Permit CITY TIGARD , ^ ' MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00052
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/3/2009
PARCEL: 1 S 135AB -01004
SITE ADDRESS: 10220 SW GREENBURG RD 570 ZONING: C -
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT: JURISDICTION: TIG
PROJECT: SPEC SPACE
Project Description: Relocate (3) supply grilles. Project Value: $3, 364
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA #300
PORTLAND, OR 97258 [MECH] Permit Fee 2/3/2009 $104.70
[TAX] 12% State Surch 2/3/2009 $12.56
Total $117.26
Phone: 503- 412 -4800
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
Reg #: LIC 33135
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B : Permiftee Signature: �G' G
Call 503.639.4175 by 7:00 a.m. for inspections 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.
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Mechanical Permit Application • FOR OFFICE USE ONLY Y_�
City of Tigard . Date/By � � / PermitNn.: � ,..4.4 , , j�'
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
' a Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Date/By:
T I G AR D Inspection Line: 503.639.4175 Date Ready/By: fa See Page 2 for
- Internet: www.tigard - or.gov Notified/Method: WM Supplemental Information
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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.
- :.7
-: �= _ a. CATEGORY:OF' CONSTRUCTION,. ,r, : , ?�sr� � .R.:cst ; � � .x, - ��;��' -
< " + ,R P EQ[JIPMEI .1 SYSTEMS F ED ; ti f .;
❑ 1- and 2- family dwelling c ommerc ia l / ❑ Accessory bu " "'`"�
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description . i Qty. I Ea. Total
r - °S ' =- -' ` LO ' ION •` `� " ° ' ' F Heating/cooling
rS`H` .,- � �, �dOB �. ,.,� ._.,�F` -'�;� � °�:._. �.�,
O 2 2 / / Air conditioning or heat pump
Job site address: s (.'ye. , ht/f3 Rd d (requires site plan showing placement) 14.00
City/State /ZIP: -- / - jg a we ' c2/ '722 3 Furnace 100,000 BTU (ducts/vents) 14.00
1 Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: 0 Project name: Vs p- V4/10 -CO 7 Gas heat pump 14.00
Cross street/directions too site: t . 4 Gf 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
�.�-I t Water heater 10.00
,, , ; " gam. + 5 DESCRIP OE W0 `, ' • . AU
- s
d y ,:-,:r '' '' "- 10.00
Gas fireplace
Ye / OCe - fie 3 SU, f' /y / Flue vent for water heater or gas
/ f I fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
; ,. i , - Chimney /liner /flue /vent 10.00
a ki ., �] P OWN s 3 ° x x3' - lI ,TE1 Y '
. :, a " .. �..�. _ � .,.�, ., �� �. Other. 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
,.� T - ' fi g , 47 = ," : � ; la ; , ®�CQN'JX 'f''''''''45.' �$ Attic /crawlspace fans 10.00
1 , / 1 ..,. U Other:
Business name: A e r / Cas n / ee ' -/ 7 '�� Fuel piping
Contact name: DG/e G/4r!/rle:.7L $5.40 for first four; $1.00 for each additional
// Furnace, etc.
Address: /33 SF �Q,de D h s-_/_ Gas heat pump
City/State /ZIP: Po r---MA//C/ Q/) C77 2 0 Z WalUsuspended/unit heater '
e� Water he
Phone: (503) 23 /- y I Fax: : (So3) 23 -703 F atr ater Fireplace
he -
E -mail: . • Range
- . x _ A s` - lfatt , ''CONNTRA CIO R' — F. ,, .' , , I T „ '., 1 Barbecue •
L �T- Clothes dryer (gas)
Business name: d /C6t n /�e' 7 /s'I . f-n G Other y .
/ 33 , s E (01 Jeo S „N r i-JW. Einr i,cAVTAI N $' _ ' ' .
Address: it -
City/State /ZIP: P6 ,.' / /ti,, J' OR 972 D2 Subtotal _ _
Minimum permit fee ($72.50) i /Qy. W)
Phone: (5o3 2 3 y- 9' 0 b Fax: (sd3 ) 2 37-7o3 $ Plan review (25% of permit fee) +63
CCB lic.: 33 /3 . State surcharge (12% of permit fee) /",p ..S
TOTAL PERMIT FEE // 7 A 2
This permit application expires if a permit is not obtained within 180
Authorized Signature: days after it has been accepted as complete.
. Print name: s <J ivia., Cli esfe/- Date: 2 -,3 -0 ! • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 4404617T (11 /02/COM/WEB)