Permit CITY TIGARD MECHANICAL PERMIT
i �► DEVELOPMENT SERVICES PERMIT #: MEC2006 -00070
DATE ISSUED: 4/24/2006
--.& 13125 SW Hall Blvd., Tigard, OR 97223 503-639-4171
PARCEL: 1512600 -00300
r' SITE ADDRESS: 09610 SW WASHINGTON SQUARE RD G -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project'Description: Duct work, grilles remove & replace VAV box. Valuation: $ 6,500.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [MECH] Permit Fee 41241200E $168.50
TIGARD, OR 97223 [TAX] 8% State Surcha 41241200E $13.48
Phone: Total $181.98
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 691 -1879
PRI 503- 692 -1565
Reg #: LIC 5193
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.
AK Issued By: ! 7 Permittee Signatur = , �
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.
,—,. f.---- /- , _ 1 \I En
Mechanical Permi c t FOR o[[IC[ us[ ONLY
1 i.. Received
City of Tigard Received Permit No.-
13125 SW Hall Blvd., Tigard, OR 97223 DD 9 4 006 Plan Review
Phone: 503.639.4171 Fax: 503.598.196( 6Pn i- iii,,,n I ,. D /B Other Permit • Ins ection Line: 503.639.4175 /:'.
p _J �. ' ' I_ 1 � Date Ready/By Juris ® See Page 2 for
w
Internet: ww.ci.tigard.or.us CITY OF IllJtt' Notified/Method: Supplemental Information
1. : 1 T i1�fk1T
- 1.1' '•Tv OF WORK _ COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Addition/alteration/replacement 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, overhead, and profit.
' CATEGORY OF CONSTRUCTION , Value: $ S O 0 0
El I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMEN // SYSTEMS FEES*
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address' i(7 p..l vl 69 rt 6i)—( Air conditioning or heat pump
G (requires site plan showing placement) 14.00
City /State /ZIP: - / �,L ( '' 7x23 Furnace 100,000 BTU (ducts/vents) 14.00
/ Furnace 100,000+ BTU (ducts/vents) 17.90 -
Suite/bldg. /apt. no.: ! _ Project name: /4..,t7XA... Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00 \
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
J 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
• ' DESCRIPTION OF WORK - . Water heater 10.00
`,,- Q Q � Gas fireplace 10.00
p,,,,,,,,- to J 9_2-04 �R
4 .w -'--Q `F V 4- U 6 ? y Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10 00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
'❑ PROPERTY OWNER - V ❑ TENANT
Chimney/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
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) partments, utili rooms 6.80
❑ APPLICANT ❑- CONTACT , PERSON - ' Attic/crawlspace fans 10.00
Business name:
Other: 10.00
Fuel piping
Contact name: $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
Fireplace
E -mail:
Range
- CONTRACTOR - _ , Barbecue
Business name: % t^fl 1,
Clothes dryer (gas)
Other:
Address: . -
MECHANICAL PERMIT FEES* -
City /State /ZIP: Subtotal /- 6W
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 57 9 3 State surcharge (8% of permit fee) )1 Y
/ TOTAL PERMIT FEE ile/ ,
Authorized Signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: A_,' 7 — 5C / f 4 /)( I Date: • Fee methodology set by Tn- County Building Industry Service Board
Budding \
I\ Permrts\NEC P 12/03 440- 4617T(II /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
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.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 6----C
BUILDING DIVISION PERMIT #: R.066 ' Do o 76
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171 ,,11 i�l
Inspection Requests (24 Hrs.): (503) 639 -4175 ...'!+� _-
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: ge ` d w A' ,S-.Q CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: �14_,.../ PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: Sid 00( Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 is 4 1 a 9N ciel -�9^0
Corrections/Comments/Instructions:
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1. P ASS ❑ PARTIAL APPROVAL ❑ ' CANCEL ❑ NO ACCESS
n FAIL 0 CALL FOR INSPECTION El ADDITI NAL EES ASSESSED
Inspector: Da l4O l 7� Phone #: (503) 718�� k )