Permit CITY O TIGARD MECHANICAL PERMIT
u r DEVELOPMENT SERVICES PERMIT #: MEC2004 -00718
c � l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/3/2004
PARCEL: 1S135AB-03400
SITE ADDRESS: 10260 SW GREENBURG RD 1160
SUBDIVISION: LINCOLN TOWER -TOWN OF METZGER ZONING: C -P
BLOCK: LOT: 014 JURISDICTION: TIG
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:
Remarks: Mechanical TI, relocate ducts & grilles.
Project Value: $4,718
Owner: FEES
EQUITY OFFICE PROPERTIES TRUST Description Date Amount
ONE SW COLUMBIA ST #300 [MECH] Permit Fee 11/3/200z $136.90
PORTLAND, OR 97258 [TAX] 8% State Surchart 11/3/200L $10.95
Phone: Total $147.85
Contractor:
AMERICAN HEATING INC
1339 SE GIDEON ST, STE. 1
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Duct Inspection
Reg #: LIC 33135 Final Inspection
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 - 001-001.0- through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246 -6699. 4--
Issued By: ,�� � ail/4 Permittee Signature: ��� G ^c $
\`' Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
' Mechanical Permit Application ;/ FOR OFFICE USE ONLY
t' Received �
��/ (((( G
City o _ Tigard Date/By: /( A •, k ,A Permit No.: G / _, 0 /
13125 S1V,rlall Blvd., Tigard, OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 //,�ptr / � le' t� DateB y Other Permit:
ri
Inspection Line: 503.639.4175 ' n
� � Date Ready /By: Juris' BI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: / /ia Supplemental Information
,r. e e .'r y:: ,.x . 'fly:. "•_. .•R}N'� � :� v ...n::"4Y
: ;n ' E ,; ;. a , ° \'; ::`i ` i �'YPE � , O ,, , A OR ,:-., - ra r -,:7.".=:, . . s r ; z t r 1 r COMMERC FEE *Y - =S C ., ,,, . LE USE „ CHECKL IS T '
. a�E�e .Yd $ ?y{ _ ,_, ., - : -.. - •rss;'�bW:- r.•cs� cws.�., a4m �. �.t .>.c `"-2, a hT .ce . 2 r3.5,�s; .,; E- : -; -. , ,. F ., .�. ,, - ,. . s . -.: -,._ ... _
Mechanical permit fees* are based on the value of the work
❑ New construction XAddltton /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
''-:s:m,16 <eu"L.S a .rr:: 5t•,; -- - - o f +:�; 5 -:.ai r ,. - _R:,y.-:- :ms��. 4: K:x ap,'_
F : ; ,s . r 4;- f= Value:
r�rt, .;c � s >� = °.CATEGO X : OFSaCONSTRUCTION . ., .. Vl $ 7 oo
� _
R E SI SYSTE FE
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
O,tv",e,,,,Iri�a,4.,. ;ori'. 9. , - .1, ;xr , , ,,,3x .: _ was ;.,:.:
ear_,. .:=� '
tt= =r. t -i e ° ',,„ ::r, ;
S .,.. e,_;�. : ,�, . JOBt$ ITE�II�F ,OR"MATIU � rF Heating/cooling
Job site address: ,r �°
I Air conditioning or heat pum
/�� k . 1` t [�_� (requires site plan showing placement) 14.00
City/State/ZIP: 7 a ,. , Furnace 100,000 BTU (ducts/vents) 14.00
Fumace 100,000+ BTU (ducts/vents) 17.90
S u ✓ it dg. /apt. no.: ✓// 0 Project name: , ,r�, . "- e ..,r 7- Gas heat pump 14.00
Cross street/directions to job site: 01- "V eg..Cr e Duct work 14.00
i./ " 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. 10.00
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
�{ - ,:„ aFe `a�':,i�n: --- M:' +='�?, =f=sr=Y?a'- °.�i e° r _ <. _ ti',..l,e.r:tes.{s'_-- e ,,: ^?c. , `;s x
� *,r -- � '�?��.� - : ��`_, � { �I.:} x:6 `t`.r;�� , �rrt� -��.,, Water heater 10.00
liti c .1I G s= <, ESC)RIPr3 ION:t~.OFt WORK . '.. i' - =mot :tr;,� .- , t ;a_
�',�,,. �t �� �, �...', t�.:;. . �`��.,`•t'"�`"�>�Sfs- .sss�`sre: vv =n�Ksu�..�a� ..,..�;u .. ...... � :.c `� .;tx.. I.
