Permit q CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00853
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/06/2016
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 571
Project: Trellborg Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Add water source heat pump with duct work and grilles.
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 01/06/2016 $260.60
Class of Work: ALT Type of Const: IIB Plan Review 01/06/2016 $65.15
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 01/06/2016 $31.27
Stories: Info Process/Archiving-Lg$2.00(over 01/06/2016 $2.00
11x17)
Project Valuation: $6,900.00 Info Process/Archiving-Sm$0.50(up to 01/06/2016 $5.00
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 $364.02
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Water source
Duct Work: heat pump
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
c
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 Applicata
CityRVE Received
13125 FOR OFFICE USE ONLY
W Tigard Blvd.,
Date/B : 9 /� Permit No. �I�j/S�Q�s3
� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie - �
Phone: 503.718.2439 Fax: 503.598.196 C 8 PDate
lan R y: 1 Other Permit:
li a Inspection Line: 503.639.4175 l ` O U�� Date Ready- : luris: ® See Page 2 for
Internet: www.tigard-or.gov (,11'Y OF 1,1(,'AHD
Notified/Method: Supplemental Information
TY
pE ". COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Add ition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$6,900.00
CATEGORY OF,,CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling M Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB"SITE INFORMATION AND"LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 10220 SW Greenburg Road Lincoln 3 Furnace 100,000 BTU(ducts/vents) 46.75
City/State/7IP:Tigard OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
� Heat um 61.06
Suite/bldg./apt.no.:571 Project name:Trellborg Duct work 23.32
Cross streeUdirections to job site: H dronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 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
DESCRH'TION OF;WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Add Wacr source heat pump with duct work and grilles fireplace 23.32
Log lighter as23.32
Wood/ ellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ .PROPERTY OWNER Other: 23.32
❑ TENANT"
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
Citv/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawls ace fans 23.32
® APPLICANT ® CONTACT.;PERSON Other: 23.32
Fuel piping:
Business name:American Heating Inc.
$14.15 for first four;$4.03 for each additional
Contact name:Brandon Hutchinson Furnace,etc.
Address:5035 SE 24th Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,OR.,97202 Water heater
Phone:(503)2394600 Fax::(503)239-7038 Fireplace
Range
E-mail:b.hutchinson@americanheating.net Barbecue
CONTRACTOR_" Clothes dryer as
Business name:American Heating Inc. Other:
ltilEtANtOAL$Eft1�1I FEES*
Address:5035 SE 24th Ave Subtotal
City/State/ZIP:Portland,OR.,97202
Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)2394600 Fax:(503)239-7038
State surcharge(12%of permit fee)
CCB lic.:33135 TOTAL PERMIT FEE
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:\Building\Permits\MEC_PermitApp_040113.dm 440-4617T(I1/02/CONVWEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Feet
$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.
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