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Permit IN CITY OF TIGARD MECHANICAL PERMIT , '. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00619 TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2012 Parcel: 1 S135AB03400 Jurisdiction: Tigard Site address: 10260 SW GREENBURG RD 110 Project: Fidelity Title Subdivision: METZGER, TOWN OF Lot: 9 Project Description: Relocate (2) grilles. Contractor: AMERICAN HEATING INC Owner: LINCOLN CENTER LLC 1339 SE GIDEON ST BY SHORENSTEIN PROPERTIES LLC PORTLAND, OR 97202 555 CALIFORNIA ST 49TH FL SAN FRANCISCO, CA 94104 PHONE: 503 - 239 -4600 PHONE: • FAX: 503 - 239 -7038 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 12/03/2012 $78.27 Class of Work: ALT Type of Const: Plan Review 12/03/2012 $19.57 ,. Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/03/2012 $9.39 Stories: Project Valuation: $750.00 • 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 $107.23 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) 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 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 t e rules or direct quest C by calling 503.232.1987 or 1.800.332.2344. Issued Permittee Signature: �� /�� 9 • � k 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 ApplicRECEIV11..ss � D FOR OFFICE USE.ONLY City of Tigard e«tved � • A Elr 3 2012 Date/By: / ` �.�J Permit No.: // �/i, 006/.94 13125 SW Hall Blvd., Tigard, OR 972 ' ` Plan Review ' Phone: 503.639.4171 Fax: 503.59 0 Date/By: Other Per T 1 GA It D Inspection Line: 503.639 ( J OF TIGARD Date Ready/By: Juria: W1 See Page 2 for Internet www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information Mechanical permit fees* are based on the value of the work ❑ New construction Q tddttton/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit n.:: _ _'t�:'i.- r,� :.;. _ _ Value: $ ... _,_.,._. :_:- -: -_ , :.,. r GOR •'OF:�CON -� " >;: �OIY > - -4;' R(S DEP.LTLAG .IJIPME TJ S CSTk'1► S F ES.s., : - ❑ 1- and 2- family dwelling in C ommercial/industrial ❑ Accessory building : ..... For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total OB y +' .� _ `- :LOCATION; =` ` S1TE ='1lY)h,OR117ATIpN.' ± _ - Heating/cooling CO O S 1 / Q / Air conditioning Job site address: /02 ( (r 4" / wee /� . Ot/r ' /� �-I (requires site plan showing placement) 46.75 City/ State/ZIP: 7 el , cf :0/ 772 3 Furnace 100,000 BTU (ducts/vents) 46.75 �/ Furnace 100,000+ BTU ( ducts/vents) 54.91 Suite/bldg. /apt. no.: / / 0 Project name: F ci ell f / 77--/e Heat pump 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 - g.rt - - _ - - _ _ - = r+r:.:,:�_. -- _:i4r - - _ Water heater 23.32 r ' � IU -.O - - IiCRIP T w I3. _ - .'::'. : .:: : � �..: ::. +F: :. ..� .; . ., -�� - re /OCq e <9r/ / / S Flue fireplace vent 33.39 for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 s; = :: Y _ :•,4 .,- -; s,:::, ,r. y > - _ _ _._..._ .,. I :..- - Chimney/liner /flue/vent 23.32 k f ; ❑? I PROPERTY :q.1: R L i ;_ I TENANT; Other: 23.32 Name: 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 _: :: ; - - - _ •r •,_ - i =a - r : ; . ;4 : = - .:.,.,::. _ - '" : " . ":7 4 n , '-: , Attic/crawls ace fans 23.32 'y.°==. -., a= - - Ili -; L I �_•_ : 1 r, :i . ^'r_COl!G CP P = = ' P Business name: A m e r / c o) r? . Head - it - 7y q ry Fuel piping 23.32 / Fuel Contact name: g ry c1 M A n G k e S f C /- $14.15 for first four; $4.03 for each additional Furnace, etc Address: / 3 3 .7 SE // 6 / cJ C O i 5-I-- Gas heat pump City/State/ZIP: PO r -t- / a r7 ci 0 / .17Z 02. Wall/suspended/unit heater Phone: (503 )23 °J- 1/6,0 0 0 Fax:: (So 3) 239 -703 s Water heater Fireplace E -mail: Range -z; - - Barbecue ''u - _CO�PI'R.A Business name: A j C r 1 C p r r7 11 C' - 't- l. Clothes dryer (gas) Other r: Address: /33 E CO r-,, . -.,-:: . ,. S ci -e O r 7 S t:.. �-' - MECH ANICt�L%' RE11VIIT PEES`: " f „ i'. ; " _. _.- = City/ State/ZIP: PO r- f- land 0 I? '717202 Subtotal 7_1 .27 Minimum permit fee Phone: (50 3) 239- 1-/&00 Fax: (50 3 ) 2 3c7 -703 g rmit fee Plan review (25% o: ;]etTnit fee) /Ie. C7 CCB lic.: 3'3 136 Slate surcharge (12 % or ,ermit fee) , .3 ' TOTAL PERMIT FEE 74 7.;-3 ,�e./4.,, This permit application expires if a permit is not obtained within 180 Authorized signature: / lx " G days after it has beeq accepted as complete. Print name: groid / ' I anc 4 CS -1-- G 1- . Date: 12 3 • Fee methodology set by Tri -County Building Industry Service Board 1 :\Buildinn\Permits \MEC- PermitApo doc 10/01/09 440 -46 7T (11 /02JCOM/WEB)