Permit CITY OF TIGARD MECHANICAL PERMIT
II I COMMUNITY DEVELOPMENT Permit #: MEC2012 -00454
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/05/2012
Parcel: 1 S 135AB04500
Jurisdiction: Tigard
Site address: 10250 SW GREENBURG RD 200
Project: GTS Subdivision: 1991 -055 PARTITION PLAT Lot: 1
Project Description: HVAC modification and 2 ton ductless split system for TI
Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC
1339 SE GIDEON ST BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97202 5335 MEADOWS ROAD, SUITE 300
LAKE OSWEGO, OR 97035
PHONE: 503 - 239 -4600 PHONE: 503 - 619 -3200
FAX: 503 - 239 -7038
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/05/2012 $1,079.23
Class of Work: ALT Type of Const: Plan Review 09/05/2012 $269.81
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 09/05/2012 $129.51
Stories: Info Process /Archiving - Lg $2.00 (over 09/05/2012 $2.00
11x17)
Project Valuation: $38,774.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 1
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $1,480.55
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 Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. M les n , 1�(� /' /CinG 2✓`
Issued By: J1 � . �� ��,) 1� f' Permittee Signature:
J`'►"'v",
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
City of Tigard Received Date/By: 9 Permit No.:1" y/ /C 4.
III 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
e Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:Q// Q q n1 �- D •
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: ��VI See Page 2 for
Internet: www.tigard - or.gov Notified/Method: 1-1 Supplemental Information
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: $ $38,774.00
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: 10250 Sw Greenburg Road (requires site plan showing placement) 46.75
City/ State/ZIP: Tigard OR 97224 Furnace 100,000 BTU ( ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 200 Project name: CTS Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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: 23.32
Tax map /parcel no.:
Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace/insert 33.39
relocate 42 existing supply diffusers and 7 existing return air grilles Flue vent for water heater or gas
add 12 new supply ducts and diffusers and add 8 return air grilles fireplace 23.32
Log lighter (gas) 23.32
2 ton ductless split system Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER ❑ TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Single -duct exhaust (bathrooms,
F ax:
( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: American Heating Other: 23.32
Fuel piping:
Contact name: Brad Manchester $14.15 for first four; $4.03 for each additional
Address: 1339 SE Gideon Street Furnace, etc.
Gas heat pump
City/State/ZIP: Portland OR 97202 Wall/suspended/unit heater
Phone: (503) 239 -4600 Fax: : (503) 239 -7038 Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: American Heating Clothes dryer (gas)
Other:
Address: 1339 SE Gideon Street MECHANICAL PERMIT FEES*
City/State/ZIP: Portland OR 97202 _ Subtotal
Phone: (503) 239 -4600 Fax: (503) 2239 -7038 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: 33135 State surcharge (12% of permit fee)
/f TOTAL PERMIT FEE /L'gD • SS
/12e. �l� i�i� '— This permit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: Brad Manchester Date: 9/4/12 * Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Peemits\MEC- PemitApp.doe 03/07/12 440- 4617r(Il /02/COM/WEB)