Permit CITY OF TIGARD MECHANICAL PERMIT
111 to COMMUNITY DEVELOPMENT Permit #: MEC2012 00116
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/08/2012
TIGARD . 9 Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 601
Project: Matrix Absence Management Subdivision: METZGER, TOWN OF Lot: 9
Project Description: HVAC modifications
Contractor: STREIMER SHEET METAL WORKS INC Owner: LINCOLN CENTER LLC
740 N KNOTT STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97227 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 288 -9393 PHONE:
FAX: 503 - 288 -3327
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/08/2012 $383.27
Class of Work: ALT Type of Const IIB Plan Review 03/08/2012 $95.82
Occupancy Grp: B Occupancy Load: 12% State Surcharge - Mechanical 03/08/2012 $45.99
Stories: Info Process /Archiving - Sm $0.50 (up to 03/08/2012 $1.00
11x17)
Project Valuation: $11,390.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Fumaces < 100K BTU: 0 -3 HP:
Fumaces >= 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 $526.08
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: VAV
Duct Work: 1
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. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuan ._ . ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util' Notification Center. Th. e rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
o' direct quest'ons to OUN • calli g 5• •.232.1987 or 1.800.332.2344.
I - ued By: / Permittee Sign ! J/
Call 503.639.4175 by 7:00 a.m. for the next available inspection • ate.
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 1012 OFFICE USE ONLY
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`J Tigard Date/By: p 1 & �Qf�C [ f
City of Ti and Per mit No.:
III
n 13125 SW Hall Blvd., Tigard, OR 9
Plan Review
`
Phone: 503.718.2439 Fax: 503.598.1960 g01 Date /By: � �/ 3 Other Permit: a / `
O/ - oev33
T I G A R D Inspection Line: 503.639 MAR L L Date Ready :y: Juris: El See Page 2 for
Internet: www.tigard - or.gov Notified/Method:5 /7/t , / r Supplemental Information
CITY OF TIG r� A' �L /
TYPE Oli CO ERCIAL 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: $ 11,390
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES`
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 3 Lincoln Center 10220 Sw Greenburg Rd (requires site plan showing placement) 46.75
Fumace 100,000 BTU (ducts/vents) 46.75
City/ State/ZIP: Tigard, Or. Furnace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldg. /apt. no.;,661 Project name: Matrix ti Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job si e: Lincoln Center bldg 3 Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
. hydronic) 23.32
Unit heaters (fuel -type, not electric),
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
HVAC Tenant Improvement, Add Vav box Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
0 PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 23.32
Other: 23.32
Name: Shorenstein Realty Services Environmental exhaust and ventilation:
Address: One SW Columbia St, Suite 300 Range hood /other kitchen
equipment 33.39
City/ State/ZIP: Portland, Oregon Clothes dryer exhaust 33.39
Phone: (503)288 -9393 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
0 APPLICANT 0 CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Streimer Sheet Metal Works, Inc. Other: 23.32
Fuel piping:
Contact name: Paul Lukes $14.15 for first four; $4.03 for each additional_
Address: 740 N. Knott St Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, Or. 97227 Wall /suspended/unit heater
Phone: (503) 288 -9393 Fax: : (503) 288 -3327 Water heater
Fireplace
E -mail: Pa_lukes @comcast.net Range
CONTRACTOR Barbecue
Business name: Streimer Sheet Metal Works, Inc. Clothes dryer (gas)
Other:
Address: 740 N Knott St MECHANICAL PERMIT FEES"
City /State/ZIP: Ptld., Or 97227 Subtotal
Phone: (503) 288 -9393 Fax: (503) 288 -3327 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 2365 r 0/a.7 / �, State surcharge (12% of permit fee)
I TOTAL PERMIT FEE
Authorized signature: _ _ (1 Q ,� ` n This permit application expires if a permit is not within 180
GZ�� days s after r it t has been accepted as complete.
Print name: Paul Lukes I Date: 3 - - • Fee methodology set by Tri- County Building Industry Service Board
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