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Permit
CIT OF TIGARD MECHANICAL PERMIT alb DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00211 l 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/4/2005 PARCEL: 1S135AB-01003 SITE ADDRESS: 10300 SW GREENBURG RD 220 ZONING: C -P SUBDIVISION: LINCOLN ONE /RED LOBSTER /CASA L LOT: JURISDICTION: TIG Project Description: Mechanical TI, relocate (2) supply diffusers, add (1) new exhaust fan, relocate (1) pneumatic t -stat. Project value: $1,375. CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1 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: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES EQUITY OFFICE PROPERTIES TRUST Description Date Amount ONE SW COLUMBIA ST #300 [MECH] Permit Fee 5/4/2005 $72.50 PORTLAND, OR 97258 [TAX] 8% State SurcharE 5/4/2005 $5.80 Phone: 503- 412 -4800 Total $78.30 Contractor: MCKINSTRY CO 5400 NE COLUMBIA BLVD REQUIRED ITEMS AND REPORTS PORTLAND, OR 97218 Phone: 503 331 - 0234 Reg #: LIC 40981 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- 2 -23 Issued y: 1 00 Permittee Signature: Call 503 - 639 -4175 by 7:00 a.m. for inspections th usiness 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. AMechan.ical Permit Application ',. ': < y t';' w'QB ' oitektY .r -, _- , r Received Citl`'1if Lraard Date/By: 5 ©05 , li PermitNo.: t(I„,,iC / 13 l'3 SW Hall Blvd., Tigard, OR 97223 Plan Review w J Phone. 303.639.4 171 Fax: 503 591.1960 !r dl �1 ll Date /By: Other Pernur. oection Line: 503.639.4175 Date Ready /8y : t� am 0 See page' for ;met www.ci.tigard.or.us Notified/Nlethod: 1 ( Supplemental Information • TYPE OF WORK COMMERCL&L FEE` SCHEDULE - USE CHECKLIST Mechanical permit fees' are based on the value of the work ❑ New construction XAddition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit. Value: $ ! (`r� CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES' ❑ 1- and 2 family dwelling .Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. Ea. j Total JOB SITE INFORMATION AND LOCATION Heating /cooling Job site address: f ��?(b Air conditioning or heat pump G o„,,,„ Q� m (requires site plan shnwg placement) 14.00 City/State /ZIP: 5 - J 4__ -py� I ,� �`��c Furnace 100.000 BTU (ducts /vents) I 14.00 Furnace 100,000= BTU (ducts /vents) I 17.90 Suit ldg. /apt. no.: 2 2. 0 Project name: ?., [ a-CC Gas heat pump 14.00 Cross street/directions to job site: Duct work I 14.00 I Hydronic hot water system I 14.00 Residennal boiler (radiator or hvdronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 10.00 Flue /vent for any of above I 10.00 I Subdivision: • Lot no.: Other: I I 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 �E1 ` 2__. p ? ^ ` � i Fr Gas fireplace 10.00 S l 1.J �`t" C � Flue vent for water heater or gas / �� /rte fireplace 10.00 ` N tsZJ (7,-, i- Log lighter (gas) 10.00 ��LCL:4; I P,eoye.- A1-t T- Sf -(- Wood /pellet stove 10.00 Wood fireplace /insen 10.00 Chtmnev /liner /flue /vent 10.00 ❑ PROPERTY OWNER I El TENANT Other: I 10.00 Name: Environmental exhaust and ventilation Range hood /other kitchen Address: equipment 10.00 City/State /ZIP: Clothes dryer exhaust I 10.00 Single -duct exhaust (bathrooms, • Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT ,, CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: c_k N CC» , Fuei t io P�P g Contact name: ` l 85.40 for first four; 81.00 for each additional J (�1 Furnace, etc. Address: SyOZD Ne7 lUv�. I ✓�,- Pin), r Gas heat pump I City/State /ZIP: 4 _� cs,4„, L c ? '72._/ e, Wall/suspended /unit heater I Phone: (i ce) 'S3 1 - Z e.' it I Fax:: ( ) Water heater Fireplace E -mail: • Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: A Gk_ t A.„,-,7--e-ii Other: �-- 6l tia. Sc.� pp >U 6 � r,„_--, U w � Address: *,. MECHANICAL PERMIT FEES* City/State /ZIP: Pp 4:1 (,,-K..b C99____ /72./ Subtotal Minimum permit fee ($72.50) 7/ Phone: ( 7 j 7> ( - YZ-({ I Fax: ( ) Plan review (25% of permit fee) CCB lie.: GQ 9s/ State surcharge (8% of permit fee) 5[ V TOTAL PERMIT FEE -7g, ,0 T his permit application expires if a permit is not obtained within 180 Authorized signature So days after it has been accepted as complete. Print name: jp 0:24,,f, f YT D ate: � --11 -6c` * Fee methodology set by Tn- County Building Industry Service Board