Permit 11111- CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00435
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/31/2013
Parcel: 1 S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 110
Project: Family Health Subdivision: 1991 -055 PARTITION PLAT Lot: 1
Project Description: Relocate supply diffusers, add supply diffusers and new duct work
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
1339 SE GIDEON ST BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97202 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 239 -4600 PHONE:
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/31/2013 $235.31
Class of Work: ALT Type of Const: Plan Review 07/31/2013 $58.83
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 07/31/2013 $28.24
Stories:
Project Valuation: $6,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & 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 $322.38
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 • ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U Notification C- •ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
• r direct questions to 0 - • calling 503.232.1987 or 1.800.332.2344. r M
Issued By: ` d Permittee Signature: �q I 4'i c Ac J S - c 0•
4
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 Applicatio E E ' Received FOR OFFICE USE ONLY
City of Tigard Date /By: 7 t Mew PermitNo.: mEca13_6e 3
IN • 13125 SW Hall Blvd., Tigard, OR 97223 JUL 3 0 2013
C Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date /Ry: Other Permit: %. Li ea 6
TI G A R D Inspection Line: 503.639 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 6000
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 Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 10250 SW Greenburg Road Furnace 100,000 BTU (ducts /vents) 46.75
City/State /ZIP: Portland OR 97223 Furnace 100,000+ BTU (ducts /vents) 54.91
Heat pump 61.06
Suite/bldg. /apt. no.: 110 Project name: Family Health Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
relocate supply diffusers fireplace 23.32
new supply diffusers Log lighter (gas) 23.32
Wood/pellet stove 33.39
new duct work Wood fireplace/insert 23.32
Chimney /liner /flue/vent 23.32
❑ PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State /ZIP: Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic /crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name: American Heating
$14.15 for first four; $4.03 for each additional
Contact name: Brad Manchester Furnace, etc.
Address: 5035 SE 24 Ave Gas heat pump
Wall/suspended/unit heater
City/State /ZIP: Portland OR 97202 Water heater
Phone: (503) 239 -4600 Fax: : (503) 239 -7038 Fireplace
Range
E -mail: Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: American Heating Other:
MECHANICAL PERMIT FEES*
Address: 5035 SE 24 Ave
Subtotal ��S• 3l
City/State /ZIP: Portland OR 97202 Minimum permit fee ($90.00) ---
Phone: (503) 239 -4600 Fax: (503) 239 - 7038 Plan review (25% of permit fee) /j Q . <625
State surcharge (12% of permit fee) a g . ay
CCB lic.: 33135 TOTAL PERMIT FEE 3a, 2.34g,
This permit application expires if a permit is not obtained within 180
R - 12 ��� 4 � �_ days after it has been accepted as complete.
Authorized signature: � / ' * Fee methodology set by Tri - County Building Industry Service Board
Print name: Brad Manchester Date: 7/3 /3
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