Permit CITY OF TIGARD
MECHANICAL PERMIT
111 ii COMMUNITY DEVELOPMENT Permit #: MEC2009 -00352
Ti 'GA1DD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/17/2009
Parcel: 1 S 135AB03400
Jurisdiction: Tigard
Site address: 10260 SW GREENBURG RD 1165
Subdivision: LINCOLN TOWER Lot: 0
Project: Erik Bucher and Greenspan
Project Description: HVAC modifications. No plan review required.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
Permit Fee 07/17/2009 $113.90
CALIFORNIA ST 49TH FL
12% State Surcharge - Mechanical 07/17/2009 $13.67
PHONE:
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 $127.57
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 4
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 Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / g-CY\ Permittee Signature: gy -qj Mac) C , i e S'i e 7
• 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.
L *.
Mechanical Permit Application RECE • - FOR OFFICE USE
City of Tigard D . - : Permit No.: • ..y . /IL li
- • 13125 SW Hall Blvd., Tigard, OR 97223 J U L 1. .1 170.! eview Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
T I GAD Inspection Line: 503.639 CITY OF TI ►�3, ady/By. Juris. El See Page 2 for
Internet: www.tigard- or.gov , , A. ethod: Supplemental Information
BUILDING D ► i ll.
w i ettie. S ^ "" TYPE OF ; WORK y ; a s t a - 4 ,CO4M4CIAL FEE'' S CHEDULE - USE CHEC KLIST
❑ New construction X 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
' -v - - - :=_t.. > '; : = : gli : Value: $ 3 000
� , a : u v,0, , e i T : ' CATEGORY O CONSTRUCTI ,, 1 r ?-�
" 4j1 > RESIDENTIAL / SYSTEMS FE ES *y -
❑ 1- and 2- family dwelling C ommercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
Aw s JOB SITEIINFORMATION AND.IOC t , ,„ , p = Heating/cooling
Air conditioning or heat pump
Job site address: OZ 60 5 w 6✓ eG l7 b V !� (requires site plan showing placement) 14.00
City/State /ZIP: Tf at d 0 R 9 7 22 - Furnace 100,000 BTU (ducts /vents) 14.00
J E V t Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: / / 6 5 Project name: /3 e r V'e f n 5 1 7C3 ►'? 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
t t �.._ . � ,' r DESCRIPTION OF WORKS f y' a +, Water heater 10.00
1 ` " " " Gas fireplace 10.00
H 1/ A C /1'7 O ci, f C r-f 1 / ° ' 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
x4r Chimney /liner /flue /vent 10.00
° �° Q ,pROPERTIk OWNER, k _ . Q ; TENAN , , " Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
�� ,;" ": , " ' " z rail CONT P ER SO N ' v k$ Attic /crawlspace fans
, , 1,' �� ' 'APPLICANT _ if" c rte; .iKk . ,. . ,sn..< :r.., .- `-,:,:.,� , 10.00
,
Other 10.00
Business name: A Kr? cri c a . 4 �e e - / /h j Fuel piping
Contact name: 17e /.e Hq)77,vJ t° - f t $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: 133 el S E / Gideon Gas heat pump
City /State /ZIP: / f f /a/J c Q g 72 02 Wall /suspended/unit heater
/ Fax: p Water he
Phone: (503) 2 3q- yG 0 0 : ( S O 3 ) 2 3°I- 74 3 8 ater ater
Fireplace
he
E -mail: Range
�,
�Barbecue
71 s T AL � , � q CONTRACTOR sn. - :, k t e ., r 4 , :.
Clothes dryer (gas)
Business name: 4 m eei C G'4 yeq 1 /7 y Tn G
Other:
3
/3'' 5 E con-1 �'. MECHANICAL PERMIT FE * n ' "''
Address: �O/ S � �' k ��F` ;�
City /State /ZIP: POr-f-- /a c OR 772 02- Subtotal it 2 q 0
Minimum permit fee ($72.50)
Phone: (503) 2 3 7 - %/ (O O 7 Fax: (6 0 3) 23?-703 0 Plan review (25% of permit fee)
CCB lie.: ? 5 State surcharge (12% of permit fee) i ,_ , IQ
TOTAL PERMIT FEE 07.57
�� 4' This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: g mafic h e$ -fey- Date: 7 — / 7- 0 9 * Fee methodology set by Tri -County Building Industry Service Board
I \ Building \Permits\MEC- PermitApp.doc 01/19/07 440 -4617T (11 /02 /COM/WEB)
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