Permit 71 4 ; . CITY OF TIGARD MECHANICAL PERMIT
S COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00476
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/24/2008
PARCEL: 1 S135AB -00900
SITE ADDRESS: 10200 SW GREENBURG RD 700 ZONING: C -P
SUBDIVISION: LINCOLN CENTER /FIVE LINCOLN LOT: JURISDICTION: TIG
PROJECT: FARMERS INSURANCE
Project Description: HVAC TI - no plan review required. Project Value: $8,908
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
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 [TAX] 12% State Surch 9/24/200E $25.62
[MECH] Permit Fee 9/24/200E $213.88
Total $239.50
Phone: 503- 412 -4800
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 239 -4600
FAX 503- 239 -7038
Reg #: LIC 33135
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
■ Iss d By: . / / / i - Permittee Sign ure: / � J
� d
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
"L Of Tigard D and E � ' ece a e vie 9 �/ O G Permit No.: L 1 i 4/74
111 1'J eB .. 8
13125 SW Hall Blvd., Tigard, OR 97223
� : Plan Review Other Permit:
Phone: .503.639.4171 Fax: 503.598.1960 Date/B
T I G ARD Inspection Line: 503 S �P t om' 1 Date Ready/By: Ions: ® See Page 2 for
. Internet: www.tigard - or.gov �' N.tifia.iMethod: & Supplemental Information •
�.._ ,.,:= w < _ .•. .,..• „ ULE' =`U$E KLIST
� ,: ,.< „..t., ,•�.....<.,.�..,.. OF.,W RK '�� , M �COMl1�RCIA _,.....,.. .
_ .� �. �; °. K '. . � :'� t �� , FE E , * SCHED .,' . �. _. -
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition CD Other: mechanical materials, equipment, labor, overhead, and profit.
��, ,;,;: -��, .. - ...- ,�.,., '. �: ; , µ; �s, : , . ;�f�.; Value:
:_� ;- <•_:�.= `,�:.- =, CATEGORI':�OF: CONSTRUCTION•., �_ gip. ^:�,,, - -
-” `- ) :RESIDENTIAL EQUIPMENT %SYSTEMS FEES . �; �1
❑ 1- and 2- family dwelling CotnmercialIindustrial ❑ Accessory building `� _.;,• ,,:_....,,.::. . ,:.,..,_ :: - ; "_,<
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. 1 Total
= „ _= ttar , .:JOB;St1E;._ INFORMATION "AND „. „ '_. HeatinWcooling
Job site address: /02 00 7recn b(/r� prJ Air conditioning or heat pump
O �`JJ /� (requires site plan showing placement) 14.00
City/State /ZIP: T /\ q �d o Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 0 0 Project name: FG ,e,v7e r- $ 171,51/ ('%1Ct 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
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
01 ;, * . DESCRIPTION OR M° '• : k 4. . 4 ,' W a t er h ea t er 10.00
,.. _ (- 4.1V-- sue GaS fireplace 10.00
G/ / /' /5 7 U7t /ot7 c ho e 5 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
lit PROPERTY OWNER a , ANT i : Chimney/liner /flue /vent 10.00
® TEN 9 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 -
r t °� r r u'''" . ' Attic /crawlspace fans 10.00
APPLICANT � e .1 � s ® .CONTACTPERSON -�, i�
i� Other: 10.00
Business name: Amer!e4n � � Fuel piping
t% e /'nm
Contact name: /G /Jae /..f $5.40 for first four; $1.00 for each additional
Address: 1331 SE 6 i d eon s/- /ec '� Furnace, etc.
p Gas heat pump
City/State /ZIP: Portland Q /` 9720 2. Walllsuspended/unit heater
Phone: (503) 239- x600 Fax: : (503) 231- 7038 Water heater
Fireplace
E -mail: • Range .
:*”' ;* m CONTRACTOR r _: ° Barbecue
Business name: A re,- 1 C4 ft Heal / ii r < Clothes dryer (gas)
Other:
Address: // _
133-1 sE &i Co✓i S MEC - 1 ES . :
City/State /ZIP: & l- 1 J oR 972o2 S ubtotal _
Minimum permit fee ($72.50) ,4 3.5
Phone: (j o31 23- L / () 0 Fax: (503) 231-7038 Plan review (25% of permit fee)
CCB lie.: 33/ 3 5 State surcharge (12% of permit fee) a S 6o,
TOTAL PERMIT FEE 2 ,3 9./2-
Authorized signature: V //?d� v This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ,(C{d, TanGj,e. — I - e r Date: 9 23 -O8 * Fee methodology set by Tri -County Building Industry Service Board
I:\Building\Permits\IdEC- PermitApp.doc 01/19/07 440 -4617T (11 /02/COM/WEB)
- - ,
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: MEC2008-00476
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9124/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1102008 TIME: 7:01AM PAGE: 10
SITE ADDRESS: 10200 SW GREENBURG RD 700 CLASS OF WORK:
SUBDIVISION: LINCOLN CENTER/FIVE LINCOLN LOT #: TYPE OF USE:
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: FIVAC TI - no plan review required. Project Value: $8,908
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412-4800
CONTRACTOR: AMERICAN HEATING INC PHONE #: 503-239-4600
Inspection Request Scheduled For: Date: 11/612008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 077688-01 503-209-1389 V
Corrections/Comments/Instructions:
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ti, r:
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(*PASS 1 1 PARTIAL APPROVAL I CANCEL NO ACCESS
I I FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
.5
Inspector: Z-S Date: eVicif 0 B Phone #: (503) 718- /
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. . . . _
.. -
CITY OF TIGARD
BUILDING DIVISION i,
PERMIT #:
MEC2008-00476
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/24/2008
Phone: (503) 639-4171 470a11
Inspection Requests (24 Hrs.): (503) 639-4175 .
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/16/200R TIME: 26
SITE ADDRESS: CLASS OF WORK:
10200 SW GREENBURG RD 700
SUBDIVISION: LOT #: TYPE OF USE:
LINCOLN CENTER/FIVE LINCOLN
PROJECT NAME: FARMERS INSURANCE
DESCRIPTION: HVAC TI - no plan review required. Project Value: $8,908
OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: -
• is:,03-412-4800
CONTRACTOR AMERICAN HEATING INC PHONE #: 603-239-4600
Inspection Request Scheduled For: Date: Pour Time:
10/1&2008
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 076792-01 503-209-1389 N
Corrections/Comments/Instructions:
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I M PASS 0 El PARTIAL APPROVAL 0 CANCEL 0 NO ACCESS
n FAIL CALL FOR INSPECTION El ADDITIONAL EES ASSESSED
-
Inspector: Date: 6 vf Phone #: (503) 718- _.0_ Z10-
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