Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2007 -00576
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/3/2007
PARCEL: 1S12600-00300
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD T13 ZONING: C - G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
PROJECT: POTTERY BARN KIDS
Project Description: Ductwork & grilles for stock room. Add to existing system. $4000.00
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
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
9585 SW WASHINGTON SQUARE RD [MECH] Permit Fee 10/3/20W $118.50
TIGARD, OR 97223 [TAX] 8% State Surcha 10/3/200 $9.48
Phone: Total $127.98
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 462 -4822
FAX 503- 462 -6555
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 1 800.332.2344.
Issued By: Permittee Signature: 7i .l.GP i
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 Permi ►° ; • i : s -s r 1 FOR OFFICE USE ONLY
— Cit `of Ti a nd ' •� Received (�
�' g Date/By: 3 /n1 Permit 1 1 o y9
ry_ J,/ _
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review �vo7 V
Phone: 503.639.4171 Fax: 503.598.1960 C^ r. n �av r Date/By • Ocher Pe y(J
Inspection Line: 503.639.4175 L,1 Os 200 ��
Internet: �nvw.Ci.ti ard.or.t>s `! I Date Ready/By tun+ See Page 2 for
g Notified/Method: Supplemental Information
cn' Y (it i i A' ill
T ED !/•I COIV[MERCIAI; FEE*, SCHEDULE =' USE CHECI.0 LST',
Mechanical permit fees* are based on the value of the work
❑ New construction dditlo teration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ ther: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY - OF 'CONSTRUCTION - - = -- _ - - - Value: $'-); 000. CZ)
RESIDENTIAL EQUIPMENT / SYSTEMS *'
❑ 1- and 2- family dwelling ommer dustrial ❑ Accessory building For special information use checklist.
❑ Multi - family [Master builder ❑ Other:
Description I Qty. I Ea- I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
(/�•p /0 �/ C�
Air g conditioning o i n g t pump
Job site address:
- JO 5 st k(af J (requires site plan showing placement) 14.00
City /State2iP: Furnace 100,000 BTU (ducts/vents) 14.00
73 c / Ore��
no. J Project name: } t r - p ( ( Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. p 1 GL ►t•714 , ., !. ,t -I L .k Gy-S Gas heat pump 14.00
Cross street/directions to job ste: E51,0 Ft �, t Duct work 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. 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
/ � Gas fireplace 10.00
( W 4C- v `y1't-t Le 4 'i -P n a m 5 -1-(T -i of A s°t,J Flue vent for water heater or gas
�rr� o ``-_ f fireplace 10.00
S (.+/ r o cm (An OU JQJ)c (S4 - vl3 5 . 4 -if S'e ill Log lighter (gas) 10.00
J Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER ' - f ❑ TENANT Ot y/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
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT . I CONTACT PERSON Attic /crawlspace fans 10 00
T � Other: 10 00
Business name: - .1412 , �L>� Fuel piping
Contact name: . eL-f L G tty $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
-` • .... CONTRACTOR Barbecue
Business name: A�D� Clothes dryer (gas)
Other:
Address: 5(R•- SL 0 (A ),„,y MECHANICAL PERMIT FEES .. _ •
City/State/ZIP: nq C , q Q Y Subtotal J /$;
Phone: (50 (-10) H R.-).:), TF ax: ( 5(i) - 3 ) 4( jss Minimum permit fee ($72.50)
Plan review (25% of permit fee) '7' . vg
CCB lie.: 5 508 , 9 7 State surcharge (8% of permit fee) `� S � � — C rn� Gv 1 TOTAL PERMIT FEE oll .
Authorized si ature: This permit application expires if a permit is not obtained l 180
within 180
days after it has been accepted as complete.
Print name: S il'Lrn e., Rab -/Std Date: 10/3 / O 7 • Fee methodology set by Tri -County Building Industry Service Board
c\ Building\PamitatMEC- PennaApp I2/03 450- 4617T(It /0'JCOM/WEB)
CITY OF ��D W.
C ® G WR4o7- 0o67 (P
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 VIII
Inspection Requests (24 Hrs.): (503) 639 -4175 ° _ /. 5 4"
INSPECTION WORKSHEET FOR DATE: 1 D/ I Z/ o 7 TIME: 1U-6' PAGE:
SITE ADDRESS: j \ ' 4.s VI , 54_ 1 5 CLASS OF WORK:
SUBDIVISION: LOT #: 'TYPE OF USE: '
PROJECT NAME:
DESCRIPTION: n c
,�/� &leo , � O WNER: r t� o ' `J / \N v
5 PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
(-10 wi g - -1(4^---06■Q '
Corrections/Comments/Instructions:
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le....\)J1.7VP1.).) •
•
_ ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ' ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1 ° 1 2/0 7 Phone #: (503) 718- 2-49
%r,.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00576
13125 SW Hall Blvd., Tigard, OR 97223 Al DATE ISSUED: 10/3/200/
Phone: (503) 639- 4171j�l
Inspection Requests (24 Hrs.): (503) 639 -4175 ° -...
INSPECTION WORKSHEET FOR DATE: 10112/2007 TIME: 7 :01AM PAGE: 34
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD T13 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN KIDS
DESCRIPTION: Ductwork & grilles for stock room. Add to existing system. $4000.00
0 .„....--1
OWNER: WASHINGTON SQUARE I_LC, PHONE #:
CONTRACTOR: HVAC INC PHONE #: 503. 462.4822
Inspection Request Scheduled For: Date: 10/1222007 Pour Time: J
Code # Inspection Description Confirm # Contact # Message 1
615 Mechanical rough -in 057528 -01 503.516 -6412 N
Corr ct ns /Comm nts /Instructions:
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l ikIDASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/
Inspector: L/ / 0/r2 i0 Date: i f (� Phone #: (503) 718- Z 7 L
,/ , 2 ) .
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Ni(,C2007 OC1 =a76
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10V3 /2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/12/2007 TIME: 7:01AM PAGE: 33
SITE ADDRESS: 09345 SW WASHINGTON SQUARE RD T13 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: POTTERY BARN KIDS
DESCRIPTION: Ductwork & grilles for stock room. Add to exit -ling system. $4000.00
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: HVAC INC PHONE #: 503 - 462 -482
Inspection Request Scheduled For: Date: 10/17J2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 �5 Duct work 057520-02 503- 516-6412 N
Corrections /Comments /Instructions:
•
•
•
./
'A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \J /�c ( -a6 #: (503) 718- �� L (, '
p Date: Phone . ( ) /