Permit CITY TIGARD MECHANICAL PERMIT
w 4111, f'* DEVELOPMENT SERVICES PERMIT #: MEC2005 -00595
ca l II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H -16 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Duct, grille, VAV Value: $6500.00
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:
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 10/3/200E $168.50
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 10/3/200: $42.58
TIGARD, OR 97223 [TAX] 8% State Surchar€ 10/3/200E $13.62
Phone: 503 639 - 8865 Total $224.70
Contractor:
BEWLEY MECHANICAL
7911 NE 33RD DR SUITE 250 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97211
Phone: 503 - 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 :lans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 189 d.ys. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those r = s : re set forth in OAR 952 - 001 -0010
through OAR 952 -001 -0100. You may obtain copies of these rules or direct q - ons to OUNC by calling 503 - 246 -6699
or 1-88e . -
Iss d By c I �_ ' Permittee Signature:
Call 503- 639 -4175 by 7:00 a.m. for inspections t at business day\
This permit card shall be kept in a conspicuous place on the job site until completi of the project.
Approved plans are required on the job site at the time of each inspect n.
Sy6 ��y,, )�- 5 6\, .
1Vlec�
1 i_al Per i t Application FOR OFFICE USE
Cl of Tigard Received 9 ' ,' Permit No
City g r -- IP Date/By _ 61Li ii.- �,. �,. /G
13125 SW Hall Blvd., Tigard, OR 9722 I ‘ , / Plan Revi �1 4
Phone. 503.639.4171 Fax. 503 598.19 !' / a ,J , y r Clo Other Perim t�/
Ins ection Line: 503.639.4175 h Daze/By / ' OS I d ��� -�a "
p 1: !.1 - =' l _ I i Date Ready/B 0 S Page 2 for
Internet: www.ci.tigard.or.us '� CE r'ty9 21 Z Noufied/Method .;1:1 SupBJementai Information
TYPutRl P RD COMMERCIAL FEE* S EDULE — USE CHECKLIST
LA New construction ❑ Add$1�fid/�t fldr)/re Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, ead, a
ver nd profit.
CATEGORY OF CONSTRUCTION Value $ tCa
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2 family dwelling ercial /industrial ❑ Accessory building
❑ Multi family 0 Master builder For special information use checklist.
❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
/�
Air conditioning or heat pump
Job site address' i eq(f / s ' M 59/9 t. l/ ). I/i 12/1 1,' 4Ryl (requires site plan showing placement) 14.00
City/State/ZIP: J Z) V t (� + (/ e / Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: I Project name P^ , ,, , J M qii L A j C. ) r G Gas heat pump 14.00
Cross street /directions to job site: �( J Duct work 14.00
r / 6f# — /f vK�( /� Hydronic hot water system 1400
(/V �',/i/ z—.P 'P 7 c. Residential boiler (radiator or .
/
P hydronic) 14.00
l� Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: I Lot no.:
er: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF W RK Water heater 10.00
� Gas fireplace 10.00
/, /r e -C.1 - c., s : . c),e Flue vent for water heater or gas
C \ (� ' / fireplace 10.00
"� g �' �r�� r V Log lighter (gas) 10.00
� ,2 1 42/J7 r •7 i4 C ./ j - Wood/pellet stove 10.00
lllb��� Wood fireplace /insert 10.00
❑ PROPERTY OWNER IENANT - Chimney/liner/flue/vent 10.00
Other 10.00
Name: � 'e�� °s �dAr3 5 ° � Q J Q —
J 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 42 Ii:CCO TACT PERSO141/4"/C tic/crawlspace fans 10.00
/ er: 10.00
�/
Business name: ! o �� 4 & P �� Fuel piping
Contact name 7 $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone- 4 6 P ( 0 1 - G ` 8g' � F ( ) Water heater
`� l7JAl bee" yr/°C//it� h CC ,C C
Fireplace
E-mail • / � �' / �yo,t Rang e
>;
[CONTRACTOR Barbecue
� Clothes dryer (gas)
Business name: ..er.,0 / 10/21 117/„, / L4..,n �. Other.
Address: ',Cf // A) : DA_ e R/4 . - v•P '..t, ; a MECHANICAL PERMIT FEES*
City /State/ZIP: c I 97 2( 1 Subtotal
1 Minimum permit fee ($72.50) /68,S0
Phone: (.ice, ( P LCP ,SC,,, Fax: (99, CP /4_) r (,c.;3 Liter Plan review (25% of permit fee) 3
CCB lic.: ( 03 � r �, State surcharge (8% of permit fee) / , `;Z
TOTAL PERMIT FEE ,7
Authorized signature: This p ermit a expires if a permit is not obtained within 180
1,704 days after it has been accepted as complete.
Print name: G - e.• rZ , 'J �� I Date: PI ■ L / ^ C) 5 • Fee methodology set by Tri- County Building Industry Service Board
i \Budding\Permits\MEC- PermrtApp doc 12/03 440 -4617T (11 /02/COM/WEB)
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 V
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.
l:\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD
BUIL DI-NG DIVISION PERMIT #: MEC2005 -00595
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2006
Phone: (503) 639 -4171 4 1141 '
Inspection Requests (24 Hrs.): (503) 639 -4175 °7 I I
INSPECTION WORKSHEET FOR DATE: 11/4/2005 TIME: 7:08AM PAGE: 70
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H - -16. CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BERGMAN- TRAVEL _SHOP
DESCRIPTION: Duct, grille, VAV Value: $6500.00
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-8865
CONTRACTOR: BEWLEY MECHANICAL PHONE #: 503- 626 -8986
Inspection Request Scheduled For: Date: 11/4/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 ' Mechanical rough -in 020329-02 503 -819 -4832 N
• Corrections /Comments /Instructions:
_
■AL ∎' : two 4/W. • I slf
10
rei • ' ( Big. 'T D l . rc _ r , _ •
❑ 173 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
\ 610 Inspector: ( ( Date: I hone #: (503) 718 -
CITY OF TIGARD
lD
BUILDING DIVISION PERMIT #: MEC2005-00595
13125 S\■ Blvd., Tigard, OR 97223 DATE ISSUED: 10/4/2005
Phone: (503) 639 -4171 �w
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/15/2005 TIME: 7:02AM . PAGE: 80
SITE ADDRESS: 09546 SW WASHINGTON SQUARE RD H -16 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: BERGMAN TRAVEL SHOP
DESCRIPTION: Duct, grille, VAV Value: $6500,00 •
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: BEWLEY MECHANICAL PHONE #: 503 - 626-8986
Inspection Request Scheduled For: Date: 11/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021276 -01 503 - 819-4832 Y
•
Corrections /Comments /Instructions:
•
•
•
•
iKSS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITNAL FEES ASSESSED •
Inspector: r � I Date: 1 #: (503) 718-