Permit • A CITY OF TIGARD MECHANICAL PERMIT
� DEVELOPMENT SERVICES PERMIT #: MEC2001 -00083
r� II 13125 SW Hall Blvd., Tigar OR 97223 (503) 639 -4171 DATE ISSUED: 3/7/01
PARCEL: 1 S 126C0 -01107
SITE ADDRESS: 09400 SW WASHINGTON SQUARE RD
SUBDIVISION: tORAISVINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
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:
LPG 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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Gas piping only for new generator (replacement of diesel generator with gas).
Owner: FEES
PPR WASHINGTON SQUARE LLC Type By Date Amount Receipt
BY MACERICH COMPANY PRMT CTR 3/7/01 $72.50 2720010000
ATTN: JANET FISHER, ASSET MGN 5PCT CTR 3/7/01 $5.80 2720010000
SANTA MONICA, CA 90407
Total $78.30
Phone:
Contractor:
REITMEIER MECHANICAL INC
7051 SW SANDBURG ST STE 400
TIGARD, OR 97223 -8011 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 603 -0205
Reg #: LIC 63242
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 -0010L#hroue OAR 952 -101 -0080. You may obtain copies of these rules o direct questi +ns to OUNC by
calling X63)24 -91 • .
Issue y: ` .4 . ! / Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the ne f usiness day
Mechanical Permit Application ul
Date received: x/7/0 / Permit no.:/ /F'2)D1� 3
f A f 1 • �''Y: � City of Ti Project/appl. no.: Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: By: ..��� = erptno.:
Phone: (503) 639 -4171 k
Fax: (503) 598 -1960 Case file no.: Payment type:
Land use approval: Building permit no.:
TYPE OF 1' 'R1 IT
❑ 1 & 2 family dwelling or accessory X Commercial/industrial ❑ Multi- family ❑ Tenant improvement
❑ New construction ❑ Addition/alteration/replacement ❑ Other:
JOB SITE INFORMATION COMMERCIAL VALUATION SCHEDULE
1
Job address: 94 $W 1.4.)ASt4 /AJ4 SQtlA Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: lu(eQV iii /Asa 63?, I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ 233 2 • at' •
Lot: IBlock: ISubdivision: 'See checklist for important application information and
Project name: jurisdiction's fee schedule for residential permit fee.
City /county: I ZIP: 1 & 2 FAMILY DWELLING PERMIT FEE SCHEDULE
Description and location of work on premises: pt PLUG re/L AND COMMERICAL/INDUSTRIAL EQUIPMENTSCIIEDULE
ILEP1.14C601 .WT 4.E /JE A.TDR. (II/ otM P) Fee(ea.) Total
Est. date of completion /inspection: / Description Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? ❑ Yes ❑ No , Air handling unit CFM
space insulated? ❑ Yes ❑ No Air conditioning rati of existing plan C
Is existing system
8 P Alterati of existing H VAC system
' MECHANICAL CONTRACTOR Boiler /compressors
Business name: 2E1 TM.Ete/L. AkEG�( -4cJt C4(,,. State boiler permit no.:
HP Tons BTU/H
Address: '105 ( cu.) 5AnJr gQ4 2• • Sucre 400 Fire /smoke dampers /duct smoke detectors
City: TGA� I State: MI ZIP: 43722;5 Heat pump (site plan required)
Ph — G03- 0205 IFa03-403 -O/0 -mail: Install/replace furnace/burner BTU /H
Including ductwork/vent liner ❑ Yes ❑ No
CCB no.: 4)32,4. Z. Install/replace/relocate suspended,
City /metro lic. no.: wall, or floor mounted
Name (please print): , AJ So rJ Vent for a . • liance other than furnace
CONTACT PERSON ' efngerason:
Absorption units BTU/H
c -�-
Name: VO blA, So#41 Chillers HP Compressors HP
Address: Environmental exhaust and ventilation:
City: I State: I ZIP: Appliance vent
P •,�. • _ , • — 02C Far — , i , a15 mail: Dryer exhaust
OWNER Hoods, Type lUres. kitchen/hazmat
hood fire suppression system
Name: Exhaust fan with single duct (bath fans)
Mailing address: Exhaust system apart from heating or AC
City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets)
Type: LPG NG Oil I
Phone: Fax: E -mail: Fuel i ing each additi nal over 4 outlets
recess p p g (schematic required)
Number of outlets
Name: Other listed appliance or equipment:
Address: Decorative fireplace
City: I State: I ZIP: Insert — type
Phone: I Fax: I E -mail: Woodstove/pelletstove
Other:
Applicant's signature: I Date: Other
Name (print):
Not all jurisdictions accept credit cards, please can jurisdiction for more information. Permit fee $
Notice: This permit application
