Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00556
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/13/2015
Parcel: 1S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 410
Project: The Hello Foundation Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Relocate existing ductwork and grilles. Add(1)new VAV.
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
5035 SE 24TH AVE BY SHORENSTEIN PROPERTIES LLC
PORTLAND,OR 97202-4765 235 MONTGOMERY ST, 16TH FLOOR
SAN FRANCISCO, CA 94104
PHONE: 503-239-4600 PHONE:
FAX: 503-239-7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 08/13/2015 $145.81
Class of Work: ALT Type of Const: Plan Review 08/13/2015 $36.45
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 08/13/2015 $17.50
Stories:
Info Process/Archiving-Lg$2.00(over 08/13/2015 $2.00
11x17)
Project Valuation: $3,000.00 Info Process/Archiving-Sm$0.50(up to 08/13/2015 $2.00
11x17)
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 $203.76
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, • ' • k is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit 'otiflcation Ce -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or:irect questions to OU c. lin! 03.232.1987 or 1.800.332.2344.
ssued By: r I ' Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit AppEIVEP FOR OFFI( l USE ONLY
City of Tigard Received g�'� Penni,No.: tf ft. �0/�" 5-gyp at e/B y
1111
- ° 13125 SW Hall Blvd.,Tigard,OR i9 31 3 2015 Plan Review e
Phone: 503.718.2439 Fax: 503.s�$. Date/By: Other Permit: • t /J-G't ,1
TI G A RD Inspection Line: 503.639.4175 Date Ready/By: 1°ris: ® See Page 2 for
Internet: www.tigard-or.gov (,ITY Or TIGARU Notified/Method: Supplemental Information
RIIILDING D!VISIO'.
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
El Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$3,000.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling Z Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑ Master builder ❑Other: Description r Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 4.6.75
Job site address: 10300 SW Greenburg Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97234 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:410 Project name:The Hello Foundation 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 existing ductwork and grilles fireplace 23.32
Add(1)new VAV Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER S 23.32
❑ TENAT\1 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 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 iPamericanheating.net Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:American Heating Inc. Other:
MECHANICAL PERMIT FEES*
Address:5035 SE 24th Ave Subtotal
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)
State surcharge(12%of permit fee)
CCB lie.:33135 TOTAL PERMIT FEE &a&,74,
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 I Date: t?-/ ,3 -,,"
I:\Building\Permits\MEC_PermitApp_0401 I3.doc 440-4617T(11/02/COM/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.
I:\Building\Pennits\MEC_PermitApp_040113.doc 2