Permit C ITY OF TIGARD MECHANICAL PERMIT
I n DEVELOPMENT SERVICES PERMIT #: MEC2005 -00069
. � I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/22/2005
PARCEL: 1S12600-00300
SITE ADDRESS: A19-7-08 WASHINGTON SQUARE RD F -2
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: q7 b c LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: 1
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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm:
GAS OUTLETS:
Remarks: Vav boxe, duct htr.,stat ductwork and grilles. Value: $4000.00
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 2/22/200E $118.50
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchar€ 2/22/200: $9.49
TIGARD, OR 97223
Phone: Total $127.99
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97222
Phone: 462 - 4822
Reg #: LIC 50897
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.
Issued By: � ""'`'- /�`�" Permittee Signature: , 0 _, o 10C�iJU�2
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical % .. . FOR01 MCI: I'SI:O;NI.1
City of Tigard Received /0 5 Perm No. Jln co
1 5j .. 13125 SW Hall Blvd., Tigard, OR 9722
Phone: 503.639.4171 Fax 503 598.190t B 2 2 2005 'Oh! Date/By Other Permit
Inspection Line. p. -iY'
503.639.4175 �• r �
Plan Review III c
I Date Ready/By sans El See Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIC�AiZD Y Notified/Method Supplemental Information
BUIIIIAVAWISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
® New construction ® Addition/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: $ $4,000.00
El 1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ® Commercial/industrial ❑ A ccessory building
For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description I Qty I Ea. I Total
TA, JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: SW Washington Sq Rd. Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU ( ducts/vents) 14 00
Fumace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Space F -9A Project name: Crabtree & Evelyn TI 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
Gas fireplace 10.00
furnish & install vav box w /electric duct htr & pneumatic stat, ceiling exhaust fan Flue vent for water heater or gas
ductwork & grilles fireplace 10 00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER IS TENANT Chimney/liner /flue /vent 10.00
Other. 10.00
Name: Crabtree & Evelyn 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) 6.80
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: HVAC, Inc. Fuel Ito
PP g
Contact name: Diane Gardner $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 -mai I:
Range
CONTRACTOR Barbecue
Business name: HVAC, Inc Clothes dryer (gas)
Other
Address: 5188 SE International Way MECHANICAL PERMIT FEES*
City/State /ZIP: Milwaukie, Oregon 97222 Subtotal
Phone: (503) 462 -4822 Fax: (503) 462-6555 Minimum permit fee ($72 50) �j
Plan review (25% of permit fee)
CCB lic.: 50897 State surcharge (8% of permit fee) ,J p
TOTAL PERMIT FEE /-7 f(. ? )
Authorized signature: � ie � Thi perm app li c ation expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name: Sherrie Rnhincon I Date: 2/1R/05 I " Fee methodology set by Tn -County Building Industry Service Board
CITY OF TIGARD `\
BUILDING DIVISION • PERMIT #: MEC2005 -00069
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/22/2005
Phone: (503) 639 -4171 P r , , I
Inspection Requests (24 Hrs.): (503) 639 -4175 -.. `
INSPECTION WORKSHEET FOR • DATE: 4/12/2005 TIME: 7 :09AM PAGE: 17
SITE ADDRESS: 09706 SW WASHINGTON SQUARE RD F -9A CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: CRABTREE & EVELYN
DESCRIPTION: Vav boxe, duct htr.,stat ductwork and grilles. Value: $4000.00 .
OWNER: WASHINGTON SQUARE LLC, . PHONE #: _
CONTRACTOR: HVAC INC PHONE #: 462 -4822
Inspection Request Scheduled For: Date: 4/12/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 4 : / Mechanical final 004312 -01 503.462 -4822 N
i orrecti ns /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑.FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:/6 S Phone #: (503) 718-