Permit CITY OF TIGARD MECHANICAL PERMIT
r'1 COMMUNITY DEVELOPMENT Permit#: MEC2015-00084
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/18/2015
Parcel: 1 S135AB01004
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 400
Project: Maxim Healthcare Subdivision: METZGER,TOWN OF Lot: 9
Project Description: (1)new VAV box and(1)ceiling mounted exhaust fan.
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:
FAX: 503-331-6907
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/18/2015 $115.11
Class of Work: ALT Type of Const: Plan Review 02/18/2015 $28.78
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 02/18/2015 $13.81
Stories:
Project Valuation: $2,000.00
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 $157.70
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: VAV
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 q -. • •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued = Permittee Signature: p
Call 503.639.4175 by 7:00 a.m.for the next available inspectio •• e.
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 A llCai EIVED FOR OFFICE USE ONLY
City of Tigard Received
r Date/By: (8/1 S !1} Permit No.: Mae pZ/i s"i l�,ip
III
• 13125 SW Hall Blvd.,Tigard,OR 972x3 EB 1 8 2015
S Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Other Permit: 1S""C+��C�
r 1(;A R n Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris: H See age 2 for 1
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: G Supplemental Information
4771 '9 3 ,. - -. .�G,I I� * i J `+5 0€ 17, ,1
i
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:$2000.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family d∎selling ®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 46.75
Job site address: 10220 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
Suite/bldg./apt.no.:400 I Project name:Maxim Healthcare Heat pump 61.06 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), :35 in-wall,in-duct,suspended,etc. 1 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 diffusers/grilles fireplace 23.32
Install one new cooling VAN' and one new ceiling mounted exhaust fan. Log lighter(gas) 23.32
Wood/pellet stove 33.39
— Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPER I Y OWNER Other: 23.32
Environmental exhaust and ventilation:
Name:Shorenstein Realty Services L.P. Range hood/other kitchen
equipment 33.39
Address: 10220 SW Greenburg Road,Suite 310 Clothes dryer exhaust 33.39
City/State/ZIP:Portland,OR 97223 Single-duct exhaust(bathrooms, 1
toilet compartments,utility rooms) 1 23.32 13,1)7_
Phone:(503)619-3100 Fax:(503)619-3110 Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 23.32
Fuel piping:
Business name:McKinstry Co
514.15 for first four;S4.03 for each additional
Contact name:Antonija Krizanac Furnace,etc.
Address: 16790 NE Mason Street,Suite 100 Gas heat pump
WalUsuspended/unit heater
City/State/ZIP:Portland,OR 97230 Water heater
Phone:(503)331-0234 I Fax::(503)331-6906 Fireplace
Range
E-mail:antonijak @mckinstry.com Barbecue
::-r ;.:, : ` o .. � ,R Clothes dryer(gas)
Business name:McKinstry Co. �,
Other:
sr,« .:tt ...., _.,. +sett .'. ,}', iIN'
Address: 16790 NE Mason Street,Suite 100 Subtotal
City/State/ZIP:Portland,OR 97230 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)331-0234 Fax:(503)331-6906 State surcharge(12%of permit fee)
CCB lic.:172811 TOTAL PERMIT FEE 1i5 ?. '�
This permit application expires if a permit is not obtaine within 180
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name:Antonija Krizanac Date: (?f (S
I:\Building\Permits\MEC_PermitApp_040113.doe 440-4617T(I I/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10220 SW GREENBURG RD 400, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00084
Chip Barnett
Violation Summary:
Inspector Contractor