Permit IN -.; CITY OF TIGARD MECHANICAL PERMIT
e COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00555
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/11/2007
PARCEL: 1512600 -00300
SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD V05 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: LUCY
Project Description: TI $15,900
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 2 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WASHINGTON SQ. LLC Description Date Amount
9585 SW WASHINGTON SQ. RD
TIGARD, OR 97223 [MECH] Permit Fee 10/11/20( $311.15
[MECPLN] Plan Rev 10/11/20C $77.79
[TAX] 8% State Surcha 10/11/20( $24.89
Phone:
Total $413.83
Contractor:
•
ELDER JONES
1120 E. 80TH #211
BLOOMINGTON, MN 55420 REQUIRED ITEMS AND REPORTS
Contact #: PRI 952- 854 -2854
Reg #: LIC 64459
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 m 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: 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.
Mechanical Permit Applic . t FOR OFFICE USE ONLY,, .
City
of Tigard f' r.. -�- Dat By i a 7 / I P No /A # f��0�s
13125 SW HaII Blvd , Tigard, OR 97223 - OQ Da R °� Y
i I Phone 503 639 4171 Fax. 503 598 It960� 1 Plan Revi ► , , 't) in Other Permit
Inspection Line 503 639 4175 ' Date By + BJ0 , ,
Ins
T I G A R D P apt p� T IG� �1 d/Mthd :
D ate Ready /By t Q ® See Page 2 for
tigard-or 1 � I VI SIO V Notified/Method www Supplemental Informa .1.n ,
TYPE OF WORK - ' COMMERCIAL ` EE* : - ;1 DULE -: C E t; . 4 T
❑ New construction ddition /alteration/replacement Mechanical permit es* are based on the value of the work
performed Indic, e the value (rounded to the nearest dollar) o 711
❑ Demolition ❑ Other: mechanical mat; tats, equipment, labor, overhead, and profit
- . Value $ (5 q0 0
. CATEGORY,OF CONSTRUCTION '
- RESIDE 1 " • QUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling Commercial /industrial ❑ Accessory building
For sp - . al in i •' : non use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description y _ a Total
JOB 'SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 950,2 / / ` Air conditioning or heat pump
Sj,tJ Gi r„�, - ua4 4/ (requires site plan showing placement) 14 00
City /State /ZIP: / G ` � Qr Furnace 100,000 BTU (ducts /vents) 14.00
S� T// / Furnace 100,000+ BTU (ducts /vents) 17 90
Suite/bldg. /apt. no.: Project name: L G Gas heat pump 14 00
Cross street/directions to job site: Duct work 10 00
Hydronlc hot water system 14 00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 14 00
Subdivision: I Lot no.: Flue /vent for any of above 6 80
Other. 10 00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 10 00
// > l /� / / Gas fireplace 10 00
/'L✓l7 � G( // [/�'� i/!� , �� ��.G; 4 .- - Flue vent for water heater or gas
1 /� ll fireplace 10 00
Cr y 'A; 0 n7 - o0' /yo Log lighter (gas) 10 00
Wood/pellet stove 10 00
Wood fireplace /insert 10 00
ID PROPERTY OWNER ,TENANT
Chimney/liner/flue/vent 10 00
Other 10 00
Name: / a r A J .-3/bt, 5q I LL Environmental exhaust and ventilation
Range hood/other kitchen
Address: 3l J 5 A LJ ' Kijusirici ✓lf equipment 10 00
City /State /ZIP: 1 / /r 72 6 j/ W wA 'd -s d er exhaust 10 00
in le -duct exhaust (bathrooms,
Phone: ( i'4'3) 2 9_ Fax: ( ) GJ toilet compartments, utility rooms) 680
' • ( . APPLICANT • ❑ CONTACT PERSON - Attic /crawlspace fans 10 00
Business name: ✓ Q r Other 10 00
s /Gs/ / e17Z-LY -V Fuel piping
Contact name: / , W7 T' �''-
$5.40 for first four; $1.00 for each additional
i -6'T
Address: / Furnace, etc
�3 3 SE /4 u er 2 ..,Z Gas heat pump
City/State /ZIP: 1 4 7 WalUsuspended/unit heater
Phone: ( J l 47 31 3 _ i77 - Fax :: (03) c>7-6--„26:36 Water heater
a / )1 Fireplace
E-mail: 1 �` 4/L - J � , C014"- Range
CONTRACTOR . Barbecue
Business name: _�� ' . / jr �� - �� . Clothes dryer (gas)
' Other:
Address: / 1pZ 0 : ` rk e . < MECHANICAL PERMIT FEES* • -
City /State /ZIP: / a"' al-_ 44 Ar 5-5-46 Subtotal
Phone: (W ' iie S,5/ I Fax: ( ) Minimum permit fee ($72 50)
d- / Plan review (25% of permit fee)
CCB lic.: (.0 o. a 7 - i D State surcharge (8% of permit fee)
` TOTAL RMI b Q /
Authorized signature: This permit application aspires if a per is T not FEE obtain wit 180
days after it has been accepted as complete. i /
Print name: Z Date: 9 cv _e 7 • Fee methodology set by Tri- County Building Industry Service Bo.
