Permit ( o
CITY TIGARD MECHANICAL PERMIT
In DEVELOPMENT SERVICES PERMIT #: MEC2005 -00355
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/24/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: HVAC TI. Project value: $50,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: 1 VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
ELE 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: 2 OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 8/24/200f $771.50
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchar€ 8/24/200f. $61.72
TIGARD, OR 97223 [MECPLN] Plan Rev 8/24/200E $192.87
Phone: 503 639 - 8865 Total $1,026.09
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone: 692 - 1565
Reg #: LIC 5193
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 -33 - 344.
Issued B • A44.44e Permittee Signature: ,� " i/
Call 503 - 639 -4175 by 7:00 a.m. for inspections that 7 ay.
This permit card shall be kept in a conspicuous place on the job site • it co -lion of the project.
Approved plans are required on the job site at the time of each inspection.
732? SW WAS,* ) wit' so .
M'2chtnical Permit Applications ,,, FOR OFFICE USE ONLY
City of'rigard ta ��� D '�� Permit No puu_ ' g : 3
13125 SW Hall Blvd Ti aril OR 97223 I i
g
Phone 503 639.4171 Fax Plan Revi -
503 598.1960 I 1 Date/By �' , _ Other Permit « , i , r 5 ` p 02.5"
Inspection Line 503 639.4175 {++aa J � �
tigard.or us �� � a Date Ready a 3uris See 'age 2 for
Internet www.ci tl
g ifie. etho hod 7 �� / Q , Supplemental Information
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TYPE OF WbiNC ni r COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
1:I 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 $ � , 6
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist
❑ Multi- family 0 Master builder 0 Other:
Description I Qty I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 9329 S.W. WASHINGTON SQUARE ROAD (requires site plan showing placement) 3 14 00
City /State /ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ducts /vents) • 14.00
Furnace 100,000+ BTU (ducts /vents) 17 90
Suite/bldg. /apt. no.: T -7 I Project name: SEPHORA Gas heat pump 14 00
Cross street/directions to job site: Duct work i 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 Z 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
INTERIOR REMODEL OF EXSISTING RETAIL TENANT SPACE FOR NEW Gas fireplace 10 00
Flue vent for water heater or gas
TENANT fireplace 10 00
Log lighter (gas) 10 00
Wood/pellet stove 10 00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER I ® TENANT Chimney/liner /flue /vent 10 00
Other 10 00
Name: SEPHORA Environmental exhaust and ventilation
Address: 525 MARKET STREET, 11 FLOOR Range hood/other kitchen
equipment 10 00
City /State /ZIP: SAN FANCISCO, CA 94105 Clothes dryer exhaust 10 00
Fax: 415 284 -3421
Single-duct tomp rtm ents (bathrooms, rooms) s,
Phone:
(415)284-3477 ( ) toilet compartments, utility rooms) 2 6 80
. ❑ APPLICANT ® CONTACT PERSON Attic /crawlspace fans 10 00
Other 10 00
Business name: SEPHORA Fuel piping
X Contact name: TIM SCHENK $5.40 for first four; $1.00 for each additional
Address: 1120 EAST 80 STREET, SUITE 211 Furnace, etc
Gas heat pump
City /State /ZIP: BLOOMINGTON, MN 55420 Wall /suspended/unit heater
Phone: (800) 541 -0821 Fax: : (952) 854 -4909 Water heater -
Fireplace Ic I '
E-mail:
Range O S
CONTRACTOR Barbecue --
Business name:'T' B:B- a.Q a „b0 Clothes dryer (gas) 4
- � i1 Other � (�
Address: MECHANICAL PERMIT FEES* �/`
City /State /ZIP: Subtotal
Phone: ( ) Fax:( )
Minimum permit fee ($72 50) ') f ,55C)
Plan review (25% of permit fee) - 7. -- —
•
CCB lic.: State surcharge (8% of permit fee) (B r
TOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained 'thin 1 80
days after it has been accepted as complete.
Print name: Date: * Fee methodology set by Tri- County Building Indtry Service Board e l
I \ Building\PermitsU�{EC- PermitApp doe 12/03 440-4617T (i I /02 /COM/WEB) f/ O ^��
I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200500355
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 812412005
Phone: (503) 639- 4171 �±
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 61
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPI-IORA
DESCRIPTION: HVAC TI. Project value: $50,000
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 020713 -01 303- 921 -4940 N
Corrections /Comments /Instructions:
•
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
CITY .OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2005 -00365 i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/24 /2005
Phone: (503) 639 -4171 V Inspection Requests (24 Hrs.): (503) 639 -4175 .,...
INSPECTION WORKSHEET FOR DATE: 10/27/2005 TIME: 4: 11PM PAGE: 66
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: HVAC TI. Project value: $50,000
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OWNER: WASHINGTON SQUARE LLC, PHONE #: 503. 639 -8866
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 10128/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 019588 -01 503 -692 -1565 N
Corrections/Comments/Instructions:
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f P flu•H , ' V IAL APPROVAL El CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
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Inspector: Date: 1 :1 , � J� Phone #: (503) 718 -
CIT TI,GARD VI (--
, BUILDING DIVISION PERMIT #:p c ----- S S
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A hl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 1J,4Sit r - SG -'I' 7 CLASS OF WORK:
SUBDIVISION: 13Zc, kJ* J m , J LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: ___,..... ,:_,,... i i PHONE #:
CONTRACTOR: calk PHONE #:
Inspection Request Scheduled For: bate: Pour Time:
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Code # Inspection Description Confirm # • Contact # Message
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Corrections /Comments/ Instructions:
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❑ P A ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL • • R INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 Date: /6/ --' Phone #: (503) 718-
CITY',QE TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00355 1
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/24 /2005
Phone: (503) 639 -4171 Ne
Inspection Requests (24 Hrs.): (503) 639 -4175 "__..
INSPECTION WORKSHEET FOR DATE: 9/19/2005 TIME: 7 :06AM PAGE: 57
SITE ADDRESS: 09329 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: SEPHORA
DESCRIPTION: HVAC TI . Project value: $50,000
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639 -8865
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 9/19/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 015963-01 503-692-1565 N
Corrections/Comments/Instructions:
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•tA -, IIIV I . 7 IA I. W . r • `�" ,„„. ,
. .
❑ PASS PARTIAL APPROVAL
❑ CANCEL ❑ NO ACCESS
❑ FAIL • ❑ CALL FOR INSPECTION ❑ ADDITIONAL F ES ASSESSED
Inspector: 1� �• • Date: I 05 Phone #: (503) 718 -