Permit _ —
CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2015-00164
i
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/06/2015
T f i.,�1 RD g Parcel: 1 S 135AB01002
Jurisdiction: Tigard
Site address: 10220 SW GREENBURG RD 417
Project: Cypress Semiconductor Subdivision: METZGER,TOWN OF Lot: 9
Project Description: HVAC modifications,add(1)new water source heat pump and new supply and return ducting.
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 04/06/2015 $474.71
Class of Work: ALT Type of Const: IIB Plan Review 04/06/2015 $118.68
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 04/06/2015 $56.97
Info Process/Archiving-Lg$2.00(over 04/06/2015 $2.00
Stories: 11x17)
Project Valuation: $15,000.00 Info Process/Archiving-Sm$0.50(up to 04/06/2015 $5.00
11x17)
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: 1
Appliances
Vent Fans: Vent Systems: Total $657.36
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: water source
Duct Work: 1 heat pump
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 • ca ion ':• er. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or.'ect questions to OU . by • g 503.232.1987 or 1.800.332.2344.
Iss ed By: i I �� Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection .. :.
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 Applic1tEIVEP FOR OFFICE USE ONLY
City of Tigard Date/By: 3 /S J Permit Nu: �L � �-a ccy
III • 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Revie
a Phone: 503.718.2439 Fax: 503.598.1 ` other Permit:
Inspection Line: 503.639.4175 8 2 6 2015 DateBy:d i '/ t'S A(Pa0/-3�-ezocAt
T I G A R I) Date Rea.. • - kris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGA1tD d 4 r
. . . % I i . 1i. 4..'
I�[AL 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:$$15,000.00
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 46.75
Job site address: 10220 SW'Greenburg Road Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 1 61.06
Suite/bldg./apt.no.:417 Project name:Cypress Expansion Duct work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
1 new water source heat pump and new supply and return ducting. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
--_- Other: 23.32
® PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name:Shorenstein Realty Sen ices,1.P Range hood/other kitchen
equipment 33.39
Address: 10220 SW Greenburg Road,Suite 310 Clothes dryer exhaust 33.39
City/State/ZIP:Portland,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)619-3100 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: 23.32 _
Fuel piping:
Business name:11cI{instry Co $14.15 for first four;$4.03 for each additional
Contact name:Antonija Krizanac Furnace,etc.
Address:16790 NE Mason Street,Suite 100 Gas heat pump
WalUsuspended/unit heater
City/State/ZIP:Portland,OR 97230 Water heater
Phone:(503)331-0234 Fax::(503)331-6906 Fireplace
Range
E-mail:antonijak a mckinstry.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other
Business name:blcKinstry Co. MECHANICAL PERMIT FEES*
Address: 16790 NE Mason Street,Suite 100 Subtotal
City/State/ZIP:Portland,OR 97230 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)331-0234 Fax:(503)331-6906
State surcharge(12%of permit fee)
CCB lie.: 172811 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
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� days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name: A-042 h a'w kir)7 OAcc C— Date: 3/Z61,/jc
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1:\BuildingermitsEC_PermitApp_40113.doe 440-4617T(11/02/COM/WEB)