Permit U ' a CITY OF TIGARD MECHANICAL PERMIT
4 �
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00580
7IG'ARL? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/02/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9483 SW WASHINGTON SQUARE DR A06B
Subdivision: Lot: 0
Project: Pac Sun
Project Description: TI
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 Permit Fee 02/02/2010 $449.31
Plan Review 02/02/2010 $112.33
PHONE: 12% State Surcharge - Mechanical 02/02/2010 $53.92
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062
PHONE: 503 - 692 -1565
FAX: 503 - 691 -1879
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: M Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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: 1 Vent Systems: Total $615.56
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: vav
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: / ) Permittee Signature: \ •
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
=i lVlethanical Permit Application -
;` � o f I . , - - 0 0 , w ;a; t .
City of Tigard ° � w Received
`J �� Date/By: A Pennit No /
y Y g D ��IIl�I go
13125 SW Hall Blvd., Tigard, OR 97223 , � p : � .a 3 ,..
r g. GA4ro-ti Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: 7.. w ether Per""[
Inspection Line: 503.639.4175 $�� Y : ��
P oci T 3 0 ,,, V I A L Date Ready /: : 11, ' El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: • / j Cv Supplemental Information
CITY OF TIGARn
TYPE EnI% j DIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction - Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ / 000
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ I- and 2- family dwelling MCommercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. Ea. I Total
9i Q Z JOB SITE INFORMATION AND LOCATION . Heating/cooling
address: q 10 Dju „h; A - (/ 1,(0 e,„ Air conditioning o heat pump
Job site
v N (J � r (requires site plan showing placement) 14.00
City/State/ZIP: Ti 6 A -(7, c i7 Z2-, Furnace 100,000 BTU (ducts/vents) 14.00
�) Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: A o& J3 G /
Project name: TA g J
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
j, Flue /vent for any of above 10.00
Subdivision: 04) W GlA N � Q( _ Lot no.: Other: ' 10.00 0
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
AAI .a.) Gas fireplace 10.00
.a.) (/ ,4lJ 00X Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue/vent 10.00
❑ PROPERTY OWNER 'TENANT
Other: 10.00
Name: qAtG 10 IQ Environmental exhaust and ventilation
Address: jf fayo 6 (o / 0644 O de, Range hood/other kitchen
✓✓ /, equipment 10.00
City/State /ZIP: fI n (Lk GI/�- C 0 b Clothes dryer exhaust 10.00
1 u Single -duct exhaust (bathrooms,
Phone: ( '/) q' I y 6 Fax: ( ) toilet compartments, utility rooms) 6.80
1 APPLICANT m CONTACT PERSON Attic /crawlspace fans 10.00
fe Fuel 10.00
Business name:
Fuel piping
Contact name: / Y” 7 4 es $5.40 for first four; $1.00 for each additional
Address: 75 6
h 6 54- i..) Furnace, etc.
Gas heat pump
City/ State/ZIP: W A) M / / e 1 / y95x5 WalUsuspended/unit heater
Phone: (8 U0) a G y /Pp C, Fax:: (b &, ) Y g3 q 3 5/ Water heater
1 Fireplace
E -mail: / Ce p c /o f at Ind /ft • t Range
F b / >CONTRACTOR ` Barbecue
Business name: r � Q r�� CV\ Other: dryer (gas)
Ay , _
Address: t"� MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: \ 9 3 State surcharge (8% of permit fee)
D TOTAL PERMIT FEE
i
Authorized signature / - ( 0 ! This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: L y p- p f of Date: /0 .#0 7 * Fee methodology set by Tri-County Building Industry Service Board
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i:Building PennitsMEC-- PennitApp.doc 12/03 440-4617T (11 /02/COM/WEB)