Permit 1 y n CITY OF TIGARD MECHANICAL PERMIT
11 s COMMUNITY DEVELOPMENT Permit #: MEC2012 -00667
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012
Parcel: 1 S135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 500
Project: Bridgewell Subdivision: METZGER, TOWN OF Lot: 9
Project Description: Relocate (1) diffuser and tie into an existing duct work off a fan powered box.
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 12/17/2012 $112.04
Class of Work: ALT Type of Const: Plan Review 12/17/2012 $28.01
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 12/17/2012 $13.44
Stories:
Project Valuation: $1,813.00
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 $153.49
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 Notifi - • 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 • estions to • - C by calling 503.232.1987 or 1.800.332.2344.
Issued B : I I 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
City of Tigard Received Mk Permit No.:
111 -
ta g Date/By: /2 i7 /`�.
13125 SW Hall Blvd., Tig• . P ...,,,,,,66 ■ Phone: 503.718.2439 Fax: b ` . • •'I Plan Review Other Permit:
Inspection Line: 503.639.4175 7 Date /By.
T I G A R D 1• 012 Date Ready /By: Juris: 65 See Page 2 for
Internet: www.tigard-or.gov DEC Notified/Method: Supplemental Information
. r ! 1
pl r t - - Mechanical permit fees* are based on the value of the work
❑ New construction ® Ad ■ ition a teration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $1,813
I
❑ 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
`- , , J OB SITE INFO!, ,: Heating/cooling:
.. Air conditioning
Job site address: 10200 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.: 500 I Project name: Bridgewell Suite 500 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:
Water heater 23.32
vent f
Relocate (1) existing diffuser and tie in to existing duct work off a fan Gas Flue vent fireplace
vo e 33.39
for water heater or gas
powered box. fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER ® TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: Bridgewell _ 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,
( ) Fax: ( ) toilet compartments, utility rooms) 23.32
• t, Attic /crawlspace fans 2332
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 I Fax: : (503) 331.6907 Water heater
Fireplace
E -mail: janell @mckinstry.com Range
.rya: , . - - s , _. Barbecue
Business name: McKinstry Compan', LLC Clothes dryer (gas)
Other:
Address: same as above
City/State /ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 172811 State surcharge (12% of permit fee) !
�
r TOTAL PERMIT FEE 7/ 5 3 • `
Authorized Signatu This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Janel Lipe Date: 12.17.2012 • Fee methodology set by Tri-County Building Industry Service Board
1i\ Building \ Permits \MEC- PermitApp.doc 09 /09/10 440- 4617T(11 /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 $100.00 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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