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Permit 31 : CITY O F TIGARD MECHANICAL PERMIT q COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00041 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/27/2009 PARCEL: 1 S135AB -01003 SITE ADDRESS: 10300 SW GREENBURG RD 280 ZONING: C -P SUBDIVISION: LINCOLN CENTER /ONE LINCOLN LOT: JURISDICTION: TIG PROJECT: SPEC SPACE Project Description: Relocate grilles for TI. Project Value: $2,100 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: Owner: FEES SHORENSTEIN REALTY SERVICES Description Date Amount ONE SW COLUMBIA ST #300 PORTLAND, OR 97258 [MECH] Permit Fee 1/27/200. $74.80 [TAX] 12% State Surch 1/27/200E $8.98 Total $83.78 Phone: 503- 412 -4800 Contractor: PROTEMP ASSOCIATES INC 9788 SE 17TH AVE PORTLAND, OR 97222 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -519 -6199 FAX 503- 238 -9767 Reg #: LIC 38868 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 1.800.332.2344. Issued By. t,j �j - k i � Permittee Signature: ± Call 503.639.4175 by 7:00 a.m. for inspections 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. Mechanical Permit Applicatio CAD FOR OFFICE USE ONLY City of Ti and JAN 2 7 2009 Received l n el permit No.: I `J g Date /BY: /' / / a{1.6 e 13125 SW Hall Blvd., Tigard, OR 97223 - Phone: 503.639.4171 Fax: 503.598.196 an Review �� OF7'�CjA� Dan Other Permit: TIGARD Inspection Line: 503.639.4175 D ate Ready /By: ® See Page 2 for BUILDING DIVISION Internet: www.tigard- or.gov Notified /Method: Supplemental Information , ,�..T � YPE;. F;�W RK :-,.;_; _.. � � -. E SCHEDULE USE CIiEC1CtiIS7' �>::.., ;; � �� ,..� �� � ,. F ��_ � °. °trUM.MERCIAI.r EC ❑ New construction ® 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. ,:: '' -g," .ems. Ma ::.,. :v:, Value: $ $2,100.00 i ' �: CA EGORir OE Gt1, S' :itLlw9N RESIDBN`I QUTPMEST§i .. -: EM ES , El 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building : - NT-f SY < -' u.:: ..: For special information use checklist. Multi -famil ❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total :; Heating/cooling Job site address: 10300 SW GREENBURGH RD Air conditioning or heat pump (requires site plan showing placement) 14.00 City/State /ZIP: TIGARD OREGON 97224 Furnace 100,000 BTU (ducts /vents) 14.00 cc Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: 280 Project name: tc d PAC 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.: Flue/vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances �F ' ' Water heater 10.00 � °. �.. DESCRIPTION OF WORK . :�;e� =:'� Gas fireplace 10.00 MOVE GRILLS FOR NEW FLOOR PLAN 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 zw* •• < .;,, y x• Chimney /liner /flue /vent 10.00 4 TY :.. 5:<4 Eli= OWNER" - -NANT" : . A, , ? :.._ Other 10.00 Name: 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 ; gym AppLIG� `'n Attic/crawlspace fans 10.00 Business name: PROTEMP ASSOCIATES Other: 10.00 Fuel piping Contact name: BRUCE BUTNER $5.40 for first four; $1.00 for each additional Address: 9788 SE 17 AVE Furnace, etc. Gas heat pump City/State /ZIP: PORTLAND OREGON 97222 Wall/suspended/unit heater Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Water heater Fireplace E -mail: Range _ - �;? :sue ^w e, ,, Y> - - '?. �m , 7 =CONfiI2A Barbecue Business name: SAME AS ABOVE Clothes dryer (gas) Other: Address: � - ::_`MECIi2�1VT� ERMT'T FEES* City/State /ZIP: Subtotal Minimum permit fee ($72.50) 7 f . 8o Phone: ( ) Fax: ( ) Plan review (25% of permit fee) • CCB lie.: 38868 State surcharge (12% of permit fee) , 9 TOTAL PERMIT FEE R 3 . 7 g Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: BRUCE BUTNER Date: 1/27/09 * Fee methodology set by Tri -County Building Industry Service Board I:\ Building \Permits \MEC- PermitApp.doc 01/19/07 440- 4617T(II /02 /COM/WEB) . -CITY OF v��n wo���mn��� BUILDING DIVISION PERMIT �"°"�"~~"~ #: MEC2009-00041 . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/2712009 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 =�j . IL INSPECTION WORKSHEET FOR DATE: TIME: PAGE: i/2�� �O�B � ��O1�K� : 17 SITE ADDRESS CLASS 1��D08V�(�REE WORK: SUBDIVISION: LINCOLN CENTER/ONE LINCOLN LOT #: TYPE OF USE: PROJECT NAME: SPEC SPACE DESCRIPTION: Relocate riIIes for TI. Project Value: $2.100 OWNER: SHORENSTEIN REALTY SERVICES, PHONE #: 503-412~4808 CONTRACTOR: PROTEMP ASSOCIATES INC PHONE #: 503-51 ..3-8199 Inspection Request Scheduled For: Date: 1/280009 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 080088'01 503-619-6199 0 Corrections/Comments/Instructions: / APPROVAL 0 CANCEL r l NO ACCESS ` li FAIL j r CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED ' -..N.. f Inspector: Date: /�-^�/�~' /' Phone (G83\718'^�-1��/' �m� / y `' ' /~