Permit CITY OF TIGARD MECHANICAL PERMIT
r T
s COMMUNITY DEVELOPMENT Permit#: MEC2015-00013
T[CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/14/2015
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 740
Project: Pollmeier Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Modification of ducts and grilles,add(2)new supply ducts and grilles,add(2)new return grilles.
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
5035 SE 24TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND,OR 97202-4765 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 01/14/2015 $121.25
Class of Work: ALT Type of Const: Plan Review 01/14/2015 $30.31
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/14/2015 $14.55
Stories:
Project Valuation: $2,200.00
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 $166.11
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 Notification Center. 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 ques• s to O1*C by c ' 503.232.1987 or 1.800.332.2344.
Issued By: t Permittee Signature:
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.
ft �EjVEP
Mechanical Permit App coy, FOR OFFICE USE ONLY
City of Tigard �� 14 2015 Received / /� i S (� te a.o/5-eva,5
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 3
' ti Phone: 503.718.2439 Fax: 5 Plan Review /�
rt1` t� Date/By: Other Permit: Iola A�/ _QQ�3
T I G;�k D Inspection Line: 503.639.417, U' !IGARD Date Ready/By: Juri3 hi See Page 2 for
Internet: www.tigard-or.goni1ir fJNi DIV1S!O1' Notified/Method: Supplemental Information
TYPE OF WORK 1/ 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
❑l)emolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$2,200.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building special information use checklist Multi-family ❑Master builder ❑Other: Description Qty. i Ea. I Total
JOB sum INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:10200 SW Greenburg Road Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91 ,
Heat pump 61.06
Suite/bldg./apt.no.:740 Project name:Pollmeier 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
Remove and Relocate Duct work and grilles,Add(2)new supply ducts and grilles fireplace 23.32
Add(2)New return grilles Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER L ❑ TENANT
Environmental 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/LIP: 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 Inc.
$14.15 for first four,$4.03 for each additional
Contact name:Brandon Hutchinson Furnace,etc.
Address:5035 SE 24th 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:b.hutchinson@americanheating.net Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:American Heating Inc. Other:
-- MECHANICAL PERMIT FEES*
Address:5035 SE 24th Ave subtotal /,21/..2 53
City/State/ZIP:Portland,OR.,97202 Minimum permit fee($90.00) •
Plan review(25%of permit fee) 50.9/
Phone:(503)239-4600 Fax:(503)239-7038 State surcharge(12%of permit fee) 14f.S5'
CCB lie.:33135 TOTAL PERMIT FEE /46v, 1/
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Brandon Hutchinson Date: //9,/$'
I\Building\Perm \M oe
itsEC_PermitApp 040113 d 440-4617x(1 l/02/`COM/WEB)
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