Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00473
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/08/2010
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9669 SW WASHINGTON SQUARE DR CO3
Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project: Express
Project Description: HVAC modifications for TI
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
2235 FARADAY AVE STE #O Permit Fee 10/08/2010 $723.63
CARLSBAD, CA 92008 Plan Review 10/08/2010 $180.91
PHONE: 12% State Surcharge - Mechanical 10/08/2010 $86.84
Contractor:
PACE HEATING & AIR
1884 FESCUE ST SE
ALBANY, OR 97322
PHONE: 541 - 926 -4328
FAX: 541- 926 -4543
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: 4
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: 2 Vent Systems: Total $991.38
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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 800.332.2344.
Issued By: — Permittee Sign: -
Call 503.639.4175 by 7:00 a.m. for an inspection that : `*' " ess 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.
09/29/2010 WED 11:54 FAX 5032667238 21002/009
Mechanical Permit Application FOR OFFICE USE ONLY
Received �� . �
a_ _ City of Tigard sta... Datun3 / v , • /` Permi No.: �/� W 7
• 13125 SW Hall Blvd.. Tigard, OR C� 2� Plan I(c in, �l ,/ .
-
Phone: 503.639.4171 Fax: 503.59 1 O /7/(o U'1 `'V OtherPerntit:k ee5 /�
Date %13y: / Ake
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TYPE .OF 11c0 �` J%S • COMMERCIAL EC* . SCHEDl1LE USECHLCKLIST
j `�� �� Mechanical permit Ices' are based 011 the value of the work
❑ New construction Addition %elte,kalT'cpl1wcnlcnl
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead. and profit.
.
Value: S O , OL)
CATCGORY 01 .CONSTRUCTION. __J
•
RESIDENTI,AL.EQUIPMENT(SVSTEMS FEES ;' . •
❑ 1- and 2- f.•nnily dwelling 44Sit Commercial/industrial ❑ Accessory building
For special informs tiun me Oecklisl.
❑ Multi - family ❑ Master builder ❑ Other: Dcscri ttion
p I Qty. I La. I Total
JOB SITE INFORMATION ;AND LOCATION .. Heating /coolie'
17447y. // /� Air conditioning
Job site address: �SteJ t- ) C(SjL44 / f , J f un tE' GGl - (n .ails pion showing placement) 46.75
'�-t ' Furnace 10(1,000 BTU lductsrcnts) 46.75
City /Stale /ZIP: � / (% CC /L L f L�l� --..
.� -- - � Furnace (003)004 ETU Woo cal.) 54.91
Suite /bldg. /apt. no.: G) 3 Project name: ; �> A rQ 3' `f Heal pump 61_06
Cross street /directions to job site: Duct work 23.32
_ r y 1 liy(b'onic hot water system 23.32
<Jr� /' /Sj Lt U✓askirto yJ .S &.[,Girt(' / �lr. e,� J Residential boiler (radiator or
v � / ' hy(h'onic) 23.32
\G4 « (
Unit heaters (fuel -type, not electric),
in -wall, in -duct. sus tended, etc. 46.75 '
' - Flue/vent for any of above 23.32
Subdivision: 1.01 no.:
Other: 23.32
Tax map /parcel no.: Outer fuel appliances _ _
Dr5C'R1M'ION. or WORK Water heater 23.32
` 1 Gas fireplace 33.39
b u.c..-A t-\ (")L1t�( t`-Q_ 3 ovIS 4 I /jl0 -D O f -�7 Q Floc oral Ibi tv:uei healer or gas
,� _ t �� fireplace 23.32
�^ �1- due -�Y '' Log lighter (gas) 23.32
\\V- Wood fireplace /instil - -^ 23.32
) Wood.'pellet stove 33.39
( W
\1 ... ❑ PROP.ERTY' O)'VNGR .. ..• 0:T ENANI' : u n } mu /Iluc/ uu
C'h• t e /I' 23 32
Olhcr: 23.32
t - -
M
Name: Environmental exhaust and ventilation
Address: Range hoxl /other kitchen
N equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments. utility rooms) 23.32
APPLICANT . • ❑ PERSON Attic /cr:nvlspacc fans 23.32
Other: 23.32 •
,V pit) - Business name: (!- E / / ..a H 4 n -7/- Fuel piping
/mi ^5 Contact name: �r j €LV I`? LAi I t 4 , $14.15 for first four; $4.03 for each additional
Address: ' %i Furnace, pill.
- Gas heal pump
cit /State /ZIP: t - .b j , :wa- 073 ao. Wall /suspended /unit heater
Phone: (SZ. /,4 C .. L/3 t9 p ( Fax:: (Se //) 90244 -- Llj (i3 Walei healer
h_'_i J)lacc -
E -mail: /p - /ail ) do /)G) eeL. ' GI /17- -. ✓ -/' COil -) Range --
GON'I'll arbe u
fl•i�ce
Business name: N- CtL (4 tq-Ti p A/2 Clothe. (1)01 (gas) -- -�
Othe
Address: gy r� 5e � ,----z._ A'IECHA.NI(AL.P ?CES".
City /State /ZIP: ,4L- / ?41.) y O 2 97,32. ' ' Subtotal - 193,6, 7 ,
Minimum permit lee (S90.00)
hone: ' . 9ay - 4/ 3v-$ _ 5 -9 2G- ei3
Plan review (25% of permit fee) I 4 6C , , e l
C('B lie.: 77, 2 945/, - State surchatgc (12% of permit fee) j •‘(.44 �J TOTAL PERMIT FEE qqt. j
This permit application expires it a permit is not abtained within 180 l
Al11I101'I %C(I signature: ` ( c It-/L � -9 -?
d - 113)'S after it has been accepted as complete.
Print name: L i ►'\rl'L �l e: IL) u_ HMI) Dale: (1 . (2 0 -. /c0 1 ` Fee methodology set hy 'fri- ('ounty Building Industry Set (tee Board
1: nuildin( Peron \IC( I'c,n,■,App.duc 10 11 09 - 1.10- 16171' 11 I U_' ('0 3 H1-111
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