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Permit
CITY TIGARD MECHANICAL PERMIT i DEVELOPMENT SERVICES PERMIT #: MEC2005 -00564 A. will 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/12/2005 PARCEL: 1S12600-00300 SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD ZONING: C -G SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG Project Description: TI - Project Value: $17,000 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: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES WASHINGTON SQUARE LLC Description Date Amount BY THE MACERICH COMPANY [MECH] Permit Fee 9/12/200E $326.00 9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 9/12/200E $81.50 TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/12/200E $26.08 Phone: 503 639 - 8865 Total $433.58 Contractor: HVAC INC 5188 SE INTERNATIONAL WAY REQUIRED ITEMS AND REPORTS MILWAUKIE, OR 97222 • Phone: 503 462 - 4822 Reg #: LIC 50897 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 -801 32 -23 • • . Issued ' _ _ Permittee Signature: k 4 ij. s_, �� 6� 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. 1V1cechtinical Permit Application FoR (FI IC I USE ()NIX City of Tigard Received Date/By. c j / 05-- Permit No.:H , / ,` 54 '4 X , 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review J Phone: 503.639.4171 Fax: 503.598.1960 ;, Alb„ ;d � Date/By Other Permit: 'j Inspection Line: 503.639.4175 44 '.1.L.1 Date Ready/By RI See Page 2 for Internet: www.ci.tigard.or.us Notified/Method Supplemental Information TYPE OF WORK 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, equipment, labor, overhead, and profit. Value: $ (7 MD: CATEGORY OF CONSTRUCTION t El 1 - and 2 family dwelling - Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES* For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: ' ' I ] Q Air conditioning or heat pump `f .5J(v� (,C� tz�►1 � lY/ (requires site plan showing placement) 14.00 City /State/ZIP: L ak �.Q 1 I �� Furnace 100,000 BTU (ducts/vents) 14.00 t " C Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: (u�� !' Croject nametu t, 7 otts Gas heat pump 14.00 Cross street /directions to joblite. - T ".. il �c k � 1- Duct work 14.00 rCU�cy Load Hydronic hot water system 14.00 Construction Type Residential boiler (radiator or Rated Corridor hydronic) 14.00 Etter y Cade Unit heaters (fuel -type, not electric), Accessibility ^r; in -wall, in -duct, suspended, etc. . 10.00 Subdivision: Lot no.: Flue /vent for any of above 10 00 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 L Gas fireplace 10.00 flea) ,1 we , 3 cpreir ► 671n A d - Uritio cry�./y .& 4 ti Flue vent for water heater or gas EP rcx - l 4 o - (L . ! i n i 9 All.. fireplace 10.00 r (� f r'�f l r/. Log lighter (gas) 10.00 C L i-tc. Luk p t.n o Wood/pellet stove 10.00 Wood fireplace/insert 10.00 - ❑ PROPERTY OWNER I ❑ TENANT - Chimney /liner /flue/vent 10.00 Other: 10.00 Name: Environmental exhaust and ventilation Address: Range hood/other kitchen 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: Fuel piping Contact name: $5.40 for first four; $1.00 for each a dditional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater . Phone: ( ) Fax:: ( ) Water heater Fireplace E -mail: Range CONTRACTOR - - Barbecue Business name: 4 V AC ,� Clothes dryer (gas) tc2� Sty v Other: S Address: r• �� (�'� MECHANICAL PERMIT FEES* City / State/ZIP: rw L a C� . ( t l 2 6 ,, Subtotal I_ _ Phone: ( ) 4 f>?2 --c' �,a Fax: ( 2 -- (9555 Minimum permit fee ($72.50) " O Plan review (25% of permit fee) / ,,ft) CCB lic.: ©C1 L State surcharge (8% of permit fee) ( g TOTAL PERMIT FEE 33.56 Authorized signature: This permit application expires if a permit is not obtained within 180 _ [/YlQ(1l days after it has been accepted as complete. Print name: St e,, rte., p_.°,3 typlSDr'1 I Date: €k. 1 Co J 0 s • Fee methodology set by Tn -County Building Industry Service Board i \ Building \PermibVMEC- PennitApp doe 11/03 4104617T (I I /0LCOM/WEB) 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. $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 s $1.25 for each additional $100.00 or stitT fraction thereof, to and including C.a 1 y 31;cso+a:f3 $100,000.00. ,a nri9UtlE2tt() $100,000.01 and up $1,396.50 for the first $100,000.00 and i,;Llr*3 t :i $1.10 for each additional $100.00 or of c 7 'ts'a;;f fraction thereof. _,. ktilidi?ztrnh Note: All new commercial buildings require 2 sets of plans. i:\Building\Permits\MEC- PermitApp.doc 12/03 2 CITY :O_F TIGARD BUIL ®INd DIVISION PERMIT #: MEC2005 -00664 i 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2006 Phone: (503) 639 -4171 I i Inspection Requests (24 Hrs.): (503) 639 -4175 ... ° 'I L. INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 47 SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: WHITEHOUSE BLACK MARKET DESCRIPTION: TI - Project Value: $17,000 OWNER: WASHINGTON SQUARE LLC, PHONE #: 603- 639-8865 CONTRACTOR: HVAC INC PHONE #: 503- 462 -4822 Inspection Request Scheduled For: Date: 10/31/2005 Pour Time: Code # • Inspection Description Confirm # Contact # Me 699 Mechanical final 019836-01 603 -432 -4822 Y Corrections /Comments /Instructions: ,------ IMP' ,0 / �� _ &VI • ' • \I \,--c r ,, J f p A SS ❑ P ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL p CA FOR I \ .PECTION ❑ ADDITI NAL ES ASSESSED . '„r w &sl ' Inspector: \ Date: _ ( 3 1 J ' ' Phone #: (503) 718 - • CITY Or TIGARD BUILDING DIVISION PERMIT #: MEC2005-00564 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2006 Phone: (503) 639 -4171 j111 Inspection Requests (24 Hrs.): (503) 6394175 __.. INSPECTION WORKSHEET FOR DATE: 9/22005 TIME: 7 :08AM PAGE: 71 SITE ADDRESS: 09336 SW WASHINGTON SQUARE RD • CLASS OF WORK: SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE: PROJECT NAME: WHITEHOUSE BLACK MARKET DESCRIPTION: TI - Project Value: $17,000 OWNER: WASHINGTON SQUARE LLC, PHONE # : 503-639-8865 CONTRACTOR: PHONE #: HVAC INC 503 -462 -4822 Inspection Request Scheduled For: Date: 9/28/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message . 615 Mechanical rough -in 016811 -01 503- 462 -4822 Y Corrections /Comments /Instructions: _„10 C 1-t 2 - Cs 62iN - v S SITE ntwainstimairey • ❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED ■ � A ' 1, Inspector: Date: `-.' Rao Phone #: (503) 718-