Permit ,, CITY OF TIGARD MECHANICAL PERMIT
.... COMMUNITY DEVELOPMENT Permit #: MEC2011 -00285 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/21/2011
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 220
Project: Lecroy Subdivision: METZGER, TOWN OF Lot:
Project Description: Ceiling exhaust fan.
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 06/21/2011 $75.20
Class of Work: ALT Type of Const: Plan Review 06/21/2011 $18.80
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 06/21/2011 $9.02
Stories: Info Process /Archiving - Lg Sheet (over 06/21/2011 $2.00
11x17)
Project Valuation: $669.00
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: 1 Vent Systems: Total $105.02
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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 • NC by calling 503.232.1987 o ! $ 332.2344. n nc)eS er-
C_ I"I
Issued By: / -- Permittee Signature: /�
all 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 USEONLY -
Ci of Ti gard �� Received Permit No.: Date/By: (p • ;AO Y' d! - DDo2�5
• 13125 SW Hall Blvd., T igar d , OR \ \
0 Plan Revie / �,
Phone: 503.639.4171 Fax: 503.5 q -, � ' Date/By: j �'� ��� /�� Other Perm 4/ //-0()' (:
TIGAItp Inspection Line:' 503.639.4175 \\\ V „iQ w \ Date ReaPI y: JAS: r See Page 2 for .
Internet: www.tigard- or.gov J" O 'S\ )T ^ \C\`a Notified/Method: 'j Supplemental Information
r=
:..: - _. -, -- TYPE �' - - - - `.COMMA0CWA kS.,..UI,_ ICI. S'f
❑ N ew construction A dd i t i on/alterat i o t`ep lacement 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 grofrt
_ :w.<;�,,: :. = Value: S a
:a
CA•
V CO 1
GOT 'i�'I�IIO - � -
-
- �'`OF.-CONS
�::.. '::':: ice.:, �_ t -
i ' RESIAEIYTIAL EQUIRNf LVTJ'SYSTE�1i S F F
❑ 1- and 2- family dwelling Commercial/industrial ❑ Accessory building .... :...•.::.___k::::: >.., -:r:_ ...:;... , .:
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: . Description I Qty. J Ea. Total
.JOB;= SITE INT.ORA1ATIOhI:` �A - :q's::: ` Heating/cooling
Job site address: I 0 22 0 51A/ / b Air conditioning
W l(J re e t� V (requires site plan showing placement) 46.75
City / State/ZIP: T q a.rd 0 R 9/ 2 2 Z Furnace 100,000 BTU (ducts/vents) 46.75
�J Furnace 100,000+ BTU (ducts/vents) 54.91
- Suite/bldg. /apt. no.: Z2 O Project name: L e C r 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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
`t - Water heater 2
.... . :- c . ov -oil: -R - ;.. _ ,�t<' _
I fireplace
33.39
_•: ci 'CI I : ':: :', C e i I I -n e Ii US + T Gas o ) Flue vent for water heater or gas l
U fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
= lt _ /y - - Chimney/liner /fluelvent 23.32
,Ii ' •R•� -
"
23.32
P OPE TY'sb R
rte.
VI'1`1E -
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
• v= rz G " Attielcrawls ace fans 23.32
1 _ az ^ -- t ® ; ;rM d - , r•t, - i s . OP]'I`AGI``'PI';RSOIY',-- - . ._.
T;
� .... �' �,.,:,; ,SAY IfiICAL��, - �' = -` : _ .: T . _.. . , - � � ....... ._
k
Business name: Ar r C DI /'7 " H e R / ✓! q
Other: 23.32
✓ Fuel piping
Contact name: r r., cJ M Or? (,`j e S - f G C' $14.15 for first four; $4.03 for each additional
/ Fumace, etc.
Address: / 3 ` 33 9 5 E I U con S "! ,/__ Gas heat pump •
City/State /ZIP: PO r -i- !art ci 0g 97 Z O 2. Wall/suspended/unit heater
Phone: (503 ) Z 3 ° 1 - L/6, Q O Fax: : (503)237-7(23 s Water heater
Fireplace
E-mail: Range
-
_ - - O R S . _ ��'> �`. '= �a " ~',:.<1; °<`y_;;; ;;,; Barbecue
Clothes dryer (gas)
Business name: Atli c r l c g 0 / el - 1 - I n
Other:
Address: /33 6
/33 � S � S --" ' ;;MEChiANIOAIzPERMITFEES . = ` ":• ``` ` :
City/ State/ZIP: Po r lard 0 I 172 02 Subtotal
•
Phone: (50 3 ) 239- L/GQO Fax: (50 ) 23 -7-703 S Minimum 25%itfeennitfee) —
Plan review (ZS% o.`;lermit fee)
. CCB lic.: 3'3 13.6 State surcharge (12% of ,permit fee)
TOTAL PERMIT FEE fj•`o5
Authorized signature: / � ��
This permit application expires if a permit is not obtained within 180 c 14 -S � days after it has been accepted as complete.
Print name: g Maoc l e5 + G.^ . Date: a) lie / i i * Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \PermitslMEC- PermitApo.doc 10/01/09 440 -4617T (11 /02/COM/WEB) .