t _ , Gas fireplace 10.00
/ , {,'= " v'°de ",Pd afie" - 7 Flue vent for water heater or gas
"i ( /� /1
tOIL) fireplace 10.00
A I �/���� Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
+ i . E • : M • . m _tom � x .-,. , :x Chimney /liner /flue /vent 10.00
- � gARIW ROPERT itiz iszfum . *. ,� . is " � Ttmusn,`,* %� :
F ... _
� - Other: 10.00
Name: e+0 Gd P , / 4 Environmental exhaust and ventilation
d•
Address: / Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 6.80
'< 'i= .., vrir %` °. .•2 I fi• `x^,: r "c,__ 4 . ,r°s 4 J - . -,. `-> •a�-.r T.. RSONI. ,,,,s,Lx< Attic/crawlspace •'t_i „ F . , �� , j�A PP ICANT ` : , r f : _ _- Attic / cra Ispace fans 10.00
: �r.,.,. �:. ,. �� �f �� �� �Z' �,. p' �,r. � d' �;;= ��' =m;sCON�ACI `>'aPERSON� >•� -�,;: ,��E
n.- Other: 10.00
Business name: / J,)t"`",.)'rF?/i ea 4 „ - Fuel t to
P K
Contact name ® "; ./z, c !-./ $5.40 for first f ur; $1.00 for each additional
Address: 432 9 ,ate 4 4,) c ,-, ,,...5771- Fumace, etc.
j Gas heat pump
�
City/State/ZIP: x ,,.,...7 4 ace 7204. 0 Wall /suspended/unit heater
Phone: ) 0,35 s 246 Od f [Fax :: (, 0 . 3C1 703 Water heater
E -mail: Fireplace
Range
`; '.i, "j s, ?`.�7 °^ t F. : '`*4 - �.su « �E.V- t `A""i:; ;rrr �:ca a - $ e.':Si^ `z+'s- -v, � : e'•. =xe -° 3 .:
?a,..._.t.>- �.. ...z.uxi.3u .'�i,"7.:c�+?- ss.: < �,°�',,:" a�,'�a; y ..xif, ,' = sx�,q
i =' �r 0.1vi•. .w I r _ - t l t ..CON :., srAK1: 'i . ,t 4 t., =_ l - i t A • ;�. Barbecue
.:.?.�`- ..=,t.,...�xx �' �`�,'wrsrn'k�:�.. " ^.._�,.r;rz'�z r�; s�' s`> �: e.._ �. � a• r , ra ww,.,,:�...�...-- .:r,�r «, > L� #�= �.:�t'�.., -:. _. 4,L- ,..v- �n��.: _�.�p�,
Clothes dryer (gas)
Business name: . r 6 t = `, ) i /101
Other:
Address: # ;f c 4' '4.: " = `=" z t PE F EES *
City/State/ZIP: oh --/0 : t 1 6 je. 720 , Subtotal / , 96
t Minimum permit fee ($72.50)
Phone: ( ,517b, 2 aq _4.4 660 Fax: ($ 3) - 4 _ 70 Plan review (25% of permit fee)
CCB lie.: 33/3 State surcharge (8% of permit fee) /,e) 9r 5
r TOTAL PERMIT FEE `t o� 5"
This permit application expires if a permit is not obtained within 180
Authorized signature:'';_ M � ," .,P - ;,.; -? days after it has been accepted as complete.
Print name: 41 1 5 „, a .`=- Date: * Fee methodology set by Tri- County Building Industry Service Board
i' \Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (I I /02 /COM/WEB)