I \Budding\Permits\MEC- Permit App doc 01/19/07 440-4617T (I I /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
, .; . •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.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$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.
1 \Budding \Permits\MEC - PermitApp doc 01/19/07 2
CITY OF TIGARD .- l
VIIRLZ007- d 0446
BUILDING DIVISION PERMIT #:
. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 Ai i '
Inspection Requests (24 Hrs.): (503) 639 -4175 s_' ": _..
INSPECTION WORKSHEET FOR DATE: IIA kV /67 TIME: PAGE:
SITE ADDRESS: 13 V&5L IAA Soh"' S piO + CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: (/11 G 4 7 PHONE #:
CONTRACTOR: �( PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # lnspectio Description Confirm # Contact # Message
(SA i Me 4•10%; 4a. - %'14 . 4) ,
Corrections /Comments /Instructions: i
J
.I
J
C1(..._ 1
! I "-iii
. !ic/, , PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
\A\ p Inspector: i (g ` - Date: 1 I o -) Phone #: (503) 7 18- I f
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00555
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/11/2007
Phone: (503) 639 -4171 /kw
Inspection Requests (24 Hrs.): (503) 639 -4175 �..' ^'.I..
INSPECTION WORKSHEET FOR DATE: 10f24/2007 TIME: 7:00AM PAGE: 71
SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD VO5 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE - LOT #: TYPE OF USE:
PROJECT NAME: LUCY
DESCRIPTION: TI $15,900
OWNER: WASHINGTON SO. LLC, PHONE #:
CONTRACTOR: ELDER JONES PHONE #: 952 - 8&1 - 2864
Inspection Request Scheduled For: Date: 10/24/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough-in 058205.01 503-626- 8986 N
Corrections /Comments / Instructions:
='- -rAekA A A-k-1A — k --4-
(0
❑ PASS CkPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \. (�+ ( Date: t 0/2;02 Phone #: (503) 718 -2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: INEC2007 00555
13125 SW Hall Blvd., Tigard, OR 97223 —/ DATE ISSUED: 10/11/2007
Phone: (503) 639 -4171 �1'1I O C/
Inspection Requests (24 Hrs.): (503) 639 -4175 ,,
r
INSPECTION WORKSHEET FOR DATE: 10/15/2007 TIM j7 1AM PAGE: 23
SITE ADDRESS: 09302 SW WASHINGTON SQUARE RD V05 LASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: LUCY
DESCRIPTION: TI $15,900
OWNER: WASHINGTON SO. LLC, PHONE #:
CONTRACTOR: ELDER ,JONES PHONE #: 952 - 851 - 2854
Inspection Request Scheduled For: Date: 10/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 IvIncharrical rough -in 057611 -01 503. 625-8986 N
Corrections/Comments/Instructions:
c Z ' D i
U s
k. ,____ 5 (--vt_.-tc."--- (----7/LSI-vci-e-A-C
( -I
, - f diallf s
ir
PIZ ' 470 (// ✓ X
. _ - = - - )
r
/
i v /
■
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
•
` 0 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
t Ins ector: Date: �� / Phone #: (503) 718 -