Permit CITY OF TIGARD MECHANICAL PERMIT
1111 2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00096
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/21/2012
Parcel: 1 S135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 201
Project: Radiant Senior Living Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Mechanical for TI.
Contractor: MCKINSTRY COMPANY LLC Owner: LINCOLN CENTER LLC
16790 NE MASON ST., STE. 100 BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97230 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 331 -0234 PHONE:
FAX: 503 - 331 -6907
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/21/2012 $235.31
Class of Work: ALT Type of Const: Plan Review 02/21/2012 $58.83
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/21/2012 $28.24
Stories:
•
Project Valuation: $5,963.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: 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 $322.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Exhaust fan /
Duct Work: 2 VAV box
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 Not :. . - - - . Those les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dire questions to OUN .y , • in. 5 e - 232.1987 or 1.800.332.2344.
Iss d By: I / Ap.,04,016 Permittee Signature:
•
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 Application FOR OFFICE USE ONLY
III City of Tigard Date/By: Permit No.: /6
° 13125 SW Hall Blvd., Tigard, OR 972 ' : y J r �
g r \, Plan Review
Phone: 503.718.2439 Fax: 503.598. iQi Date/By: Other Permit: j, A . _a
T I G A R U Inspection Line: 503.639.4175 1 �� ��\ •
Date Ready/By: orris: El Se e Page 2 for
Internet: www.tigard- or.gov �a �j �� Notified/Method: Supplemental Information
TYPE OF WORK��'� �` 0\� COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
V����C? Mechanical permit fees* are based on the value of the work
®
❑ New construction Addition/alteratio ment performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $5,963.00
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 I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning
Job site address: 10220 SW Greenburg Road (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 201 Project name: Radiant Senior Living Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 2 23.32 46.64
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: Cooling VAV Box 1 _ 23.32 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Diffuser and thermostat relocates/adds. Install (1) new 300 cfm exhaust fan in Gas fireplace f 33.39
Flue vent for water heater or gas
theServer Room. Install (1) new 8" cooling only VAV box in the Conference fireplace 23.32
Log lighter (gas) 23.32
Room. Wood/pellet stove 33.39
McKinstry Job # 70747 Russell Construction Job #112074 Wood fireplace /insert 23.32
❑ PROPERTY OWNER ® TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: Radiant Senior Living Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
0 APPLICANT ® CONTACT PERSON Attic /crawlspace fans 1 23.32 23.32
Business name: McKinstry Company, LLC Other: 23.32
Fuel piping:
Contact name: Janel Lipe $14.15 for first four; $4.03 for each additional
Address: 16790 N.E. Mason Street, Suite 100 Furnace, etc.
Gas heat pump
City/State /ZIP: Portland, OR 97230 Wall /suspended/unit heater
Phone: (503) 278.3954 Fax: : (503) 331.6907 Water heater
Fireplace
E - mail: janell @mckinstry.com Range
CONTRACTOR Barbecue
Business name: McKinstry Company, LLC Clothes dryer (gas)
Other:
Address: same as above MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 235
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) -
Plan review (25% of permit fee) 5 g ' 3
CCB lie.: 172811 State surcharge (12% of permit fee) r).-g', .9
TOTAL PERMIT FEE , 3
Authorized si a[ This permit application expires if a permit is not obtain Td within 180
days after it has been accepted as complete.
Print name: Janel Lipe I Date: OJ, - ^-_ 1 • Fee methodology set by Tri - County Building Industry Service Board
I:\Building\PermitsUMEC- PermitApp.doc 09/09/10 4404617T(I1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $1 00.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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