Permit n CITY OF TIGARD MECHANICAL PERMIT
11111 COMMUNITY DEVELOPMENT Permit #: MEC2009-00253
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/02/2009
Parcel: 1S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 120
Subdivision: Lot: 0
Project: Ameriprise Financial
Project Description: TI - relocate ducts. No plan review required.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee 06/02/2009 $72.50
CALIFORNIA ST 49TH FL 12% State Surcharge - Mechanical 06/02/2009 $8.70
PHONE:
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222
PHONE: 503 - 233 -6911
FAX: 503- 238 -9767
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $81.20
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_ • II work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issua -, or if work is so 'ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util Notification Center. T' . e rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by .. in. :'.246.6699 or 1.800.332.2344.
Is - ued By: A // 0- ) • Permittee Signature: , / j
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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
lr E1VED FOR OFFICE USE ONLY
City of Tigard
!II SW Tigard, OR 97223 '2:3CY1 Permit No.: H 5 -
Received i_ D
Date/By: Le 69 ' e g oo y... 0 . ) ( 2
I I 13125 Hall Blvd., ,'
Plan Review l
S .: Phone: 503.639.4171 Fax: 503.598.1960 r , r T 1G ARD
M 0 2
Date/By: Other Permit:
Inspection Line: 503.639.4175 CM VI ' leinNI
TIGARD G DI lats. • Date Ready/By: ra l0 See Page 2 for
rn
Inteet: www.tigard BUILD1N Notified/Method: /6 Supplemental Information
i41,44:AZIVai'N-k 9,11 -;, !';f 6 :1440,4,WW 6 C ii- Pkt410"0:0:4101
0 New construction Addition/alteration/replacement
Mechanical permit fees* are based on the value of the work
Z
perfonned. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
M SIV '''''"'' ''''.,W- Value: $ $1,250.00
Lk
RESIDENTIAL EQUIPMENT -Y-v-sTEI:4:f FE ig61
El 1- and 2-family dwelling Z Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description I Qty. Ea. I Total
I'2:Wi111Ilr*:*S:t:1r,q§iw**oO4. . ,,,,i:,: : -'- Heating/cooling
Job site address: 10220 SW GREENBERG RD 2 LINCOLN Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: TIGARD OREGON 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: #120 Project name: AMERIPRISE FINANCIAL
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
II *111k OF WORK; = ' ':::,' - ' Nifelca Water heater 10.00
Gas fireplace 10.00
RE DUCT FOR NEW TENANT IMPROVEMENT Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
,:, , ii -,,, ,, , , m,:ra;,,,,: Chimney/liner/flue/vent 10.00
tn Ovyi■initalW 1•214a..."1AIN4NEIlliiiKegglir, Oth 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address:
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
: Ilippoww,,. 4 Attic/crawlspace fans 10.00
Other: 10.00
Business name: PROTEMP ASSOCIATES
Fuel piping
Contact name: BRUCE BUTNER $5.40 for first four; $1.00 for each additional
Address: 9788 SE 17 AVE Furnace, etc.
Gas heat pump
City/State/ZIP: PORTLAND OREGON 97222 Wall/suspended/unit heater
Phone: (503) 519 Fax: : (503) 238 Water heater
Fireplace
E bruce@protmp.com Range
CONTRACTOR i-.4., -2' ,f4ML . L.
k-.w.i. I ..,.. yr.' ' -' .,.... - ','' ' -%;50,::::':: ijitel Barbecue
Business name: Clothes dryer (gas)
Other:
Address: f! r: gi:1PEttAilfrEigifigg311
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lic.: 38868 6(14(et State surcharge (12% of permit fee)
.
TOTAL PERMIT FEE 57( . AD
Authori7ed signature: ,<A,e
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 6/1/09 * Fee methodology set by Tri-County Building Industry Service Board
1: \Building \ Permits \ MEC-PerrnitApp.doc 01/19/07 440-4617T (11/02/COM/WEB)