Permit II :1` ' CITY OF TIGARD MECHANICAL PERMIT
; COMMUNITY DEVELOPMENT Permit ii: MEC2009 -00392
Ti G ARU
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/13/2009
Parcel: 1 S135AB01003
Jurisdiction: Tigard
Site address: 10300 SW GREENBURG RD 380
Subdivision: Lot: 0
Project: Maxim
Project Description: Add /relocate diffusers relocate existing pneumatic thermostat, add new return grill, and server
room exhaust fan.
Owner: FEES
LINCOLN CENTER LLC Description Date Amount
BY SHORENSTEIN PROPERTIES LLC, 555
CALIFORNIA ST 49TH FL Permit Fee 08/13/2009 $141.50
Plan Review 08/03/2009 $35.38
PHONE. 12% State Surcharge - Mechanical 08/13/2009 $16.98
Contractor:
MCKINSTRY COMPANY
12021 NE AIRPORT WAY SUITE G
PORTLAND, OR 97220
PHONE: 503 - 331 -2461
FAX: 503- 331 -6906
Type of Use: COM
Class of Work: ALT Type of Const: IB
Occupancy Grp: B Occupancy Load:
Stories: 5
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 - 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: 1 Vent Systems: Total $193.86
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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 -er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. Y ay obtain a copy of th ules
or direct questio•s to e % calling 503.246.6699 or 1.800.332.2344.
�r ( 1 j 1 C 6 ii, Issued By: �� Permi ttee Signature: ,
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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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 App1icat1011 I V ED " ": FOR OFFICE _USE "ONLY
City of Tigard Date /B 4,1, I Permit No.: i . 0 • • kyr •
. IN q 13125 SW Hall Blvd., Tigard, OR 97223 AUG 0 3 2009 Plan Review ', di � " r
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: BM tp 101 Other Permit:
T1 GARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: saris 0 See Page 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified /Method:Q 7' C .j nt(G Supplemental Information
��'a O E lAL"`�FE C E UL Ea E �KLI
TYPE: ?OF- �.ORIC`' �t�•.. C, MM RC ;S ,a.U , @H C S T.
... ..�� ..r..v , ° .&'',:, ..;, fi e6 �. :SCc.L'.•..��� °'i�. ... d�.� .-aew.,�ex
Mechanical 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.
IDENT
`� ; c OF'CUNSTRUCTION z . ; �'
° < Value: S $5,000.00
s .,,., .., ,� •:... , < .., . ....,.:• : , .,.: --- ...�,-e„a =ge .mom .,.. ..,,... ..�...,.,,. -��;.
. -> RESIA UIPIVIENT>/SYSTEMS-FEES 4
*` '.' ' .
Q:A.K
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building ' "' " " `" " "' " " ''
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB INF < T V„ ATIO
�„ ,�, n. __ � A ION;' N °.; Heating/cooling
Job site address: 10300 SW GREENBURG ROAD Air con pump
(requires ditioning site plan showing or heat p 14.00
City/State /ZIP: PORTLAND, OREGON Furnace 100,000 BTU (ducts /vents) 14.00
Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: 380 Project name: MAXIM ills +`HEALTHCARE Gas heat pump 14.00
Cross street /directions to job site: Duct work 10.00
McKinstry Job #70288 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
., .e.., tiu wee•;.; „.�;.:_- v - "s i °3'
-= " - DESCRIPTION OF `WORK < §t� ,F". ` " `
= Water heater 10.00
Gas fireplace 10.00
Add /relocate diffusers, relocate existing pneumatic thermostat, add new return g Flue vent for water heater or gas
Add server room exhaust fan. fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
.;:. : ;, „, ;. Chimney /liner /flue /vent 10.00
°: PROPERTY `,o VN ER` : , I`N '
. �.,..° , .� .,,. ,,,.. �,. E _ . __. 1;3:,1. Other: 10.00
Name: Maximum Healthcare 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
.' ✓' �” �` °' Attic /crawacefans 10.00 ls
- i Aiipti ANT i eii a ^ ..COIVTACtz :"PERSON' - , > + °q; Attic/crawlspace
10.00
Business name: McKinstry Company, LLC Fuel r m
P g
Contact name: Hobie Miller, Project Manager /Diane Parke $5.40 for first four; $1.00 for each additional
Address: 16790 NE Mason St., Suite 100 Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, OR 972330 Wall /suspended/unit heater
Phone: (503.) 262.2342 Fax: : (503) 331.6907 Water heater
Fireplace
E - mail: hobiem@mckinstry.com mckinstry.com Range
°':? CONTRACTOR y, : yel Barbecue
Business name: McKinstry Company, LLC Clothes dryer (gas)
Other:
Address: same as applicant " `', : , , . _ i lTii :_:,,, EES* ,,• i „
ME
,. CIIANICAI�P.EI2MIT�FE S �;��; �r
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( - ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 172811 State surcharge (12% of permit fee) 3 1
1 TOTAL PERMIT FEE
C/WeC i is Authorized signature: = This perm ap plication expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Diane Parke Date: 8/3/09 * Fee methodology set by Tri- County Building Industry Service Board
1: \Building \Permits \MEC- PermitApp.doe 01/19/07 440 -4617T (1 l /02 /COM /WEB)