Permit CITY TIGARD MECHANICAL PERMIT
�1�; DEVELOPMENT SERVICES DATE ISSUED: 5/17/2005
AJ 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PERMIT #: MEC2005 -00234
PARCEL: 1S12600-00300
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G -12 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Install (1) new VAV box, (10) SA grilles & (1) return grille. Valuation: $7850.
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 5/17/200° $191.90
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchar€ 5/17/200f $15.35
TIGARD, OR 97223 [MECPLN] Plan Rev 5/17/200f $47.98
Phone: Total $255.23
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Phone: 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.
Issued By: j Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspectio 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. -
9�y? tvaisA 4.01. ss ill
Mechanical.-. e�'Viit Application FOR OFFICE USE ONLY
Receivey
City of Tigard • Date - 7 Permit No
B C.2605....-6,0, _
13125 SW Hall Blvd , Tigard, OR 97223 `� Plan Review
Phone. 503 639.4171 Fax 503 q l � �I / d , I Date/By: Other Permit
Inspection Line: 503.639.4175 E LI i
I1 Date Ready/By: WI RI See Page 2 for
Internet: www.ci tigard.or.us i,, AN t ^oo Notified/Method. Supplemental Information
TYPT,de° ®Ce COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
%G 1 v Mechanical permit fees* are based on the value of the work
❑ New construction ®�(i� repla performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ ther: mechanical materials, equipment, labor, overhead, and profit.
7 CATEGORY OF CONSTRUCTION Value: $ gSO
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling El", Commercialltndustrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: r Air conditioning or heat pump
L L J 1 0 ( , r eG I G rl (requires site plan showing placement) 14.00
City/State /ZIP: Furnace 100,000 BTU (ducts/vents) 14.00
�� � p ' / Q I L " L Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: lY - Project name: C A CHG 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),
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
,/ ` a `n n Gas fireplace 10.00
/ /V Jfl T LL a J ! L.0 V n (I £ Q x (10) S 11 Ga L. cis Flue vent for water heater or gas
a &I-aft 74 6 2 I LL!
fireplace 10.00
lT� L G Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ 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: ( ) t toilet compartments, utility rooms) 6.80
❑ APPLICANT 111 CONTACT PERSON Attic /crawlspace fans 10.00
Business name: Other: 10.00
� /C W J'4t( ((.» C - W4.0 - r trIcTOs Fuel piping
Contact name: , a21- 5 C ( 4 A C H EiZ_ $5.40 for first four; $1.00 for each additional
Address: 103 3 O S� I T. �P a ,r,a, Furnace, etc
�'� L �''vt Gas heat pump
i
City/State /ZIP li # cal-JAI 07R-14 70 (Z Wall /suspended/unit heater
Phone: () 61z,- / 5`(, 5 Fax: (.'Q3) (c � - � Y 7? Water heater
3
Fireplace
E -mail: Range
CONTRACTOR I Barbecue
Business name: /kilo t i
/I L , ,// c A. L Ci p# R4 Cl- Clothes dryer (gas)
Other.
Address: / 0 3. 0 $ ( _ / i •L/J T / ! )j 0 MECHANICAL PERMIT FEES*
City/State /ZIP: ' i o 4 f0 2 ,_ Subtotal ,/9 /° 9e)
O ) a - i5'6 ' Fax: ( Minimum permit fee ($72.50)
Phone: (
�3 �� 7� Plan review (25% of permit fee) e, 7.9 (
CCB lic.: 5i 9 3 State surcharge (8% of permit fee) / 3.-,
lip TOTAL PERMIT FEE Z,} j 2,-4 Authorized signature: ei
_ This permit application expires if a permit is not obtained within 180
Al r
/J days after it has been accepted as complete.
Print name: /%j9 Date: s- _. /2_ 2.5 • Fee methodology set by Tn -County Building Industry Service Board
Mechanical Permit Application - City of Ti •
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 .
BUILDING DIVISION . v PERMIT #: MEC2005 -00234
r
13125 SW Hall Blvd., Tigard, OR 97223 11 DATE ISSUED: 5/17/2005
Phone: (503) 639 -4171 , N11110
Inspection Requests (24 Hrs.): (503) 639 -4175 ,�__W
INSPECTION WORKSHEET FOR DATE: 6/8/2005 TIME: 7:12AM =. PAGE: 84
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G -12 CLASSSOF°WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CACHE
DESCRIPTION: Install (1) new VAV box, (10) SA grilles & (1) return grille. Valuation: $7850.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 6/8 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 008663 -01 • 503 -692 -1565 N
Corr ctions /Comments /Instructions:
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i cX PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
r
Inspector: Date: / one#: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00234
13125 SW Hall Blvd., Tigard, OR 97223 (L — DATE ISSUED: 5/17/2005
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 _ _
INSPECTION WORKSHEET FOR DATE: 5/18/2005 TIME: 7 :34AM PAGE: 76
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G - 12 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CACHE
DESCRIPTION: Install (1) new VAV box, (10) SA grilles & (1) return grille. Valuation: $7850.
OWNER: WASHINGTON SQUARE LLC, -PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 - 1565
Inspection Request Scheduled For: . Date: 5/18/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 007169-01 503-692 -1565 Y ‘
Corrections /Comments /Instructions: •
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•
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•
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❑ PASS PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006 -00234
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17 /2005
Phone: (503) 639 -4171 Jail lit
Inspection Requests (24 Hrs.): (503) 639 -4175 __...
INSPECTION WORKSHEET FOR DATE: 5/23/2005 TIME: 7 :08AM PAGE: 90
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G - 12 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CACHE
DESCRIPTION: Install (1) new VAV box, (10) SA grilles & (1) return grille. Valuation: $7850.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 5/23/2005 Pour Time:
Code # Inspection Description Confirm # Contact # - Message
625 Duct work 007482 -01 262 - 331 -3947 N
Corrections /Comments/ Instructions:
•
•
•
•
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: v Date: / / ) Phone #: (503) 718-
t .
CITY OF TIGARD „ Y -
BUILDING DIVISION PERMIT #: C20
ME o5-oo2s
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/17/2005
Phone: (503) 639 -4171 tafrih ii
.�
Inspection Requests (24 Hrs.): (503) 639 -4175 ' `_-
INSPECTION WORKSHEET FOR DATE: 5123/2005 TIME: 7:08AM PAGE: 111
SITE ADDRESS: 09642 SW WASHINGTON SQUARE RD G - CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CACHE
DESCRIPTION: Install (1) new VAV box, (10) SA grilles & (1) return grille. Valuation: $7850.
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ARROW MECHANICAL PHONE #: 692 -1565
Inspection Request Scheduled For: Date: 5/23/2005 Pour Time: d
Code # Inspection Description Confirm # - Contact # Message L l/�
699 Mechanical final 007434 -02 503-692 -1565 Y I
Corrections /Comments / Instructions:
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1kDAS ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ - ADDITIONAL FEES ASSESSED
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Inspector: " l� Date: Phone #: (503) 718-
1