Permit (100) CITY OF TIGARD MECHANICAL PERMIT
,II.' COMMUNITY DEVELOPMENT Permit#: MEC2017-00069
Date Issued: 01/30/2017
T t G„.,,k D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 250
Project: Fidelity National Title Subdivision: METZGER,TOWN OF Lot: 9
Project Description: Modification of ducts&grilles,add(1)exhaust fan.
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 01/30/2017 $121.25
Class of Work: ALT Type of Const: Plan Review 01/30/2017 $30.31
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 01/30/2017 $14.55
Stories: Info Process/Archiving-Sm$0.50(up to 01/30/2017 $1.50
11x17)
Project Valuation: $2,151.00
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: 1 Vent Systems: Total $167.61
Hoods: Comm Incinerators: Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 Ica ionter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or rest questions to OU b ' g 503.232.1987 or 1.800.332.2344.
sued By: /� Permittee Signature: /11-------
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 Application FOR OFFICE USE ONLY
Received" /
. w .
r City of Tigard , ...By: / �� Permit No.: ��7.006 -42
9
q 13125 SW Hall Blvd.,Tigard,OR 97223 ; "` :, ._
Phone: 503.718.2439 Fax: 503.598.1960 . ; Other Permit: 6/440496a,-06,53
TI G A RD Inspection Line: 503.639.4175 Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.govNotified/Method: Supplemental Information
,9AN 3 0 L'oA
- !, TyP . e'i I f i�d4 ` t i,3 r`cz �,QQERt'11. uP4az l 111,3LE—usE Gc1 Sr '
Mechanical permit fees* based on the value of the work
❑New construction ®Addition/alteration/reilt • en rirCION performed.Indicate the value(rounded to the nearest dollar)of all
CIDemolition ElOther: V � INCI a 3 mechanical materials,equipment,labor,overhead,and profit.
Value:ue $
$2,151.00
Ex> ..
�� i� .�� I RYO <i -. ...U€1IOli �,.. ', ., �„y l:LE1ir[JlIfELIP1iIVIS iEF,S,
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
IA1NFO # D LocAT Heating/cooling:
Air conditioning 46.75
Job site address:10200 SW Greenburg Rd Lincoln 5 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.:250 Project name:Fideilty National 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 1 23.32
' ' ` Gas fireplace/insert 33.39' " O O':--''''P''' O'
„ - , " w". v ` ' ,
Flue vent for water heater or gas
Add or relocate Duct work and Grilles fireplace 23.32
add 1 exhaust fan Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
_ Other: 23.32
ROPERTY:D ❑.TENANT
ht-•- �"In-
,,,F., 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
r'aitPPLI h
» wAC1 P w4Other: 23.32
Business name:American Heating Inc. Fuel piping:
$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
y v -. C� fi iSX41 " �.
Clothes der(g )
, j A,,,,,,,>46,-;`,.!---- , ., * .
Other:
Business name:American Heating Inc. 't l n r PEJIII IT
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)239-4600 Fax:(503)239-7038 State surcharge(12%of permit fee)
CCB lit.:33135 TOTAL PERMIT FEE + l(p7 4/
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: /3 0•/7
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: .j `ern f
$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\Permits\MEC_PermitApp_040113.doc 2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
10200 SW GREENBURG RD 250, TIGARD, OR,
97223
Record Type:
Commercial - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
MEC2017-00069
Inspector:
Chip Barnett
Contractor