Permit 1 11111 a CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit a: MEC2012 00245
T I GA. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2012
Parcel: 1 S135AB01006
Jurisdiction: Tigard
Site address: 10500 SW GREENBURG RD 200
Project: Mutual Fund Subdivision: ASHBROOK FARM Lot: 6
Project Description: Modification of ductwork for new tenant.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: LINCOLN CENTER LLC
PO BOX 241 BY SHORENSTEIN PROPERTIES LLC
DUNDEE, OR 97115 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/15/2012 $224.07
Class of Work: ALT Type of Const: Plan Review 05/15/2012 $56.02
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 05/15/2012 $26.89
Stories:
Project Valuation: $5,600.00
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 $306.98
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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 tailed within 180 days of
issuance nr if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rul adopted by the Oregon
Utili Notification . -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. Yo ay •t- n a copy of the rules
or irect questions to O 6 N •y calling 503.232.1987 or 1.800.332.2344.
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Iss d By: / /, l �� / P erm i ttee Signature: a
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 Applic FOR OFFICE USE ONLY
City of Tigard ► EIVED ONLY Date/Bya 5 / Permit No.: / r - 01
to 13125 SW Hall Blvd., Tigard,OR 97223 //
111 II Phone: 503.718.2439 Fax: 503.598.1 AY Plan Review �✓ 5 2012 Date/By: Other Permit:
TI G `Ii D Inspection Line: 503.639 Date Ready/By: Juris: El See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION • -
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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.
Value: $ \ Jt)
CAORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / S¢STEMS FEES*
El 1- and 2- family dwelling Commercial/industrial ❑ Accessory building For spedal Information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
/ Air conditioning
Job site address: /O r bin /���� (requires site plan showing placement) 46.75
City/State /ZIP: ` VV ✓// it� , Furnace 100,000 BTU ( ducts/vents) 46.75
J Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgiapt. no.: roject name/ /�j � ` Heat pump
iGV how (/ J (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
lA ) �r��� / 3 Hydronic hot water system 23.32
- el:, :�!J v6 !/G[ Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
li Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
` PR PERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: S �/'� �/„4+/,� , ^ Environmental exhaust and ventilation:
6 ��!/�Y ! Range hood/other kitchen
Address: equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 23.32
/ 0 APPLICANT 'CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business nam e: /� L/��
t� Fuel piping:
�V
Contact name: ( l " rA47; 051A- $14.15 for first four; $4.03 for each additional
Y Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: Water heater
( ) --Y Fax: ( )
/A �/ Fireplace
E -mail: (Iry 1 (,�/ ,,/. , 1 / /, � , � ,,, Range
(% CONT CTOR Barbecue
Business name: D1�►� L Clothes dryer (gas)
,/ t Other:
Address: !/ l MECHANICAL PERMIT FEES*
City /State /ZIP: ✓ I ' a a/ 7711 Subtotal
Phone: (_ ( /,/. 96 / / Fax: ( ) Minimum (25% permit fee
` Plan review (25% of permit fee)
CCB tic.: C 7 1 / State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained wit to 180
days after it has been accepted as complete.
Print name: La //44 "`' / Date: 5A /WEB V/f1j • Fee methodology set by Tri -County Building Industry Service Board
I:\Buildin \Permilu\MEC- PermitA . doc 09/09/10 440 -4 t7T I 1 /02/COM
B PP C )
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
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$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 $100.00 or
fraction thereof, to and including
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$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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