Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00642
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/01/2009
TIGARD Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 300
Subdivision: Lot: 0
Project: Forest City
Project Description: Relocate diffusers, grilles and (2) split systems.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555 Permit Fee 12/01/2009 $906.51
CALIFORNIA ST 49TH FL 12% State Surcharge - Mechanical 12/01/2009 $108.78
PHONE. Additional Plan Review 12/01/2009 $90.00
Contractor:
MCKINSTRY COMPANY
12021 NE AIRPORT WAY SUITE G
PORTLAND, OR 97220
PHONE: 503 - 331 -2461
FAX: 503- 331 -6906
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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 $1,105.29
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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 r adopted by the Orege
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Y may ibtain a copy of the rules
or direct questions OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
V t�( 1 \�� �� � Permittee Signature: j � /l j
� l JJCC JJJJ ��`
Call 503.639.4175 by 7:00 a.m. for an inspection that b iness 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 NOISIAIa ONIcfI . FOR OFFICE USE ONLY
City of Ti and advoll J0 All) Received permit No.:
III - `J g Date /By: �� 1 _ ri `� `L'
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' Phone: 503.639.4171 Fax: 503.598.1960 6002 T 0 030 Date /By: Other Permit:
TIGARD Inspection Line: 503.639 Date Ready/By: . 0 See Page 2 for
Internet: www.tigard- o r.gov /� .t C'- Supplemental Information
_ • �.hY + ■27, S .. �� otified/Method: .": @`�• tW:'� . i„ 4'+ r��- y+.'!:Y�.:t1�xY.7fi'n�..rmGC :. -Fsx2: �6tl- x- .r .
z,. =� : ,, ., . F.,, 4 . , TYPE OF WO RK 4 �. � -'t „: - r. -: w� , COM MERCIA) ' -- aF , SCHEDUI: E= ' USECH _ ECKLIST
� � � �'�F ^f�a � _��-,r �^:: F,�F = ,�.v .�..µ,s�� °, .,��.,_ � -�: ,r y.. � .:�: s �t.�� •_- .�.f � � .,� a. � � _ .� 4,- � v . ,,� d .�, -_. _ �41�., „� _ F -... ;.� a ,a ..,��
❑ New construction ® Addition/alteration /replacement A Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
_,, �,Sa� ,;� %. , i l i �> , m,R,v ri , m ,, r.-:,�:�.o �, �.0o ,q: ;r-;F,:q .�a ti' "1Nyt t'�>r ;« s: Value: $ 32,000
� „�e`f � �u�� _�`'�n f� �,CATEGO_I21'� CONS'CRUCTION,� ��n; *�"�'��:�Tz:3� ;z, '
;n,3r cam, r .a ,k >' a
RESIDENTIAL: EQ UtPMENTy / =SI STEM FE ES* k
. ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building "�"
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
w 1 '` ` _ tae'' JOB SITE INFORMATIbN AND LOCATION v = �„ y t ` ` Heating/cooling
Air conditioning or heat pump
Job site address: 10250 SW Greenburg Road, Suite 300
(requires site plan showing placement) 14.00
City/State /ZIP: Portland, Oregon 97233 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: Forest City T.I. 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.: 04500 Flue /vent for any of above 6.80
Other 10.00
Tax map /parcel no.: 1 S135AB Other fuel appliances
?'�� -.,^.0 .x;r't w ,: ,n.: :; R „ ii 4 ,. e ,._ - x.; : Apr ,�•-�' ,: -0 �' :.:z q 10.00
'� �`�u'a },� �„1' ,�...� r�, t , _ � � � �, ��� . v. Water heater
{ap0x n , `J - DESCRIP r , L �},O F W ORK r ' "" to ,
V n it.. �'.4 24�� c`. �'...._;. -_ � ..n 'rsa -`tl�" .AY .; .4�A.M.'v: . : �' "'v�rt5 %'a -TL "�i'::.. ...:�.�>. .-.-a
Gas fireplace 10.00
Relocate Diffuser, grilles and (2) split systems. Flue vent for water heater or gas
fireplace 10.00
' Log lighter (gas) 10.00
Wood/pellet stove 10.00
McKinstry Job #9335 Wood fireplace /insert 10.00
�� z: , ® PRPERTY , im '" ' ®TENA Chimney /liner /flue /vent 10.00
: 4 .4t _ ,,,,,-,,,,,,,,„=,, .. .' ti. ii . a .. e . _ . ' ! , Other: 10.00
Name: Forest City 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
z%F�'- rn` s" ;r`�',i:;' _ a r' 4 :�r , , =1�':,f':x e4 ;;; e y.:� sou. :r >.,. ;:.Nrw�; 4a "'x 10.
s. wk .,W.T..t ®r APPLICAIV.T '? ;' ' A '';` ,. .a ®s,CONTACT PERSON ,,W Attic /crawlspace fans 00
:. .., .. Other: 10.00
Business name: McKinstry Company, LLC
Fuel piping
Contact name: Diane Parke, Project Coordinator $5.40 for first four; $1.00 for each additional
.Address: 16790 NE Mason Street, Suite 100 Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, OR 97230 Wall/suspended/unit heater
Phone: (503) 331.2465 Fax: : (503) 331.6907 Water heater
Fireplace
E -mail: dianep @mckinstry.com Range
4 `'' x . V CONTRACTOR „ " _ ".x,. 1 :! Barbecue
Business name: McKinstry Company, LLC Clothes dryer (gas)
Other:
Address: Same as above k$-" %= 00?.'r ......_: . ,r *:, °,=;- .. .
. 1VLECI�ANLCAI;EERMITFEES -',, `;;
City/State /ZIP: Subtotal
Phone: ( r Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 172 n State surcharge (12% of permit fee)
TOTAL PERMIT FEE-• - :0
� ( a z This permit application expires if a permit is not obtained w m 180
Authorized si , � / days after it has been accepted as complete.
Print name: Diie Parke Date: 11/30/09 * Fee methodology set by Tri-County Building Industry Service Board
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