Permit C ITY OF TIGARD MECHANICAL PERMIT
4 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00514
' -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/31/2004
PARCEL: 1S12600-00300
SITE ADDRESS: 09585 SW WASHINGTON SQUARE RD MGMT
SUBDIVISION: IZIII ISEIENIGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: NEW FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: S4 VENTS W/O APPL: VENT SYSTEMS:
STORIES: 4 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: 2
> 10000 cfm: GAS OUTLETS:
Remarks: Phase 1, south parking structure. Install (1) exhaust fan, CO sensor and ductwork.
Project value: $18,235
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY MACERICH COMPANY [MECH] Permit Fee 8/31/200 $276.32
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 8/31/200 $69.08
TIGARD, OR 97223 [TAX] 8% State Surchari 8/31/2001 $22.11
Phone: Total $367.51
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Phone: 692 Mechanical Insp
Final Inspection
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.
Issued By: "41111■ - 40, / ,1 Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
95 SW Lu f S q Ro
.Mechanical Permit Application Received FOR OFFICE Mechanical aI ONLY
pAit�e F S
t'TRuCTL Date/By a e V Permit No.. J
P Approval Building
City of Tigard DateBy: Permit No :
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By ff -30-D / OS p Permit No
Phone: 503 -639 -4171 Fax: 503 -598 -1960 Avow Post - Review Land Use
Date/By: 1? fi D D Case No :
Internet: www.ci.tigard.or.us .' Contact� 144/ J iria - ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 Name/MethodJQ, / ,a• Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
( New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
❑ Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling Commercial /Industrial Value: $ / ) Z 3 S ---- See Page 2 for Fee Schedule
❑ Accessory Building Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: g555 SLLJ idA _s 4 Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Pro Project Name: Hydronic hot water system 14.00
1 SOU T N PAR T t,- C l 2UGTOR.c 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: Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
. //II DESCRIPTION OF WORK Gas fireplace 10.00
I NS I a L( U� EY H!? u Ent-r 1 l f S005 tL Flue vent (water heater /gas fireplace) 10.00
. W TSL IL Log lighter (gas) 10.00
AN n vr
`( Wood/Pellet stove 10.00
Wood fireplace/insert 10.00
Chimney /liner /flue /vent 10.00
❑ PROPERTY OWNER I ❑ 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,
❑ APPLICANT le CONTACT PERSON utility rooms) / 6.80
Name: J') (2.,, C 1-t Attic /crawl space fans 10.00
Other: 10.00
Address: Io. Z0 ,S(s) - a (.11 Thy go A A Fuel Piping
City /State /Zip: ( n LA D oQ , 1 7 G- z_ * *($5.40 for first 4, $1.00 each additional) Furnace, etc. **
Phone: 1, (ate 50 ,E (p� 1 -I k 79 Ga h eat pump **
S"03 Z, s
E -mail: Wall /suspended/unit heater **
CONTRACTOR Water heater **
Business Name: /702 p (,a iiiis GH/Jfvir_A L Co traAerA25 Fireplace **
Range **
Address: A6 330 S GJ TLu,3 Lq rm iz i\ BBQ **
City /State /Zip: % ug cM vJV 6 .1706Z_ Clothes dryer (gas) **
Phone :563 ( o 6 ( 0 6 1 - - / 1 Fax: S()3 6,9f-/ y 79 Other: **
CCB Lic. #: s 9 Total:
Mechanical Permit Fees*
Authorized q�_ �, 76 . 3 ,Z
Signature: f 1 Date: ��Z Q Subtotal: $ Minimum Permit Fee $72.50 $
) fc D vdN cal � Plan Review Fee (25% of Permit Fee) $ 47 • of
/ v (Please print name) State Surcharge (8% of Permit Fee) $ Z .
TOTAL PERMIT FEE $ 3 6 7-.S I
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 Z.—Supplemental Information
.
Commercial ,Fee Schedule:
Total Valuation: Permit Fee:
$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 2 }
$1 54 for each additional $100.00 or t
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 Valuations Per Appliance: . {�� ` -
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, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to I 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:
i:\Dsts\Permit Forms\Iv1ecPermitAppPg2.doc 01/03
FATY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested /' " Z Z AM PM BUP
Location C 9 c W S /LA .- S& , Suite MEC SOD V —DO 574L
Contact Person Ph ( ) PLM
Contractor 51/VY\ l Ph ( ) (n 9 a- /S1 c. SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: c SIT
Post & Beam V r
Shear Anchors - - -- / -
Ext Sheath/Shear - / Z - , e.- - - - - - . -- i
Int Sheath/Shear C D
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler i • Fire Alarm (A)612-r-04:
' Cr Susp'd Ceiling ∎∎ -
Roof
Other:
Final � J �� q (� .�, p�
PASS PART FAIL
6' 5,�,,/J � ` _ ,r �� ( E- B y tk.,,r
PLUMBING ` (
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains /
Catch Basin / Manhole '
Storm Drain ��
Shower Pan i �' C
Other:
Final .
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
PA PART FAIL
LE ICAL
ice
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final 0 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call f %r reinspection RE: i El to insp t - no access
Fire Supply Line , c f O.. W ADA � • •
Approach/Sidewalk Date 10 Z O , Inspect gir �` ' / Ext
Other:
Final DO NOT REMOVE this Inspection record from the Job site.
PASS 'PART FAIL