Permit •
CITY OF TIGARD PERMIT #: MEC2005 -00209
IGARD MECHANICAL PERMIT
„,� DEVELOPMENT SERVICES DATE ISSUED: 5/4/2005
�-`��" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S12600-00300
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H -4,5 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Mechanical TI, (2) VAV boxes, (1) exhaust fan, relocate ducts and grilles. Project Value: $13,500
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: E3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 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: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WASHINGTON SQUARE LLC Description • Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 5/4/2005 $278.75
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 5/4/2005 $69.69
TIGARD, OR 97223 [TAX] 8% State Surchar€ 5/4/2005 $22.30
Phone: 503 639 - 8865 Total $370.74
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS - AND REPORTS
TUALATIN, OR 97062
Phone: 692 -1565
Reg #: LIC 5193
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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
throug• • -- 952 -0Q1 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -•00- 332 -2344. (1
, I Issu • • By: Permittee Signature: x •
Call 503 - 639 -4175 by 7:00 a.m. for inspections that bu. s 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.
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Mechan'c_ak.. ermit A1IDI1 FOR OFFICE USE ONLY
City of T Y 4 2005 Date/By: s5 t Permit No : td aO�5- -1 t . o •
13125 SW Hall Blvd., Tigard, OR 97223 MA
Phone: 503.639.4171 Fax: 503.598.1960 ARC' Plan Review
Y pF TIG uafia I ,� Date/By Other Permit
Inspection Line: 503.639.4175 GIT 1 ' e :I Ii
Ir 1G DIVI Date Ready/By: Si See Page 2 for
Internet. www.ci.tigard.or.u5
gU%LD Notified/Method. Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Mechanical permit fees* are based on the value of the work
Add ition/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: $ / 3 So 0 r
❑ 1 and 2 - family dwelling ® Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /YSTEMS FEES*
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 9/4 .5 U/ tjA.. If 06..7-6 N SQV kit 6 R.0 FYD (requires site plan showing placement) 14.00
City/State/ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
�j Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 5,69{ HQ s- Project name / 3en! gal I 6- Gas heat pump 14 00
Cross street/directions to job site: 1 1 A y / A/ 6. rU s41 u lY E` Duct work 14.00
W 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
( Z ) U l l v B o XES (I) E x He 14.5 T t /L/ /JG Flue vent for water heater or gas
Pdd 7 UT /( � 61Z (C e eS Log fireplace
igh 10 00
Log lighter (gas) 10.00
Wood/pellet stove 10 00
Wood fireplace /insert 10 00
❑ 'PROPERTY OWNER 1:1 TENANT Chimney /liner /flue /vent 10 00
Other. 10.00
Name. Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10 00
City/State /ZIP: Clothes dryer exhaust 10 00
Phone: ( ) Fax Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ilit CONTACT PERSON Attic /crawlspace fans 10 00
A Other 10 00
Business name: /7 2 2O W ME.C.f 1 r R C. ( r0
- � 417ZA G'T00. S Fuel piping
Contact name. A s�� /7 yl i1 $5.40 for first four; $1.00 for each additional
Address 0 � C C n Furnace, etc
1 ) n , e y/ T��L' /1 TI I \( / -f) A 7 Gas heat pump
City/State /ZIP:
--r
A LA"j/ J4 / D q-)06-e___ Wall/suspended/unit heater
Phone-66 �0 q7�' - lc(o5 I Fax. (5 b3 ) (O - Firepp lace lace / ?79 Wat er
E -mail: • Range
CONTRACTOR Barbecue
Business name AIC /C ()L) MCcH JAM, e4 C (,Q ,/}G rZ s
Clothes dryer (gas)
l � Other:
Address: / 03 3 0 e w i - , L A t TIN (L j MECHANICAL PERMIT FEES*
City/State /ZIP 14 , L, /$ -f/ /`( / OR_ 7 7 (7 6, 2 Subtotal
Phone. (So3) (pCt Z — 1 56 5 Fax (503) /_ 9 / —/ 7 Minimum permit fee ($72 )
� lU Plan review (25% of permit feeee)
CCB Itc. State surcharge (8% of permit fee) •
TOTAL PERMIT FEE
Authorized signature This permit application expires if a permit is not obtained within 180
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` days after it has been accepted as complete.
Print name- -)Ames DA vCNParzfi Date 5.. 4 _ as -- • Fee methodology set by Tri- County Building Industry Service Board
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
$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.
\Building \Permits \MEC- PermttApp.doc 12/03 2
CITY OF TIGARD .
1' BUILDING DIVISION PERMIT #: MEC2005-00209
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/4/2005
Phone: (503) 639 -4171 �omrmnpplh?ilii
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/28/2005 TIME: 7 :08AM PAGE: 57
SITE ADDRESS: 09516 SW WASHINGTON SQUARE RD H-4,5 - CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: . TYPE OF USE:
PROJECT NAME: BEN BRIDGE JEWELERS
DESCRIPTION: Mechanical TI, (2) VAV boxes, (1) exhaust fan, relocate ducts and grilles. Project Value: $13,500
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639.8865
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 7/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 012288 -01 503 -692 -1565 N
Corrections /Comments /Instructions:
it I I fif i ri
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[ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS .
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED
IAD Inspector: Date: � hone #: (503) 718 -