Permit Ri 111 . CITY O F TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00019
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/12/2009
PARCEL: 1 S 135AB -01003
SITE ADDRESS: 10300 SW GREENBURG RD 540 ZONING: C -
SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG
PROJECT: HERR & DIMONE
Project Description: Relocate grilles for TI. NO PLAN REVIEW REQUIRED. Project Value: $1,850.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA ST #300
PORTLAND, OR 97258 [MECH] Permit Fee 1/12/200K $72.50
[TAX] 12% State Surch 1/12/200 $8.70
Total $81.20
Phone: 503- 412 -4800
Contractor:
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 519 -6199
FAX 503- 238 -9767
Reg #: LIC 38868
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued — .I.Se�f J Permittee Signature
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
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 7 •
City of Tigard Received Date /By: r Q Permit No.: /I ` Ar, •
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Z Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date /B Read : Juris
and - or. ov Ready /By: S See Page l Information
Internet: www.ti
g g Notified/Method: '�' Supplementallnformation
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COM ERC y l`EC* $GIIt o E ,' USE CHECICI:IST;i.,
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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.
Vii,\ :. ..• .. .:,; -. .�. ^:..•� Value: $ $1,850.00
CATEGOR ..O CONSTRUCTIOI�I'. °, �:•
I2ESII}>rt?)QITIPME 1 ' STEM S *
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
_. , '' , , „ Jl7B SI 'INFORMATIt N �i1Vll`-'LOCATION Heating/cooling
Job site address: 10300 SW GREENBERG RD Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: TIGARD OR 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: 540 Project name: HERR &DIOME Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
�� �. < .a i E k t UFO heater : RI QN WOR _ . ,
t.,
Gas fireplace 10.00
RELOCATE GRILLS FOR NEW FLOOR PLAN
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
-:: „ � ,T Chimney /liner /flue /vent 10.00
I._ Rp y :4 OV4?1� . ® N T
:eY =.. ».:� sy' .: u: - -' Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
rm , �� ”" Attic /crawlspace fans 10.00
t1 ;PI:�ICILVT'. ®C E'� � ,t;;._ .
Business name: PROTEMP ASSOCIATES Other: 10.00
Fuel piping
Contact name: BRUCE BUTNER $5.40 for first four; $1.00 for each additional
Address: 9788 SE 17 AVE Furnace, etc.
Gas heat pump
City/State /ZIP: PORTLAND OR 97222 Wall/suspended/unit heater
Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Water heater
Fireplace
E -mail: bruce @protmp.com Range
a y Barbecue
Business name: SAME AS ABOVE Clothes dryer (gas)
Other:
Address: _�'� :, >° `. __ .
14LH1NI,Cr I'ER14II FEE'"= _. `_
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB tic.: 38868 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 1/12/09 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits \MEC- PermitApp.doc 01 /19/07 440- 4617T(Ii /02 /COM /WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ME02009-000i9
13125 SW Hall Blvd., Tigard, OR 97223
espit401& iii DATE ISSUED: in 2
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 44. A.1!. 0 "
INSPECTION WORKSHEET FOR DATE: 1/13/2009 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 10300 SW GREENBURG RD 540 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: HERR & DIMONE
DESCRIPTION: Relocate fines for TI. NO PLAN REVIEW REQUIRED. Pioject Value: $'1,850.
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-519-6199
u ,(fr
Inspection Request Scheduled For: Date: 1/13/2009 P2r . Pour Ti e:
Code # Inspection Description Confirm # Contact # Mes ge
& •
699 Mechanical final 079618-01 503-519-6199 Y
Corrections/Comments/Instructions:
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epip-A pi PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS
fl FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
(Az- Date: 3/
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Inspector: Phone #: (503) 718-