❑ Visa ❑ MasterCard �7 Minimum fee $ 2 , SCE
expires if a permit is not obtained Plan review (at % ) $
Credit card number Expir s ( with 180 days after it has been S • �v
Name of cardholder as shown on credit card accepted as complete. State surcharge (8%) $
$ TOTAL $ 7f. 30
- Cardholder signature Amount 440 -4617 (6A0/COM)
/ L / O /'14 ) Q — & 1 1 / 6 - 1 0 ,
"ex... r L
MECHANICAL PERMIT FEES ,
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price Total
$1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional $100.00 or including ducts & vents 14.00
fraction thereof, to and including 2) Furnace 100,000 BTU+
$10,000.00. including ducts & vents 17.40
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace
$1.54 for each additional $100.00 or including vent 14.00
fraction thereof, to and including 4) Suspended heater, wall heater
$25,000.00. or floor mounted heater 14.00
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit
$1.45 for each additional $100.00 or 6.80
fraction thereof, to and including 6) Repair units
$50,000.00. 12.15
$50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional $100.00 or For items 7 -11, see or • Pump Cond
fraction thereof. footnotes below. Comp* "
7) <3HP;absorb unit
to 100K BTU 14.00
ASSUMED VALUATIONS PER APPLIANCE: 8) 3 -15 HP; absorb
Value Total unit 100k to 500k BTU 25.60
Description: Qty (Ea) Amount 9) 15-30 HP; absorb
Furnace to 100,000 BTU, including 955 unit .5-1 mil BTU 35.00
ducts & vents 10) 30 -50 HP; absorb
Furnace > 100,000 BTU including 1,170 unit 1 -1.75 mil BTU 52.20
ducts & vents 11) >50HP: absorb
Floor furnace including vent 955 unit >1.75 mil BTU 87.20
Suspended heater, wall heater or 955 12) Air handling unit to 10,000 CFM
floor mounted heater 10.00
Vent not included in applicance 445 13) Air handling unit 10,000 CFM+
permit 17.20
Repair units 805 14) Non - portable evaporate cooler
< 3 hp; absorb. unit, 955 10.00
to 100k BTU 15) Vent fan connected to a single duct
3 -15 hp; absorb. unit, 1,700 6.80
101k to 500k BTU 16) Ventilation system not included in
15-30 hp; absorb. unit, 501k to 1 2,310 appliance permit 10.00
mil. BTU 17) Hood served by mechanical exhaust
30-50 hp; absorb. unit, 3,400 10.00
1 -1.75 mil. BTU • 18) Domestic incinerators
>50 hp; absorb. unit, 5,725 17.40
>1.75 mil. BTU 19) Commercial or industrial type incinerator
Air handling unit to 10,000 cfm 656 69.95
Air handling unit >10,000 cfm 1,170 20) Other units, including wood stoves
Non - portable evaporate cooler 656 10.00
Vent fan connected to a single duct 4 21) Gas piping one to four outlets
Vent system not included in 656 5.40
appliance permit 22) More than 4 -per outlet (each)
Hood served by mechanical exhaust 656 1.00
Domestic incinerator 1,170 Minimum Permit Fee $72.50 SUBTOTAL: $
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656 8% State Surcharge $
inserts, etc.
Gas piping 1-4 outlets 360 25% Plan Review Fee (of subtotal) $
Each additional outlet 6 3 Required for ALL commercial permits only .
TOTAL COMMERCIAL $ • TOTAL RESIDENTIAL PERMIT FEE: • • $
VALUATION: • • .
Other Inspections and Fees:
1. Inspections outside of normal business hours (minimum charge -two hours)
$72.50 per hour.
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
$72.50 per hour
3. Additional plan review required by changes, additions or revisions to plans (minimum
charge- one -half hour) $72.50 per hour
`State Contractor Boiler Certification required for units >200k BTU.
"Residential A/C requires site plan showing placement of unit.
i:\dsts \forms\mech- fees.doc 10/11/00
CITY OR TIGARD BUILDING INSPECTION DIVISION
. MST
24 -Houfi Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date Requested ..3 -) " AM PM BLD
Location 9 y" 6 54 " w 4- 5'( 5 CiV yvn) Suite MEC 7ti1)/ — t ) u 0 8.3
Contact Person Mo' Cit./A^ - ph 643 6 Z u PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
• Sanitary Sewer
Rain Drains
Final
PASS PART FAIL.
ANIICC
ost ts< e� am -
Rou In 41 -1 -e
as •
moke ampers
F'
ASS ART FAIL
EC ICAL .
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk D ate 9)) I ‘ 1) 1 Inspector
Other - Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.