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Permit
• • CITY OF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2005 -00196 A ll 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/26/2005 PARCEL: 1 S 126CA -01000 SITE ADDRESS: 09009 SW HALL BLVD 142 ZONING: C -G SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT: JURISDICTION: TIG Project Description: Mechanical TI, rooftop units, ductwork, exhaust fans make -up air and hoods. Project Value: $33,000 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: 4 OCCUPANCY GRP: A2 VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: 1 BOILERS /COMPRESSORS HOODS: 2 FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: 2 OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES WASHINGTON SQUARE PLAZA Description Date Amount BY THE CAFARO COMPANY P 0 BOX 422 [MECH] Permit Fee 5/26/200E $542.00 FLORHAM PARK, NJ 07932 [MECPLN] Plan Rev 5/26/200E $135.50 [TAX] 8% State Surcha 5/26/200E $43.36 Phone: Total $720.86 Contractor: ARMSTRONG COMPANY 2000 NE 42ND #164 PORTLAND, OR 97213 REQUIRED ITEMS AND REPORTS Phone: 503- 209 -3786 Reg #: LIC 158853 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: -- 7) 1.4 Permittee Signature: / Call 503 - 639 -4175 by 7:00 a.m. for inspections 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. yo Y Sw it £ /i/d- .s Mechanical Permit A elicit Q i>! ED FOR OFFICE USE ONLY Cit of Ti and �i ( j t V Received 3 t g l �+ Date/By: _ Permit No.:tnn lq (/, Ai , 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review i j Phone: 503.639.4171 Fax: 503.598. ( [ /di ,,, Other Permit: Inspection Line: 503.639.4175 � � R ' ` �oo�`� Date/By: Date Ready /By: r D r f tuns ® See Page 2 for Internet: www.ci.tigard.or.us Notitie. ethod: Supplemental Information CITY OF TIGAR��D t>< ��y ld1� BI J4I II � )XI gq ON 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, equi • . .- , a.or, o - +.. • . • . . rofit. CATEGORY OF CONSTRUCTION alue: $ / RESIDENTIAL QUIPMENT / Y V ES* ❑ 1- and 2- family dwelling Kc ommercial /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 b0 9 f ( At t7. f y Air conditioning or heat pump a� (requires site plan showing placement) 14.00 City/State /ZIP: 1 1J o g � Z 3 Furnace 100,000 BTU (ducts/vents) 14.00 Z � Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: 4 ^ '1 n 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 Flue /vent for any of above 10.00 Subdivision: I Lot no.: Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace 10.00 6 ,e_ A1/5/ , . i /S7 d eL(, 2 # J?7P' Ale- 1/4/I j5 Flue vent for water heater or gas fireplace 10.00 1/1/44. ✓0t'✓1'O ' b✓C./ ,6 K i n / ,A)5.4 04.141£4. Log lighter (gas) 10.00 Fw.//sm� 0.,01)57 M zh /9-7 iJAJI /5 /4400;\ Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 ❑ PROPERTY OWNER I TENANT Other: 10.00 Name: � n,t'1 D Qf S/ A -4-r.t 7 Environmental exhaust and ventilation t I" /' Range hood/other kitchen Address: equipment 10.00 City/State /ZIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other. 10.00 Business name: 7./A0,040 gam Fuel piping Contact name: e ( 014 /� . A 1� / / to _ $5.40 for first four; $1.00 for each additional Address: S26 v /pre 9 Z q Gas e pump City/State /ZIP: PL 7/_/71 / QA Wall/suspended/unit heater / '11: Phone: ( ,3 ) t�� 37 04, Fax: : ( ) L97 .L� / 1/ Water heater ( ti, t/ F I D ireplace ` O R E -mail: Range (fi C{� /�-� CONTRACTOR Barbecue a " ' J Clothes dryer (gas) Business name: / �/(� ! � '� ' Other: Address: z A ft 4' S- / 41 MECHANICAL PERMIT FEES* p 1 g Subtotal City/State/ZIP: D J� Minimum permit fee ($72.50) ,S Phone: ( 3) 0 q 37$b Fax: 0.'63 ) Z 7 4/7/ Plan review (25% of permit fee) / 3s, S CCB lic.: 5 - g 6 5 - 3 q` _^ It . State surcharge (8% of permit fee) y3 7 /t TOTAL PERMIT FEE 12/3, Authorized signature: j'- --r'r // / This permit application expires If a permit is not obtained within 18ff g ��(,J/ , V/ � days after it has been accepted as complete. Print name: 1) p/24C Da te: / I * Fee methodology set by Tri County Building Industry Service Board Z 6/ �S Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. dO I e $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and 1 a J V 3 $1.35 for each additional $100.00 or fraction thereof, to and including rr 161 U' $50,000.00. 20 $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and /y /� > 5 $1.25 for each additional $100.00 or r 4 10 1 fraction thereof, to and including /_ 3 $100,000.00. I j $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. q, ` U. L. 1 .1)1 r i:, Building ,Permits\MEC- PermitApp.doc 12/03 2 FTI RD CITY O GA BUILDIAG DIVISION PERMIT #: iittEe-- ZGY 5 -00 ('6 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 Alit Nl � Inspection Requests (24 Hrs.): (503) 639 -4175 ..._' __.. INSPECTION WORKSHEET FOR DATE: 67i/ TIME: PAGE: SITE ADDRESS: et[rjc7 .(4) H-PkLL_ CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME:© DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments / Instructions: S I II i 4t 'al . r Ill r 7- PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL II CALL F. - INSPECTION ❑ ADDITI NAL F ES ASSESSED Inspector: A Date: ✓ Phone #: (503) 718 - 4 111V '