Permit (26) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-00098
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Date Issued: 02/09/2017
T f C 1'4 R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1S135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 215
Project: Variant Subdivision: 1991-055 PARTITION PLAT Lot: 1
Project Description: Modifications to duct work
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 02/09/2017 $108.97
Class of Work: ALT Type of Const: Plan Review 02/09/2017 $27.24
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 02/09/2017 $13.08
Stories: Info Process/Archiving-Lg$2.00(over 02/09/2017 $2.00
11x17)
Project Valuation: $1,750.00
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 $151.29
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 Notifi enter. 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 estions to UNC by calling 503.232.1987 or 1.800.332.2344.
Issued y: 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 Applic C E FOR OFFICE USE ONLY
Ph City Of Tigard DaceBed �� Permit 4.,1-jp�
Date/By: O`{/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1Q6 7 2 011 Date/By: Other Permit: d�i`nl� 5'
TI GARD Inspection Line: 503.639.4175 tr Date Ready/By: Juris: El See Page 2 fort
Internet: www.tigard-or.govNotified/Method:Notified/Method: Supplemental Information
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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.r Value:$$1,750 00
r s:O'A'�Ct tJ P Or{:{) : .,IlnO / ,., isiiiiz x s / RESIDE '�'E I S' tea...
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
. SITE;)l ) nman.Tiktri :LMCA 11 a �,a Heating/cooling:
' Air conditioning 46.75
Job site address:10250 SW Greenburg Rd 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.:215 Project name:Variant-suite 215 lin 4 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydropic) 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
' H I;IPTIONI o� ,gar' / Gas fireplace/insert 33.39
./�, ,,, �.. = ,,,.. Flue vent for water heater or gas
Dctwork mods fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Wr yOther: 23.32❑ *OrRI'Y ! : . R ..,
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawispace fans 23.32
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Other:/F 0 PLI '• r.-.4,1 11;00-,I"- m0 ® OI l � � 23.32
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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
WalUsuspended/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� .4 `�, ''/moi/ 1 1� ,v ® ,/,, Clothes dryer(gas)
Other:
Business name:American Heating Inc.
$ft 0,IlEI3I :03%-PEVP � �S'v
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 lic.:33135 TOTAL PERMIT FEE /61,a9
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
I
Print name:Brandon Hutchinson Date: „• '7•/7
I:\Building\Permits\MEC_PermitApp_040113.doe 440-4617T(11/02/COM/WEB)