Permit V CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit# MEC2012 -00480
Date Issued 09/19/2012
T [GA FLD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 1S1260000300
Jurisdiction Tigard
Site address 9455 SW WASHINGTON SQUARE RD A15
Project Things Remembered Subdivision VASHINGTON SQUARE ESTATES NO Lot 108
Project Description New VAV & Distribution 124 lbs
Contractor ARROW MECHANICAL Owner PPR WASHINGTON SQUARE LLC
10330 SW TUALATIN RD PO BOX 847
TUALATIN, OR 97062 CARLSBAD, CA 92018
PHONE 503 - 692 -1565 PHONE
FAX 503 - 691 -1879
FEES
Specifics Description Date Amount
Type of Use COM Permit Fee 09/19/2012 $347 71
Class of Work ALT Type of Const Plan Review 09/19/2012 $86 93
Occupancy Grp Occupancy Load 12% State Surcharge - Mechanical 09/19/2012 $41 73
Stories
Project Valuation $10,000 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 $476 37
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 \itle" Permittee Signatur / •
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 Application— FOR OFFICE LSE O NE)
C 1 25 t SW Hall B lvd a Tigard,OR 97223 "
E!V ��� ' ( q Iii- s'� Pem,uNo C�'A- 00910 Phone 503 7182439 Fax 503 598 1960 SEP 1 9 Yew Other Permit EL./2,2 a- p0��
Plan OI
T I G A R D Ins Line 503 639 4175 2 �2 Date Ready/By ions ® See Page 2 for
Internet www tigard-or gov Ci l ief Nobfied/Method -� '
Supplemental Information
,� I IGARO
TYPE OF W t (2!tf r "! t Pi K M"+/ COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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 matenals, equipment, lEbor, overhead, and profit
Value $. /p,pr)v
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dweller Commercial/industnal ❑ Accessory building For special information use checklist.
❑ Multi- family e lf/ Master builder ❑ Other Descnption I Qty I Ea. I Total
Qil JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air
Job site address (requires d site plan showing lacement 46 75
City /State/ZIP /4/¢ /2 �� c} 7Z Z3 Furnace 100,000 BTU (ducts/vents) 4675
/ Furnace 100,000+ BTU (ducts/vents) 54 91
Suite/bldg /a :4.- O( Project name •7- # : z, R � Heat pump
(requires site plan showing placement) 61 06
Cross street/directions to job site 416.- Duct work 23 32
Hydronic hot water system 23 32
Residential boiler (radiator or
hydronic) 23 32
Unit heaters (fuel -type, not electnc),
in -wall, in -duct, suspended, etc 46 75
Subdivision it 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
Gas fireplace 33 39
t-C./ ✓A" I, l ) / S T/li/ %r 4%7 p A) Flue vent for water heater or gas
/ ./eri ~ 1 fireplace 23 32
Log lighter (gas) 23 32
Wood/pellet stove 33 39
Wood fireplace/insert 23 32
❑ PROPERTY OWNER I ❑ TENANT Chtmney/Imer /flue /vent 23 32
Other 23 32
Name: Environmental exhaust and ventilation:
Address Range hood/other kitchen
equipment 33 39
City/State/ZIP Clothes dryer exhaust 33 39
Single-duct exhaust (bathrooms,
Phone ( ) Fax: ( ) toilet compartments, utility rooms) 23 32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23 32
, Other 23 32
Business name.
/�/?IZs.J piae/49,�.s l e-/� t, r / c-� ciates /de. Fuel piping:
Contact name: N��Aj itf.i )s e....J 6/ $14.15 for first four; $4.03 for each additional
Address /fjc. 7i Zf'/11/ Furnace, etc
Gas heat pump
City/ State/ZIP• -7 T/ 6c_ Z. Z
Wall/suspended/unit heater
Phone. (5c,3 ) 6,2 - /5g 5 I Fax (�3) °f/ — /B, Water heater
E -mail. /4/�-- GVA.) "Eel/ Q• P, '�i7,Ef . • �Ys i R Range
CONTRACTOR Barbecue
Business name 4- pG..i N L4 / 9L ev OA K , Clothes dryer (gas)
Address /3...) %i�rJ� ,,rr,i 7Q �\ Other
�1�t � .Y MECHANICAL PERMIT FEES*
City/State /ZIP l L1I, 77 j 6z ..... 97.g 2 Subtotal
Phone (5(.) 0 Z is �� F (� y (21 /7 Minimum permit fee ($90 00)
7 Plan review (25% of permit fee)
CCB lie 5 / 9 3 State surcharge (12% of permit fee)
TOTAL PERMIT FEE D‘, .1,3
Authorized st®atur Cr` ^'" This permit application expires if a permit is not obtained within 180
li ` days after it has been accepted as complete.
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