Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00233
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/11/2012
Parcel: 1 S 135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 110
Project: Terra Staffing Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Modification of ducts and grilles, relocate and add diffusers.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 331 -0234 PHONE: 513- 619 -3200
FAX: 503 - 331 -6907
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/11/2012 $352.79
Class of Work: ALT Type of Const: Plan Review 05/11/2012 $88.20
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/11/2012 $42.33
Stories:
Project Valuation: $10,138.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers 8 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 $483.32
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
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. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notif ' enter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct estions to UNC b !ling 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature:
A _/
Call 503.639.4175 by 7:00 a.m. for the next available inspe n date.
This permit card shall be kept in a conspicuous place on the job site un • completion of the project.
Approved plans are required on the Job site at the time of each inspection.
Mechanical Permit Appjii .', . FOR OFFICE USE ONLY
Received
City of Tigard' Date/By: �' Permit No.: r/ "_ 040 , 933
I
° 13125 SW Hall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.718.2439 Fax: 503'`5�8.196i 2012 Date/By: Other Permit: ,6„, p. 90
TI GA RD Inspection Line: 503.639 Date Read B Jar
Internet: www.tigard- or.g�yI �'�/ Supplemental Ready /By: s: See Page 2 for
�y `P IG nRD Notified/Method: S Information
TYPE OF WORK COMMERCIAL 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 El Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 10,138
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 El Other: Description L Qty. I Ea. I Total
JOB SITE INFOMATION AND LOCATION Heating/cooling:
R
Air conditioning
Job site address: 10300 SW Greenburg Road (requires site plan showing placement) 46.75
Fumace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard, OR 97224 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 110 Project name: Terra Staffing Heat pump
(requires site plan showing placement) _ 61.06
Cross street/directions to job site: 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
Gas fireplace 33.39
Relocate pneumatic thermostats and re;ocate /add diffusers and return grilles to Flue vent for water heater or gas
accommodate the new floor plan. Alter existing ductwork to eliminate the fireplace 23.32
Log lighter (gas) 23.32
existing cross zone between suites. Wood/pellet stove 33.39
-
Wood fireplace /insert 23.32
❑ PROPERTY OWNER Chimney/liner/flue/vent 23.32
® TENANT
Other: 23.32
Name: Terra Staffing Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: _ Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Business name: McKinstry Company, LLC Other: 23.32
Fuel piping:
Contact name: James Meyer $14.15 for first four; $4.03 for each additional
Address: 16790 N.E. Mason Street, Suite 100 Furnace, etc.
Gas heat pump
City /State /ZIP: Portland, OR 97230 Wall /suspended/unit heater
Phone: (503) 279 -3922 Fax: : (503) 331.6907 Water heater
Fireplace
E -mail: jamesme @mckinstry.com Range
CONTRACTOR Barbecue
Business name: McKinstry Company, LLC Clothes dryer (gas)
Other:
Address: same as above MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal 352.7ff
Minimum permit fee ($90.00) -----•
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) iff. -
CCB lic.: 172811 State surcharge (12% of permit fee) l/a - 33
TOTAL PERMIT FEE 4/ $7 ,3a
Authorized Signature: x This permit application expires if a permit is not obtained within 180
iJ�ll //J �(/f
days after it has been accepted as complete.
Print name: James Meyer ! / Date: 5.9.12 * Fee methodology set by Tri- County Building Industry Service Board
11Building\PermitsMEC- PermitApp.doc 09/09/10 440-4617T (11 /071COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
(:\Building \Permits \MEC- PermitApp.doc 09/09/10 2