Permit CITY OF TIGARD MECHANICAL PERMIT
a .`r. COMMUNITY DEVELOPMENT Permit #: MEC2010 -00034
T i G
ARE). 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/03/2010
Parcel: 1S1260000300
Jurisdiction: TIGARD
Site address: 9677 SW WASHINGTON SQUARE DR CO5
Subdivision: Lot: 0
Project: Aeropostale
Project Description: Install (2) VAV boxes and ductwork for TI.
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O
CARLSBAD, CA 92008 Permit Fee 02/03/2010 $299.94
Plan Review 02/03/2010 $74.99
PHONE: 12% State Surcharge - Mechanical 02/03/2010 $35.99
Contractor:
JACOBS HEATING & AIR CONDITIONING
4474 SE MILWAUKIE
PORTLAND, OR 97202
PHONE: 503 - 234 -7331
FAX: 503 - 808 -9108
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: Vent Systems: Total $410.92
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: VAV'S
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: g c r• Rs j J j (�� Permittee Signature: Ca.
Call 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.
7V e !T ,-
Me Permit Application " 'r. i FOR OFFICE USE ONLY
,a ^ - Received
City of Tigard , 1 Permit No.: HeCA9/0 00035/
II
. Phone: 503.639.4171 Fax: 503.598.1960 ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Re : %
JAN 2 2 2010 Plan Revie
Date /By: � � i k. d Other Permit:
TIGARD Inspection Line: 503.639 Dat Rea . t: y ethod: / �II luris: S See Page l for
Internet: www.tigard- or.gov CITY OF TIGARD Notifi M ` Supplemental Information
BU,LDING DIVISIO
TYPE OF WORK 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: 5 .?„a--, —
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: (� Air conditioning
Sw WASh 1 at 59 1 ► K
I yam, A, j,_ (requires site plan showing placement) 46.75
11 � r� u
City /State /ZIP: � OR qa, Fumace 100,000 BTU (ducts /vents) 46.75
Fumace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: l r<r pt '5k K. 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
DESCRIPTION OF WORK Water heater 23.32
V
/ j 1 Gas fireplace 33.39
I n 1, t,i () n V ' l ( u n-IA.)0 (7 k_ Flue vent for water heater or gas
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
Nance: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Other: 23.32
Fuel piping
Contact name: S14.15 for first four; 54.03 for each additional
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: 0( -- ) Ine s 1 �� - 1 plc
Clothes dryer (gas)
t� Other:
Address: LLfl t4 M 1 1 �((, V Q i 1 v I � MECHANICAL PERMIT FEES*
City /State /ZIP:y. 1�1� ( ` � l2 o � 1 c a Subtotal
I 1
a5,4,.--77-21 ��ll!! vt \ —) Minimum permit fee ($90.00)
Phone: Fax. ( ' , / Plan review (25% of permit fee)
`
CCB lic.: 1 L. ) State surcharge (12% of permit fee)
� ('�� TOTAL PERMIT FEE JM'r
Authorized signature: .. i c t eyn .G� This permit application expires if a permit is not obtained within 180
✓v-� �-y days after it has been accepted as complete.
Print name: - n °pe k =✓rnrk r Date: / t a /C * Fee methodology set by Tri- County Building Industry ervice Qep
I \ Building \ Permits \MEC- PermitApp.doc 10/01/09 440 -4617T (1 I /02 /COM/WEB) /o . T
CITY OF TIGARD 5 Y I t /�1 C`�UIU- 0c-u3y
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171�'r�pilI�I�
Inspection Requests (24 Hrs.): (503) 639 -4175 ;�±i
INSPECTION WORKSHEET FOR DATE: 3A/ v TIME: . PAGE:
SITE ADDRESS: q6777 ( , " {5J? CLASS OF WORK:
SUBDIVISION: " � LO T #: TYPE OF USE:
PROJECT NAME: COS
DESCRIPTION: / �
OWNER: PHONE #: 5 3% /
CONTRACTOR: PHONE #: ocv ` l
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
C177 / Jia4' f Rwa( •4-•'`Veto --0
Corrections /Comments /Instructions:
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL El CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
2('(
Date:
Inspector: Date: �� Phone #: (503) 718 -