Permit 1
q •
CITY TIGARD MECHANICAL PERMIT
1, I� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00400
'� I � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6394171 DATE ISSUED: 6/23/2004
PARCEL: 1S12600-00300
SITE ADDRESS: 09426 SW WASHINGTON SQUARE RD K -4
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Modify ductwork, add ceiling return grille and pneumatic therostat smoke detection, ceiling exhaust fan. Vatue:
$5,000
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 6/23/20(2Y $141.50
9585 SW WASHINGTON SQ. RD. • [TAX] 8% State Surcharl 6/23/200 $11.32
PORTLAND, OR 97223
Phone: Total $152.82
Contractor:
JACOBS HEATING + A/C
4474 SE MILWAUKIE AVE
PORTLAND, OR 97202 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
Reg #: LIC 1441
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.
Issued By: Permittee Signature: orn
Call (503) 6394175 by 7:00 P.M. for inspections needed the next business day
FROM :Ja cob sHea t i n 9 FAX NO. Jun. 23 2004 08:54AM P2
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,-dort-F1‘,... ' ? ' d [R Lam- C L V E 'U Date/By: Permit No,.
13125S MIA 61Vd. Plan Review Other
Tigard, Oregon 97223 . " Date/By: Permit No., . . ,
ni .
Phone; 503 - 639 - 4171 Fax: 503- 598 -19601 ;, : Pod-Review Land Use
)piih. I Daffy Case No:
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Internet: WvV.Cl:ti ard.oi.us . � { Contact lurje, ® See Page 2 tot! .',
24 -hour Inspection Request - �� ��� Narne./Method: ! y supplemental laforieetlon.
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I■ New construction ' III Demolition Mechanical permit fees'" are based on the total value of the work
I I Addition/alteration/T • lacement • Other: performed. Indicate the value (rounded to the nearest dollar) of all
!['M -71 fr' t ." 1 w I i i r {�(- r� i t � . mechanical materials, equipment, labor, overhead and profit
Iri'• rlr�.', L�i�. ? '? i1 Sh. k� ' f�.. ��f;o k��l, t�lll 6�1i�[ f1�9, FF" �.�1��iPl,r�l�li�i�nli�iZ;�t'�
■ 1 & 2 -Famil dwellin • !1'!' Commercial/Tnndusirial Value: $ r tl r • See Page 2 for Fee Schedule
Multi-Family ai ' o,'„di? t lea 6 f: 'i51M : ' ,< ' .i1 J"� J "ij. I J 9 G �1; • � ;: q.
ii Accessory Buildin: l■ Y 11.9" Il �.f.� b_�IIS s. _ �it 1 <l .,, �.h.I �.ot a..,, .
Descri tlnn s LtMI Total
• Master Builder ; l y • Other: -e lide. '' -
. oo1W'' . ;,
ligieR iV IIE`�' .I! � . :.' y! "iia lgY .001;3 �J i e.i /4YL VAiw!t li Furnace - add air conditionin: •• 14.00
Job site address: a h■ as .,„ • A 1, ' a. das heat •u • = 14.00
' Suite #: S S " B ' ' ': ld _ ./A • t.'-: Duct work 14 -00 -
�p 1d • onic hot water stem .1111 14.00
Project Name: Residential boiler
Cross street/Directions to job site: for radiator or h dronic - stem 14.00 In
Unit heaters (fiiel, not electric)
(in wall, in - duct, suspended, etc.) , 14.00
Flue/vent for an of above 10.00 ..:
Subdivision: LLot #: Re • air units - 12 15
Oftithi'uetA' ", -Tai= `,c -"
Tax ma • / • eel #: P y Water heater ■ 10.00
iofS llii�E�''.
,. 1. o) ; . �J ' ii1,il�ff,W r� 0R i"I'' r2 }
�: , � Gl, � ,� . i. �' ��.o� �� ��`' �A Gas fi lace 10.00
M o a i ti a a &. • E e i • v e.. 1•' v1 Flue vent water heater /: ' fr lace -
solo Lo_ li for 10.00
gY 1 . 1 ‘ d pne um &I L - eimo Wood/Pellet stove M 10.00 -
- s ' ; 10.1k t . a V e ! L 1' a Wood (i dace/insert 10.00
Chimne /liner /flue/vent 10.00
I ,,q`., a i1 F • ,
V I, W ' f �,, I d 'I ;'... �,E�„f i l' 1l ;i0 it{ S- ���{,����'� �, � ' rr� x� E ' : 1y Other: 10.00 ' ��
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„,.1 t...4,I� ..: t... ei�'.'111.. 1 .. is n, rL4iu �.t ?III. f. \i.i- .S.��t3�lY.�l`I lII1�IN1�iril:��luY�r. �'�IJ
Name: ( C, . 5 ' A., w, ,C,io.>G t "< ", t,. ' .6',''`," '
Range hood/other kitchen equipment 10.00
Address: ‘ h__ . :Ana v.- I • ci Red • Clothes dryer exhaust IIIII 10.00
Cat /State/Zi • : • ' .6 4, ' y g, T►.f 310-75 Single duct exhaust
P .. , e: ,1 . - '43 Fax 1pl5 8 - qq 81 (bathrooms, toilet compartments,
kvi4 'li:' aS I i1 #,Rv ?/41 1 JII i 1 1 ( ,
� C.1f<�I4 u , /ar util rooms 6.80
�,�. .. ��..i N� „�1,�4k�1 }a Rrr�,L�_Il L� ,�.�.I ' 1�.1 _ .I. ..: 1 . 4,/ .�ti.has��. � �
Name: - '�� R Qc 4 • Attie/crawl s. ace fans 10.00
�•�� Other; ■ 1 0.00
Address: ir , . _ . . .. .... J . .... .... ;1. ;':i' ' : f
Ci /State/Zi • : �-� •• 5 .40 f that 4 S1.00 each addition
Phone: T FO. I., Mill IIIIIMIli
rt .. Wall /su nded/unit heatc ■
gemi;i meimamYi oi.58I i a,1,,If 11E - I . .1 ,I '.; , ,it N!L'p"�l�l'lii!Ii�ti�n !o4li{11 Water heater
Business Name: f;C0 • S : a • -, . Fire.lace ■ ""
Address: yy f7 `t. vvl; Lot)G:A. Y,.• Q Ran e =
Ci /State/Zi • : •t lc: - 1 .LO Clothes . - r :. " '
Phone:?, ' . 3 l Fax: .1,3` z S Other. .
CCB Lic. #: \.� - .- -.._. Total
�y 111111114ammmir=
Authorized � .
D ate :SQ22 - Subtotal: Ejr7��
Signature: Minimum Permit Fee $72.50
_11.1t t e_IO (A)C \c iov�., - •Ian 'eview 'co 'oo 'enmt `eel
J (Please print name) State Surchar: a 8% of Permit Fee riMirigF
TOTAL. PERMIT FEE 131
Notice: This permit application expires If a permit Is not obtained within *Fee methodology set by Tri- County Building Industry Service Board.
180 days after it Has been accepted as complete. **Site plan required for enamor A/C units.
•
is \Dsts\Pormit iorms\MocPermtApp.doc 01/03 - 1 - ) r
CITY OF TIGARD 24 -Hour
131j1r Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received Date Requested 17-1 AM PM _ BUP ,^,
Location / a % L01 - SQ • Suite MEC ��� J d q ( Mc )
Contact Person Ph ( ) a ' 73 3 I PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
'Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
- ASS ' PART FAIL
LEC ICAL
Service
Rough -In
UG /Slab
Low Voltage •
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL