Permit /} 0.
A CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2003 -00003
I i ' j DEV W H Blvd., MENg S SERVICES 639 -4171 DATE ISSUED: 1/10/03
PARCEL: 1S135BA-00102
SITE ADDRESS: 10100 SW WASHINGTON SQUARE RD A -1
SUBDIVISION: OAKBURG ZONING: C -G
BLOCK: LOT: 001 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: A3 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:
> 10000 cfm: GAS OUTLETS:
Remarks: Run line set and pressure test for ice makers. Project Value: $1,400
Owner: FEES
PPR SQUARE TOO LLC Description Date Amount
BY MACERICH COMPANY
ATTN: JANET FISHER, ASSET MGMT [MECH] Permit Fee 1/10/03 $72.50
SANTA MONICA, CA 90407 [TAX] 8% StateTax 1/10/03 $5.80
Phone: Total $78.30
Contractor:
HELPING HAND REFRIGERATION
2410 SE 50TH
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Final Inspection
•
Reg #: LIC 152861
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 -00 IP
Issued By: .� Permittee Signature: ( 71 - 5\",..' ,
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next bu 4 ss day
Mechanical Permit Application FOR OFFICE USE ONLY
# Received Mecham al 2 r�
., Date/By: 1 I Permit N a oo3'' 0
Planning Approval Building
City of Tigard Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
���r f
Internet: www.ci.tigard.or.us a �, r!I I Date/By: No.:
Contact Juris.: El See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 _" Name /Method: Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
n New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
.[1 Addition/alteration /replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanica r materials, equipment, labor, overhead and profit.
❑ 1 & 2 - Family dwelling Commercial /Industrial Value: t See Page 2 for Fee Schedule
❑ Accessory Building Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) [ Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add - on air conditioning ** 14.00
Job site address: to t 60 S. Or Lt . Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: t ( - Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: I Repair units 12.15
Lot #: Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
V , ••■ -- _ ..412 Flue vent (water heater /gas fireplace) 10.00
.1 p � Log Wood/Pellet (gas) 10.00
4\._ Wood/Pell stove 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER 1 ❑ TENANT Other: 10.00
Name: Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address: Clothes dryer exhaust 10.00
City /State /Zip: Single duct exhaust
Phone: Fax: (bathrooms, toilet compartments,
ISI APPLICANT ®' CONTACT PERSON utility rooms) 6.80
Name: ?uv--. Attic /crawl space fans 10.00
Address: .g-- p `- , ? . .SO 441 Other: 10.00
,gyp Y Fuel Piping
City /State /Zip: VQ. . —z� V q 7-16 to * *($5.40 for first 4, $1.00 each additional)
Phone: 563 - 8.67 Furnace, etc. ** d? '�a7T I Fax: Gas heat pump **
E -mail: WalUsuspended/unit heater **
CONTRACTOR _ Water heater **
Business Name: l4o.r,,t, -u-j Fireplace **
Range * *
Address:
.2. el 1p . SD — BBQ **
City /State /Zip: P�,, -J / Q ?7 2O� Clothes dryer (gas) **
Phone: , ' - _23`I -90fC Fax: x`03 - 69 45 Other: **
Total:
CCB Lic. #: 1 5 $6 M ec h anical Permit Fees
Authorized Subtotal: $
Signature: ' 41 ,--„, Date: _ 7� 3 Minimum Permit Fee $72.50 $ ' a ,Sts
Ian Review Fee (25% of Permit Fee) $
(Please/print name) State Surcharge (8% of Permit Fee) $ c; O n
TOTAL PERMIT FEE $ 3D
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard
Page 2'•- Supplemental Information ', . ,
•
Commercial Fee Schedule:
'Total " . :iPermit`F,ee: - ' .
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including ,
$50,000.00. •
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
-,' Assumed.' ValuationsferAppliance: - - _ '
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805 •
< 3 hp; absorb.. unit, ll 955
to 100k BTU d� •
3 -15 hp; absorb. unit, ,, .1,700 '
l O1 k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb. unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU •
Air handling unit to 10,000 cfm , 656
Air handling unit >10,000 cfm ` 1,170
Non - portable evaporate cooler 656 •
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590 •
Other unit, including wood stoves, 656 .
•
inserts, etc. '
Gas piping 1-4 outlets 360
Each additional outlet 63 ,
TOTAL COMMERCIAL ' . . $ -
VALUATION: . .
is \Dstsemiit F
\P rms\MecPermitAppPg2.doc 01/03
•
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
/ BUP
Received `� Date Requested r — � 7 AM PM BUP
/
Location / v � 00 ,� w , � , ) � Suite MEC 3 - � 3
Contact Person k`c YC/ Ph ( ) PLM
Contractor 7 h ( ) SWR
BUILDING Tenant/Owner � ' i ELC
Footing
Foundation ELC
Access:�
Ftg Drain V m ELR
Crawl Drain V _
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICA
Post & Beam
Rough -In p
Gas Line I -
Smoke Dampers
Fin _
A PART FAIL
ECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm •
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: 111 Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date • Inspector Ext
Other: ' •
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested — AM PM BUP
Location l D (0d L4) /4" - S Q. D v Suite MEC £2 3 6 2 d
Contact Person ( ar-v1 Ph ( ) 86 7 - ea- 7 1 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner -�ao ELC
Footing
Foundation ELC
Access:
Ftg Drain / , �yt ■ . ELR
Crawl Drain 1� i
Slab Inspection Notes: ticoes SIT
� +�
Post & Beam _tea N� ��
Shear Anchors
Ext Sheath/Shear $zt
Int Sheath/Shear
Framing •
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm 1 •�
Susp'd Ceiling ,._rJ L 1 (� V
Roof c
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
- Under Slab
Rough -In •
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam pp��
Rough -In �U\J ta-t/ I
Gas Line — a
Smoke Dampers
erg ,
a) PART FAIL
ICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date 2 S ` ,- Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL