Permit CITY OF TIGARD MECHANICAL PERMIT
11111 �: ' COMMUNITY DEVELOPMENT Permit#: MEC2013 00678
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/12/2013
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9585 SW WASHINGTON SQUARE RD OFFICE
Project: Washington Square Mall Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Adding(2)grills and connecting them to existing exhaust duct work.
Contractor: JACOBS HEATING&AIR CONDITIONING Owner: PPR WASHINGTON SQUARE LLC
4474 SE MILWAUKIE PO BOX 847
PORTLAND, OR 97202 CARLSBAD, CA 92018
PHONE: 503-234-7331 PHONE:
FAX: 503-808-9108
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 11/12/2013 $81.34
Class of Work: ALT Type of Const: Plan Review 11/12/2013 $20.34
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 11/12/2013 $9.76
Stories:
Project Valuation: $900.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $111.44
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Grills
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � / Permittee Signature:
Call .4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application ED FOR OFFICE USE ONLY
Received
of Tigard ,� Date/By: // /e 43 Permit No./171E6 t / __.i.,-7;1
11111 0 13125 SW Hall Blvd.,Tigard,O23 Plan Review
G Date/By: Other Permit:f a20/2,eO
Phone: 503.718.2439 Fax: 503.598.1960 q ,t91`�
T I G A R I] Inspection Line: 503.639.4175 A,Iv 1 !a Date ReadyBy: tuns. See Page 2 for
Internet: www.tigard-or.gov \`► G`f�y�C® � Notified/Method: Supplemental Information
TYPE Or-Wien/4-� �� %I11S1%Oi, COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction [�Additioneration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El
❑Other: mechanical materials,equipment,labor,overhead,�rrd profit.
Value:$ 900 ,II V
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling 51 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 1 S S 5--,...... G---.5t,j N7 Ls- Sc.t..c./'t /Id Furnace 100,000 BTU(ducts/vents) 46.75
f /� Furnace 100,000+BTU(ducts/vents) 54.91
City/State/ZIP:
`I`,f41 0t2. 5?z2I Heat pump 61.06
Suite/bldg./apt.no.: Project name: ;,-..�5 L,,,,%A r„. 51t.kc-44.. Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
I ` Flue vent for water heater or gas
cl c' C2) .";/f r) q t.,? Cc,1 ,tt c f '^5 1.--• fireplace 23.32
1 Log lighter(gas) 23.32
fa .....7.; ;'�' cy+•, `ty-Go-.-S/- el,t-7v f•'h" - Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
❑ PROPERTY OWNER 0 TENANT Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
ty toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
at APPLICANT ❑ CONTACT PERSON Other: 23.32
Oil Fuel piping:
Business name: Tic u 4 S 1 O i-I„t 5 i, / C 514.15 for first four;54.03 for each additional
Contact name: To s(,, Pi-p r-c-k... Furnace,etc.
Gas heat pump
Address: Li•-i 7 y ce. w;'t,u ki E.' et u-t. Wall/suspended/unit heater
City/State/ZIP: or, (ct c( f C,Q q?Z G Z Water heater
Phone:(Sol )'Z3y-7; ) / Fax::(Sc 3 ) •Z q 6 - s 3 S / Fireplace
Range
E-mail: 7(,;s[-P e cc 1,$ t...,t:,+;,......„ , c c t---, Barbecue
CONTRACTOR Clothes dryer(gas)
A. Other.
Business name: Telco ti S I,"ec f-,"'S 2 V � MECHANICAL PERMIT FEES*
Address: 4-i 74 Ze w;i a c,k.,-.p ct,.,rL Subtotal
City/State/ZIP: nor-i c w tJ r e 2 9 7 2 L - Minimum permit fee($90.00)
1 Plan review(25%of permit fee)
Phone:(SG y ) 13--1-7 37 i Fax:(Sic j ) 2 ct 6— S; S / State surcharge(12%of permit fee)
CCB lic.: 1 _/ J/ TOTAL PERMIT FEE al i
This permit application expires if a permit is not obtained-within i80
days after it has been accepted as complete.
Authorized signature: / • Fee methodology set by Tri-County Building Industry Service Board
Print name: d 5-c, Pd Q r c� Date: /'f//2 r /
i:Building\Permits'MEC_PermitApp 040i 13.doc 440-4617T(I1/02/COM/WEB)