Permit q CITY OF TIGARD MECHANICAL PERMIT
1111
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00687
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/28/2010
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 500
Project: Concero Subdivision: LINCOLN CENTER/TWO LINCOLN Lot: 0
Project Description: Installing (1) two-ton water source heat pump.
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 12/28/2010 $235.31
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/28/2010 $28.24
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $6,000.00
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:
Heat Pump: 1
Appliances
Vent Fans: Vent Systems: Total $263.55
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 -0090. You may obtain a copy of the rules
or direct questions to 0 C by calling 503. - . • : or 12
i(s
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Issued By: Permittee Signature:
�j 1 7 Call " : :7i? 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 A lication FOR OFFICE USE ONLY
City of Tigard CEIVED Received f �, , ,
1 Date/By: Ay • 13125 SW Hall Blvd., Tigard, OR 97223 plea Review
Phone: 503.639.4171 Fax: 503.598.1960 DEC 2 8 2010 Date/By: other permit:
TIGARD Inspection Line: 503.639 Daze Ready/By: El See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
,, INGFATVISION C Ei
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Mechanical permit fees* are based the
❑ New construction Addition/alteration/replacement value of the work
performed. Indicate the value (rounded d to the l ue nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
"' ` 5 C T OOkV OF CQNSTR1ICUOPI s y h ue $ li t Oo 0
' r, . ;- . s._ . ` _ .. _ ;.. -, Rt,S.g -- E0 P11 0" /'SYSTE S FEES" s.. -"
El 1- and 2- family dwel s , . special
[] C o mme rciaUindusttial ❑Accessory building F special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
:
, ��, <� � ,. a aJ'OB $lTE /�tOR1�fATI(5Nl AND r � , - a �,J . _ Heating/cooling
. : // Air conditioning
Job site address: / 02 2 0 SW ((/ r-e e n b V r y R d (requires site plan showing placement) 46.75
City/State/ZIP: 1 L G rd 0 f (7 72� 3 Furnace 100,000 BTU (ducts/vents) 46.75
�/ Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 5 Project name: Con c e (O Esc p _ 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 p a
t �x r =. y h Water heater appliances
23.32
, _ pION,OZ±zWORK y. = s : �.
. ° , Gas fireplace
33.39
h 514 / f lay on e 2- - ton W4 f e r Flue vent for water heater or gas
1 fireplace 23.32
Lou rc � sl e Ct ! P' P Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
4 . , Chimney/liner /flue/vent 23.32
0 V ❑ RR OPERP O WNj2 ` ,1 ` ` : ii I ., t 0 _iTENAI . - a . 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
s pr ,F.: . ` r,4 '` r 1 GOiCiff;LS cr PEj 'ON t= + r44 Attic/crawlspace fans 23.32
b2 a 4t r v. ��lLll. -- . '._ :..a r. ..r ., ., ..
• �" L ' Other: 23.32
Business name: i9 m e r I C, a1 r7 H e q / / by Fuel piping •
Contact name: /jrq cj M A r7 c. h e s f e ' $14.15 for first four; $4.03 for each additional
Gas heat U Furnace
Address: / 33 9' 5 E (D l cC o o S -1-- t etc.
I pump ,
city/State/ZIP: Port I li n, 0� 97 Z 0 2 Wall/suspended/unit heater
Phone: 503 )Z3 '7- y(o 0 0 Fax: : (5o3) 239 -703 $ Water heater
( Fireplace
E -mail: Range
- 4 . _� c,6°`It c i `�,6 ix� _ CO1! ► OR . fi • dt i g 1,,�a$ i.- 1 # f A t , Barbecue
,(f Clothes dryer (gas)
Business name: A
1,11 e r I C m b y / / C' T I ' 7 Other:
r P RM1T FEES* _
City/State/ZIP:
Address: /33 1 / S E �o ., 01.e o � S .. �n�cl>ANTear t � ,
p p 7202 Subtotal =
�a r f 1 av,e1 01\ 1 c� 2- 3$i,�i
Minimum permit tee ($90.00)
Phone: (503) 239 - 1/(/Q0 Fax: (503 )23 - 7 0 3 $ Plan review (25 %o` :permit fee)
CCB lie.: 33 13,5 State surcharge (12% or permit fee) a-8, i)
TOTAL PERMIT FEE 0&3,53'
�) ' /,i1� G L- This permit application expires if a permit is not obtain d within 180
Authorized signature: �jy' �'F / " 1 ' days after it has been accepted as complete.
Print name: / nn Gi/7G e s "tee- I Date: * F ee methodology set by Tri -County Building Industry Service Board
t 2 / 0
1 Building \Permits\.MEC- PermitApp.doc 10/01 /09 440- 4617T (I1 /07JCOM/WEB)