Permit I CITY _ r
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OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00280
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/16/2008
PARCEL: 1S135AB-01004
SITE ADDRESS: 10220 SW GREENBURG RD 600 ZONING: C -
SUBDIVISION: LINCOLN CENTER /TWO LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: TI. Relocating supply ductwork and grilles . Valuation: $4,500.00
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: 6 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: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA #300
PORTLAND, OR 97258 [MECH] Permit Fee 6/16/200€ $130.00
[MECPLN] Plan Rev 6/16/200€ $32.50
[TAX] 12% State Surch 6/16/200€ $15.60
Phone: 503 -412 -4800 Total $178.10
Contractor:
MCKINSTRY COMPANY LLC
12021 NE AIRPORT WAY SUITE G
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -331 -2461
FAX 503- 331 -6906
Reg #: LIC 172811
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 By: L _ � `� i Permittee Signature: ••- 1
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Call 503. " 175 by 7:00 a.m. for inspections that busine 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.
l JRkk)Ceko 2-2-0 vCt.) C =t-i
Mechanical Permit Application 4175 639
Inspection Line: 503.639.4175 Other Permit: qq
Ins weS FOR OFFICE USE ONLY
City of Tigard rC� Received / _
Permit No.: �j
13125 SW Hall Blvd., Tigard, OR Date /By: ey /� �p iZ).
Phone: ..ax: .. O 2 Plan Revie / .
Pho 5036394171 Fax: 5035981960 _ rI C �,1111� / p I
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.: MMER EE- .�SCHEIIIII:,E = °'IlS ,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.
"r:. ;C;A'fEGORY .CONSTRUCTION rys : 0 0
, ..,a ,=_' ,,..,... < :. -,. nnr `'' . �3 Value 4,5 NTIAL �
RESH)E„ ° ° " EQU. ",,•,,," ENT_!"SYSIEMS)F ES* `,
❑
1- and 2 - family dwelling ® Commercial /industrial ❑ Accessory building ......,,_.. _.
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
A T
=„ : ;JOB`STTET'NFORIlT � ION"�AND;- LOCAIZO1V�r ; Heating/cooling
Job site address: 1 Greenburg Rd Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: 600 Project name: Farmers Insurance 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
,n: ..•," ::� Ai Water h eate r 1
0.00
_.. �_ . .: °E�:,
va�.3
Gas fireplace 10.00
Relocate supply ductwork and grilles to accomdate new floor layout 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
Chimney/liner/flue/vent 10.00 ° '' ❑;PROEERTY .OWNER" ' ''>' ❑:: TENANT> ::' `.``,
'Ii.:_.,. , _ _ . , - : "= Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility roans) 6.80
111 'APP)IC
ANT
O craw p ce fans
10.00
C NTAC,T;;$ERSON' Attic/ ]s a
,�.. �'�, S: ,sou � ..• ?x ;.. i x3333 ".. -.v-_c < , _ ..��.< - _ ,.., >,.
Other: 10.00
Business name: McKinstry Co. Fuel r m
P g
Contact name: Jason Carver $5.40 for first four; $1.00 for each additional
Address: 12021 NE Airport Way, Ste G Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, OR 97220 Wall /suspended/unit heater
Phone: (503) 331 -2461 Fax: : (503) 331 -6906 Water heater
Fireplace
E -mail: jasonc @mckinstry.com Range
,3
Barbecue
Business name: McKinstry Co Clothes dryer (gas)
Other:
Address: 12021 NE Airport Way, Ste G MECIIANICA�LAAA 1PWT FEE@ " =,
City/State /ZIP: Portland, OR 97220 Subtotal
Minimum permit fec ($72.50)
Phone: (503) 331 -2461 Fax: (503) 331 -6906 Plan review (25% of permit fee)
CCB lie.: 172811 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Jason Carver Date: 6/3/08 * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building \Permss \MEC- PermitApp.doc 01/19/07 440 -4617T (11 /02 /COM /WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008-00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 611612008
Phone: (503) 639-4171 kaggplii,
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6119/208 TIME: 7:00AM PAGE: 1
SITE ADDRESS: 10220 SW GREENBURG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/TWO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: TI. Relocating supply ductwork and grilles . Valuation: $4,500,00
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: MCKINSTRY COMPANY LLC PHONE #: 503-331-2461
Inspection Request Scheduled For: Date: 6/19/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mes - • -
699 Mechanical final 071612-01 503-764-6949 AP
Corrections/Comments/Instructions:
OK---- 45 pc-,---1 4 es---
PASS H APPROVAL 71 CANCEL I I NO ACCESS
I FAIL CALL FOR INSPECTION VA pi
1 ADDITIONAL FEES ASSESSED
/ .............-
Inspector: A■........._ Date: C?/ Phone #: (503) 718-
vp
CITY OF TIGARD
BUILDING DIVISION ^\ , PERMIT #: MEC2000- 00260
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6116/200t3
Phone: (503) 639 -4171 .� e u�161il
Inspection Requests (24 Hrs.): (503) 639 -4175 : ±i =-__..
INSPECTION WORKSHEET FOR DATE: 0/10 /700t . .. TIME: 7 :02AM PAGE: 67
SITE ADDRESS: 10220 SW GREENt3URG RD 600 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ WO LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: TI . Relocating supply ductwork and grilles . Valuation: ;4,500.00
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503 - 412 -41300
CONTRACTOR: MCKINSTRY COMPANY LLC PHONE #: 503- 331 -2461
Inspection Request Scheduled For: Date: 6118/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 071501 -01 503 -672 -4132 N
Corrections/Comments/Instructions:
14c) P r• l c)A1 —S )77:-.S (Ptog-- 04 c--- r e-
F-- /4c 14- tP •pce.zA t n a %-kis & /" .t j t 727- (r
/1/410.- - 40- - 7)/
❑ PASS r "ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
- 11 4 FAI Z ' FOR INS" ' TI & ∎• ❑ ADDITIONAL FEES ASSESSED
Inspector: IMP Date: / , - _ Phone #: (503) 718- 7-6 cv
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