Permit 1 r •� CITY OF TIGARD MECHANICAL PERMIT
' !! ;' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00372
TirAR 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/17/2011
- Parcel: 1S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 610
Project: New York Life Subdivision: METZGER, TOWN OF Lot: PTS 7 -8
Project Description: 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 08/10/2011 $1,523.07
Class of Work: ALT Type of Const: IB Plan Review 08/10/2011 $380.77
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 08/10/2011 $182.77
Stories: 12 Info Process /Archiving - Lg Sheet (over 08/10/2011 $4.00
11x17)
Project Valuation: $56,398.00 Info Process /Archiving - Sm Sheet (up to 08/10/2011 $7.50
11x17)
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: 1 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $2,098.11
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: split system
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, uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility . Center. ho - rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or • ect questions to OUNC b4 alli • .'03.232.1987 or 1.800.332.2344.
I . ued By: a / / / ie/ I A ,y Permittee Si• r 1 ` �
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 Applica A n ECE1VED * , FoR oFFIcE~USE NEY 3
City of Tigard 0 2011 Received //
AUG t� Date/By: 6 0 Mel Permit No.: iyee 7-..4037
11111 - ® 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review V'
Fe f ' OF TIGARD Other Permit:
Phone: 503.718.2439 Fax: 503.59 Date/By: _
Inspection Line: 503.639.4175
T I CARD Date Ready :. orris: ® See Page 2 for
, Internet: www.tigard- or.gov BUILDING DIVISION (� Notified/Method: ' 1-7 1) err-T-4- f Supplemental Information
' .,: ti TYPE,'OF WORK ' 1 L f 1i Ze MMERCLAL FEE* SCCIIEDULE IISE C 1ECKLIST •
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, labor, overhead, and profit.
CATEGORY ° CONST I CTION
Value:
(
. ,.. RESIDENTIAL QUI PMENT I SYSTEMS FEES z
El 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family El Master builder ❑ Other: Description Qty. Ea. Total
it JOB SOETI1VFORMATION AND LOCATION ; . [leafing/cooling:
- ' �` ° - � Air conditioning
Job site address: 10260 SW Greenburg Road (requires site plan showing placement) 46.75
City/State/ZIP: Tigard Oregon Furnace 100,000 BTU (ducts /vents) 46.75
Fumace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.:W /,, i?") Project name: New York Life Heat pump
(requires site plan showing placement) 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:
DESCRIPTION OF WORK ,
Water heater 23.32
Gas fireplace 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
Chimney/liner/flue/vent 23.32
� PROPERTY; OWNER y �� � ❑ TE1rANT . ' ,, ;:
Other' 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
;AP PLICANT , ; `%WE ®CONTACT PERSO1 / Attic /crawlspace fans 23.32
Business name: American Heating Inc Other: 23.32
Fuel piping:
Contact name: Brad Manchester $14.15 for first four; $4.03 for each additional
Address: 1339 SE Gideon Street Furnace, etc.
Gas heat pump
City /State /ZIP: Portland OR 97209 Wall /suspended/unit heater
Phone: (503) 239 -4600 Fax: : (503) 239 -4600 Water heater
Fireplace
E-mail: Range
an
i° CON I ' V
�..� w� _ „, s ��k » - € .., - € �, ' Barbecue
Business name: American Heating Clothes dryer (gas)
Other:
Address: 1339 SE Gideon Street 1111154:11,1W#W-01E,OWt FEES*
City /State /ZIP: Portland OR 97202 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 239 -4600 Fax: (503) 239 -7038
Plan review (25% of permit fee)
CCB lie.: 33135 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 9R•
Authorized signature: - Te ��'C This permit application expires if a permit is not obtaiwithin 180
days after it has been accepted as complete.
Print name: Brad Manchester Date: 7/15/2011 * Fee methodology set by Tri -County Building Industry Service Board
I:\ Buildings 'ermits'MaC- PermitApp.doc 09/09/10 440 -4617T (11 /02 /COM/WEB)