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Permit CITY OF TIGARD MECHANICAL PERMIT I COMMUNITY DEVELOPMENT Permit #: MEC2012 -00294 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/05/2012 Parcel: 151260000300 Jurisdiction: Tigard Site address: 9681 SW WASHINGTON SQUARE RD C06 Project: Tesla Motors Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108 Project Description: New ductwork, grilles and ceiling exhaust fan. Contractor: ARROW MECHANICAL Owner: PPR WASHINGTON SQUARE LLC 10330 SW TUALATIN RD BY THOMSON PROPERTY TAX SERVICES TUALATIN, OR 97062 ATTN HILARY RAYMOND 2235 FARADY AVE, STE 0 CARLSBAD, CA 92008 PHONE: 503 - 692 -1565 PHONE: FAX: 503 - 691 -1879 FEES Specifics:, Description Date Amount Type of Use: COM Permit Fee 06/05/2012 $319.61 Class of Work: ALT Type of Const: IIB Plan Review 06/05/2012 $79.90 Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 06/05/2012 $38.35 Stories: 1 Info Process /Archiving - Lg $2.00 (over 06/05/2012 $4.00 11x17) Project Valuation: $9,000.00 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: Appliances Vent Fans: Vent Systems: Total $441.86 • Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: . Gas Outlets: Other Desc: Duct Work: 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. 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 A licati FOR OFFICE USE ONE) City of Tigard C EIVE D Received ��' ME ed Permit N� fir o�O/o2 • 13125 SW Hall Blvd., Tigard, OR 97223 ��oZ J� ;� Plan Review Phone: 503.718.2439 Fax: 503.598.1960 UN 042012 Date/By: E �� to O the r Penn _ Inspection Li 503.639.4175 ��� ��-S'� TIGAI:p DateR - . :y. ® See Page 2for Internet: www.tigardor.gov CITY OFTIGARD Notified/Method: IMI Supplemental Information BI HI DING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLLST 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. CATEGORY OF CONSTRUCTION Value: $ 90/94), - RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ 1 - and 2 family dwelling IN Commercial/industrial ❑ Accessory building For special Information use checklist. ❑ - '.� ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total q W 0 I JOB SITE INFORMATION AND LOCATION Heating/cooling: te r c5 (�� AA-) C 7 3 � ,? Air conditioning (requires ite pl Job sit t• •,:.. . - � 1 ��� ( requmes site plan showing placement) 46.75 Furnace 100,000 BTU (ducts/vents) 46.75 City/ State/ZIP: /CARS G)Z c 7 ZZ3 / Furnace 100,000+ BTU (duds/vents) 54.91 Suite/bldg. /apt. no.: 0,06 I Project name: Ta mai Heat pump (requires site plan showing placement) 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 � a-) J� ) }C Gas fireplace 33.39 q IZ/ ��� /��� CG/LJn�/ Flue vent for water heater or gas Ft90 - fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 ❑ PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32 Other: 23.32 I Name: 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/crawispace fans 23.32 Business name: 44J "t�/i e ,e4e_ �� iv25, i�e, Other: 23.32 Fuel piping: Contact name: /(' (/ j Z O 4 ��'/ (.� cam- f° $14.15 for first four; $4.03 for each additional Address: /0e33) c y3 'TiJ x-.) , /L"j) Furnace, etc. Gas heat pump City/State/ZIP: 704/_.477,/3 6SL 97G6 Z Wall/suspended/unit heater Phone: (fp ) 67z -1 S6 5-- I Fax: : ( 5- 9/ _ 4 77 Water heater Fireplace >'` 1� E -mail: t /ZOt.-- 3 1�eg1L a F ' ' — Cc ?' - Range CONTRACTOR Barbecue Business name: , ZIoCJ Mr J y ap¢(_ ea, // ZS., � d . Clothes dryer (gas) _ Other: Address: Lv 336 a -) / J j/\-, 7 i 4 / ) MECHANICAL PERMIT FEES* City/State/ZIP: 7 ? 3 / 6Z.... fill 7% Subtotal Minimum permit fee ($90.00) Phone: (p.3 ) 692_ / 5 - 6 I Fax: (53) el/-4:3 7 Plan review (25% of permit fee) — CCB lie.: $/ 93 State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized Sigma This permit application expires if a permit is not obtained within 180 L�-" days after it has been accepted as complete. D.. ..a ^•• -�•-• r�..�... I • Fep me]hnMlnav cet by TriC'minty Rnildino rnAnary Servirr Rnard ` e / f sxCLc i j4f t^o -41- -1a ' PI o Building Division . • Over- The - Counter (OTC) Mechanical Permit TIGARD Check List Project Description: 1 I APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: ACE Occupancy Group: PA Type of Construction: *Type of Use: erg& Oregon Specialty Code: Zo 15 Number of Stories: FUEL FURNACES Type: Furnace < 100K BTU Furnaces >= 100K BTU Gas Pressure: Roof Top Unit (RTU) Tons Floor Furnaces Unit Heaters Vents without Appliances Air Conditioning Heat Pump AIR HANDLERS HOODS Units <= 10000 cfm Type 1 Hood Type 2 Hood Units > 10000 cfm Grease Duct 1 Hour Shaft Fire Wrap APPLIANCES Boiler (BTUs) Vent Fans Gas Line Solid Fuel Fireplace/ Clothes Dryers Gas Outlets Woodstove Duct Work ' Gas Fireplace Fire /Smoke Dampers Other Mechanical Units — Describe: Total Project Valuation: $ q'(;O, I FEES DUE 3 / 49 I $ Mechanical Permit Fee $ - , - 4 Plan Review $ - 3 . 3 State Surcharge $ A . CO Info Proc /Arch, Lg (over 11x17 $2.00) $ Info Proc /Arch, Sm (up to 11x17 $0.50) $ Misc. Admin Fee $ Hourly Rate Fee $ Hourly Rate State Surcharge $ Other: $ Other: Building Staff: yy /. GPlo Date /Time: $ TOTAL FEES DUE *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS = fire protection system; NEW = new; OTR = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. l:\Building\Forms \OTC - MEC.docx 01/13/2011