Permit el CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 00459
Date Issued: 10/18/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718.2439 Parcel: 1S135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1180
Project: NSKB, LLC Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Remove (3) supply ducts & diffusers. Remove (2) return air grills. Relocate (3) supply ducts and diffusers Add (3)
supply ducts & diffusers, (6) return air grills.
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 10/18/2011 $155 02
Class of Work: ALT Type of Const: Plan Review 10/18/2011 $38.76
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 10/18/2011 $18.60
Stories:
Project Valuation: $3,298 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 $212 38
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 . • ork will be done in accordance with approved plans This permit will expire if work is not started within 180 days of
issuan -, or if work is pended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utili , Notification Center. +ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090 You may obtain a copy of the rules
or •trect questions to OUNC b ing 513 - '.1987 or 1 800 332 2344
Iss ed By: = " �« ,� Permittee Signature: �� ��! c
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 n.. FoR O.FFl U E ONLY [�
City of Tigard CEIVED Dat /B Received /O / a /// Permit No.. AVE," L" D/!�� Vs
m ° 13125 SW Hall Blvd., Tigard, OR 9_
Plan Review
' Phone. 503 718.2439 Fax• 503.598.1960 Date /By Other Permit
TIGARD Inspection Line: 503.639.4175 OCT 1 8 2011 Date Ready /By Juts 63 See Page 2 for
Internet www.tigard - gov Notified /Method Supplemental Information
CITY OF TIGARD
TYPE SING DIVISION 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, labor, overhead, and profit
Value. $ $3,298.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
LI Multi- family ❑ Master builder ❑ Other: Description I Qty Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
O
. Air conditioning
Job site address: 10260 SW Greenburd Rd (requires site plan showing placement) 46 75
Furnace 100,000 BTU (ducts /vents) 46 75
City /State /ZIP: Tigard Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: 1180 Project name: NSKB 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 electnc),
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
supply ducts and diffusers Gas fireplace 33 39
remove 3 existing pp y Flue vent for water heater or gas
remove 2 existing return air grills fireplace 23 32
Log lighter (gas) 23 32
relocate 3 supply ducts and diffusers Wood/pellet stove 33.39
add 3 new supply ducts and diffusers, add 6 new return air grilles Wood fireplace /insert 23.32
❑ 'PROPERTY: OWNER ❑ TENANT Chimney /liner /flue /vent 23 32
Other: 23.32
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
' ® APPLICANT ❑ CONTACT PERSON • Attic /crawlspace fans 23.32
•
Business name: American Heating Other: 23.32
Fuel piping:
Contact name' Brad Manchester $14.15 for first four; $4.03 for each additional
Address. 1339 SE Gideon Furnace, etc
Gas heat pump
City /State /ZIP: Portland Oregon 97202 Wall/suspended/unit heater
Phone: (503) 239 -4600 Fax: : (503) 239 -7038 Water heater
Fireplace
E -mail: Range
CONTRACTOR • Barbecue
Business name: American Heating Clothes dryer (gas)
Other.
Address: - • . MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal /5jl,OX
Minimum permit fee ($90 00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) g ,1$
CCB lie.: 33135 State surcharge (12% of permit fee) /g. , t
? /J� TOTAL PERMIT FEE At 2. 3s
'
Authorized signature: ,/2 "" ^G / / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Brad Manchester Date: 10/17/2011 1 * Fee methodology set by Tn -County Building Industry Service Board
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I \Building \ Permits\ MEC-PermitApp doc 09/09/10 440 -4617T (1 I /02 /COM/WEB)