Permit ■
I 4, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00414
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/11/2008
PARCEL: 1 S 135AB -04500
SITE ADDRESS: 10250 SW GREENBURG RD 200 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /LINCOLN BLDG LOT: 001 JURISDICTION: TIG
PROJECT: FOREST CITY
Project Description: Removal and replacement of cooling unit. Valuation: $4,965.00
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: 12 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 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: 0
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA ST #300
PORTLAND, OR 97258 [MECH] Permit Fee 8/11/200E $141.50
[TAX] 12% State Surch 81111200E $16.98
[MECPLN] Plan Rev 8/11/200E $35.38
Phone: 503- 412 -4800 Total $193.86
Contractor:
ACCURATE HEATING, INC.
27350 SW 95TH AVE
SUITE 3010 REQUIRED ITEMS AND REPORTS
WILSONVILLE, OR 97070
Contact #: PRI 650 -1229
FAX 650 -4845
Reg #: LIC 88423
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: ` /% / Permittee Signatur-: / ei , „j� /,
Call 503.6 .4175 by 7:00 a.m. for inspect ons ' busine day.
This permit card shall be kept in a conspicuous place on the job site until ompletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY • eceived
I ity of Tigard ., , . ` ) : eB F ai r ' Permit No.: of
° 13125 SW Hall Blvd., Tigard, OR 97223 , y i ,
C : Phone: 503.639.4171 Fax: 503.598.1960 ?'' I Date/By: ew Other Permit. i /�
Inspection Line: 503.639.4175 - ... — .h.....4 ` M E � ` '
T'1 G A R D , 1 J Date Ready/By: Juris: HI See Page 2 for
Internet: www.tigard or.gov t" 1 0O Notified/Method: Supplemental Information
TYPE OF WORK O COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction
° r., � Mechanical permit fees* are based on the value of the work
®Addition/alteration/rep LD
❑ Demolition ❑Other: Oi
�. performed. Indicate the value (rounded to the nearest dollar) of all
��� mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ $4,965.00
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 10250 SW Greenburg Road Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: Portland, Oregon 97208 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgJapt. no.: aC573 Project name: Forest City Trading 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
Subdivision: Lot no.:
Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Push/Pull - Removal and replacement of (1) Fujitsu 24CL cooling unit only. 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
❑ PROPERTY OWNER ® TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: Forest City Trading Environmental exhaust and ventilation
Address: 10250 SW Greenburg Road Range hood/other kitchen
equipment 10.00
City/State/ZIP: Portland, Oregon 97208 Clothes dryer exhaust 10.00
Single - duct exhaust (bathrooms,
Phone: (503)246.8500 Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: _ 10.00
Business name: Accurate Heating, Inc. Fuel
Piping
Contact name: Kim Williams $5.40 for first four; $1.00 for each additional
Address: 27350 SW 95 Avenue, Suite 3010 Furnace, etc.
Gas heat pump
City/State /ZIP: Wilsonville, Oregon 97070 Wall/suspended/unit heater
Phone: (503) 650.1229 Fax: : (503) 650.4845 Water heater
Fireplace
E- mail: kwilliams@accurateheating.com Range _
CONTRACTOR Barbecue
Business name: Accurate Heating, Inc.
Clothes dryer (gas)
Other:
Address: 27350 SW 95 Avenue, Suite 3010 MECHANICAL PERMIT FEES*
City/State /ZIP: Wilsonville, Oregon 97070 Subtotal
Minimum permit fee ($72.50)
Phone: (503) 650.1229 Fax: (503) 650.4845 Plan review (25% of permit fee)
CCB lie.: 88423 / State surcharge (12% of permit fee)
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized Si / .. / �j/ i�� days after it has been accepted as complete.
Print name: Kgn Date: 08.11.08 * Fee methodology set by Tri -County Building Industry Service Board
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