gas)
Business name: ` Ain e r I C g h ! I Co) T 1111 Other:
Address: /33 q 5E to 1 ci e a ei 5 r 1 IECHANIOAL'•PERMIT'F , }, i.
City/State /ZIP: /) ('-t- l ael d 0 !\ G77202 Subtotal _
Minimum permit fee ($90.00)
Phone: (5Q3) 23'?- 1/�, o Fax: (5o -? )23 Plan review (25 %o.' permit fee)
CCB lie.: 3'313 s State surcharge (12% of , )ennit fee)
TOTAL PERMIT FEE
�
Q �j� This permit application expires if a permit is not obtained within 180 C Zs Authorized signature: / "'� "' � '� i ( days after it has been accepted as complete.
Print name: �j j�q J nGl/!G !'1
/ es T L C'� / Date: Z 2 / . Fee methodology set by Tri -County Building Industry Service Board
r
1:\ Building \Permits\MEC- PermitApp.doe 10/01/09 440- 4617T (I1/02/COM/WEB)
. Building Division
Over- The - Counter (OTC) Mechanical Permit
r, IG n lZ D' Check List
Description of Project: 1 i t (- � ( 77
•
GENERAL INFORMATION
Class of Work:* rc ( Floor Furnace: Evap. Coolers:
Type of Use:* ('(3 Unit Heaters: Vent Fans:
Occupancy Group: r, Vents w/o Appl.: Vent Systems:
Stories: Boilers, Comp, Heat Pum , A /C: Hoods:
Fuel Types: 0 - 3 HP: 1 Domestic Incinerator.
ELC / GAS / NG / OIL / OTHER 3 - 15 HP: Com. /Ind. Incinerator.
- Max Input: BTU: 15 - 30 HP: Repair Units:
Fire Dampers: 30 - 50 HP: Wood Stoves:
Gas Pressure: H / M / L >50 HP Clothes Dryer.
. No. of Units: Air Handling Units: Other Units:
Furnace <100k BTU: <_10,000 CFM: Gas Outlets:
Furnace >_100k BTU: >10,000 CFM: P0C C V -
Notes: -
VkL 6 0
• INSPECTIONS I I FEES DUE
Post /beam mechanical • $ 1 76 .( Permit Fee
Gas line $ 0, I ( State Surcharge
Mechanical rough -in $ 1 ,OR Plan Review Fee
Fire damper $ Additional Permit Fee
Duct work $ Additional Plan Review Fee
Smoke detector $ Investigation Fee
Investigation inspection $ Misc. Fee
Misc. inspection $ Hourly Rate Fee
Final inspection $ Hourly Rate State Surcharge
•
$ 707. ? Total Fees Due
I OTHER PERMITS REQUIRED I
Building Electrical
• Plumbing Site Work
*OPTIONS:
TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. .
CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo;
FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings
. or canopies); REP = repair.
1:\Building\Forms\OTC- MEC.doc 09/22/06
•