Permit 1141 q CITY OF TIGAR MECHANICAL PERMIT
: COMMUNITY DEVELOP Permit #: MEC2009-00110
TtGAI D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/17/2009
Parcel: 1S135AB03400
Jurisdiction:
Site address: 10260 SW_GREENBURG_RD 375
Subdivision: Lot: 0
Project: MASTERCARE
Project Description: TI- relocating (4) supply grilles.
Owner: FEES
SHORENSTEIN REALTY SERVICES Description Date Amount
ONE SW COLUMBIA ST #300 Permit Fee 03/17/2009 $74.80
PORTLAND, OR 97258 12% State Surcharge 03/17/2009 $8.98
PHONE: 503- 412 -4800
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST
PORTLAND, OR 97202
PHONE: 503 - 239 -4600
FAX: 503 - 239 -7038
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 $83.78
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 rules adopted by the Oregon
Utility tification qter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Iss d By: Permittee Signatu
Call 503.639.4175 by 7:00 a.m. for an inspection 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.
•
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Mechanical Permit Application ' ' ' r - ,,oR OFFICE USE ONLY • •
City of Tigard - Date./By: - � u /- / • 13125 S W Hall Blvd., Tigard, OR 97223 an Review
' o Phone: 503.639.4171 Fax: 503.598.1960 MAR 17 2009
Other Permit:
Plan
Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: MI 0 See Page 2 for
CITY OF TIGARD ' . Internet: www.tigard- or.gov Notified/Method: Supplemental Information
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`' chical 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 r e , . - - ,s..,• - : ,,,,., lit raii »:,.:..c•:..a,.,... - �5 rg _ ; -: • ;; ,. � value: $ 2 03 2 ` °b
,•� h CA�'EOORY� CONSTItUCTION� att�;�2, r- ��•``'� °.:.�.. , ;." " �/ SXS 1VIS FE�S
: -�,• e.._, , ;-^ -°"� ;RESIDE�TIAI6�Q�ME�f,.,. ��.; =•_
. ❑ 1- and 2- family dwelling ,ommercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: De scription I Qty. I Ea I Total
,, 'sHx q ., r .tea -, s>c S:�' Healing/cooling r JOB••Sll' INFORM TIO 1'L0CATION?. : "
'�-= �` °' �'� � ` t" '" '" " " ,p Air conditioning or heat pump
Job site address: 10260 S k\ Green b ur5 /� (requires site plan s heat placement) 14.00
Furnace 100,000 BTU (ducts/vents) 14.00
City/ State/ZIP: 711 GI rcf Q
t_ Furnace 100,000+ B ( 17.90
Suite/bldg. /apt. no.: 5 I Project name: M - i r- Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00 14.00
Hydronic hot water system .
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: I Lot no.: Other: [ 10.00
Tax map /parcel no.: Other fuel appliances
47,57 M t >,� c '�MM ..,.t... . '''• � . a ` v , Y RI Water heater 10.00
..f,f a a l b_ D �.,• O .- ...,, -1 a, 4- „L. ' Gas fireplace 10.00
re 0c4 ed e)n S ) n y Su p p) y y r 1 I t S Flue vent for water heater or gas
J fireplace 10.00
• • Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
10.00
,� - r. Chimney/liner /flue/vent
xa . a e a emu, �� �,� �irr,:fi � , ,.., 14 ' Wgia;g Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City / State/Z]P: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( )
Fax ( ) toilet compartments, utility rooms) 6.80
,:P -- 7S a M Q O � ° ,. tWiWic :` +.�- Attic /crawlspace fans 10.00
Other: 10.00
Business name: /10'7 er / cal f eo /' _2 C Fuel piping
Contact name: DO / C 1-4 /77J77 e - t _ 2-,-, $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:. / 3 3 9 Sff 6 I tyJ .e O 4 ,S Gas heat pump
City/State/ZIP: 7'r-f/ ci ci 0/ .7720 2 WalUsuspended/unit heater
Phone: (503) g31 • 9600 I Fax:: (503) 23 7o3 S W heater
Fireplace er he he •
E -mail: Ran
' • ".= .,� .. -', vW 7-7 Barbecue •
s i `` �Y``a� i 4 i<a CO • • ty ' ' ., . ate,# k^4- Y+*-5 3 x� r"` - z n .
Clothes dryer (gas)
Business name: A m et /G 44 e4 ■ ^ Other
Address: /33 SE (O ear? f A;�Ks.�� MECHANIC �E -` . b i;
OR c� Subtotal
City/ State/ZIP: Qr f / #1 L / O / 7 20 2 Minimum permit fee ($72.50) 77' ] 60
Phone: (503 ) 231 - 'Coo Fax: (503) 23`1 =7035 Plan review (25% of permit fee) .6
CCB lie:: 33 13 5 State surcharge (12% of permit fee) .
TOTAL PERMIT FEE t3, 7$
' ' � 'This permit application expires if a permit is not obtained within 180
Authorized signature: ` /'�X /4(2164 J days after it has been accepted as complete.
Print name: bro d f o ri G / ` es -I e / / D a t e : 3 - ! C * Fee methodology set by Tri -County Building Industry Service Board
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