Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00225
c� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 5/10/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09463 SW WASHINGTON SQUARE RD Al2 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Install duct & grilles, new VAV box & pneumatic controls.Valuation $4000.
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 5/10/200° $118.50
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchar€ 5/10/200E $9.48
TIGARD, OR 97223 •
Phone: Total $127.98
Contractor:
BEWLEY MECHANICAL
5591 SW ARCTIC DR REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97005
Phone: 626 - 8986
Reg #: LIC 63582
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: ® 1 A
Call 503 - 639 -4175 by 7:00 a.m. for inspections that • siness day.
This permit card shall be kept in a conspicuous place on the job site until completion o the project.
Approved plans are required on the job site at the time of each inspection.
Mea
l anikal Permit Application , FOR OFFICE USE ONLY
A
City of Tigard Received 0
,......- -- 96-) Permit N C
Date/By j 3_0*)'-6_2-25
Phone 503.639.4171 Fax: 503.
--
13125 SW Hall Blvd., Tigard, OR
Plan Review
Other Permit:
RECEIVED 4,a/omit
_ ail Date/By:
Inspection Line: 503 639.4175
Date Ready/By Juris 10 See Page 2 for
Internet www.ci.tigard or.us
MP 1 0 2005 Notthed/Method. ..17 Supplemental Information
,pfrilittia.,,Y,Ofk.....‘,,
construction Me Chanical permit fees* are based on the value of the work
' PAUgateration/replacement
performed Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labpr, overhead, and profit
Value $ Pa
';''''''' ''A '-;,' ' ',." • ' GAfEGISIW'ot : ;:---'''
•'RtsIDir■riiAtifiLJOIY1 /SYSTEMS .FEES*
El 1- and 2-family dwellinrnmercial/industrial 0 Accessory building
For special information use checklist
0 Multi 0 Master builder 0 Other
Description Qty Ea Total
i0: 49B" SITIE-ANFT(n/ATIO ,/■111:t:ANTi" OCATION,-37 V:: s .Z",!3 : !, - ":: Heating/cooling
Job site aldress: _A.96Sc.3 k. ,..,i 1 as V q 5 S et
I Air conditioning or heat pump
(requires site plan showing placement) 14.00
1 ...:,
City/State/ZIP: 3, cyg ciltz,-- Fumace 100,000 BTU (ducts/vents) 14.00
iS Fumace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg f t_
./apt. no.: 4
-,_ Project name: St, Ate_CC di
.15 Gas heat pump 14 00
Cross street/directions to job site: Duct work 14.00
Hydro= 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
Flue/vent for any of above 10 00
Subdivision: Lot no.:
Other 10.00
Tax map/parcel no.: Other fuel appliances
DESR]1flON 0F WORK Water heater 10 00
,. Gas fireplace 10.00
i..4_ e...,,, 01........r . „.......„..Q._ c J Flue vent for water heater or gas
fireplace 10.00
,/,/4 V fvx .,--,../ "--.e..,.....,, - c- Log lighter (gas) 10 00
e (94,• f V' Wood/pellet stove 10.00
Wood fireplace/insert 10 00
--., .:,; — >,-- , _.-• -. . . .4. „Q1-/ 41. , , I r ,-,' -, ,-.., • .., ..,; Chimney/liner/flue/vent 10.00
'r I1 PROPERTY OWNER', , "-P'''-; • ''''' . ' , ' ' ' , I.J TENANT' ' , -
' Other 10 00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10 00
City/State/ZIP: • Clothes dryer exhaust 10 00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6 80
: :--;--,: : '' '-... lir--CONTACr PERSO -- -•', 7.2 Attic/crawlspace fans 10 00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
- Fireplace
E-mail: Range
1;•,„`r ,-:-• ':,:- .---, . i' 5 ` ''.'"; ".• ''- Ceiviiirkcioa' ..,,'-;-•:'.--_-; -...,,;..:=.,k,.. , ---,,-::-,,, ,,- ,- Barbecue
I II Clothes dryer (gas)
Business name:
'. r..4-3 e ak-e c Other
Address: 5 t i se.. "9 e 0 A. -- - ..-,". '':' ':IiliCHANICA1.7., = "-
City/State/ZIP: _ ec11,/ e„, de ??Ird S— Subtotal
Minimum permit fee ($72 50)
Phone: ( ( 7 _43.(5,se.„ Fax: (•'"i 62 ) 6 ti / - 6 r y
Plan review (25% of permit fee)
CCB lic.: e 3 is State surcharge (8% of permit fee)
TOTAL PERMIT FEE
vd
Authorized signature: This permit applicaafter tion it expires if a permit is not obtained within 180
r
days has been accepted as
Print name: ire L A e , e Be 4, Date: 5 -,,_ 6 5 • Fee methodology set by Tn-County Building Industry Service Board
i \Building TermitsMEC-PerrrutApp,doc 12/03 440-4617T (11/02/COM/WEB)
Mechanical Permit Application - City of Tigard •
Page 2 - Supplemental Information
Commercial Fee Schedule:
��T ;.# �,,.�... y am,. ti7t,._ 'aa= ". �; i Z'!L' "= riv,;.c.�' `s.,._ �.fi;e ;„ ,. e:. �•-, ;v;.
•otal�Val'at on:,� %-�; y�., --,x ...� � r:�,•{. - •:_. �_„ -,�,
$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 " s
$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 • . • -
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