Permit n CITY OF TIGARD MECHANICAL PERMIT
1111 1 ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00681
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/15/2015
Parcel: 1 S 1260000300
Jurisdiction: TIGARD
Site address: 9618 SW WASHINGTON SQUARE RD G05
Project: Helzberg Diamonds Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Install split system with condensing unit(roof)
Contractor: ARJAE SHEET METAL CO, INC. Owner: PPR WASHINGTON SQUARE LLC
8545 SE MCLOUGHLIN BLVD. PO BOX 847
PORTLAND, OR 97222 CARLSBAD, CA 92018
PHONE: 503-231-7717 PHONE:
FAX: 503-230-4888
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/15/2015 $601.71
Class of Work: ALT Type of Const: IIB Plan Review 10/15/2015 $150.43
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 10/15/2015 $72.21
Stories: 1 Info Process/Archiving-Lg$2.00(over 10/15/2015 $4.00
11x17)
Project Valuation: $20,000.00 Info Process/Archiving-Sm$0.50(up to 10/15/2015 $5.00
11x17)
Fuel Air Handlers
Fuel Types: Units< 10000 cfm: 1
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: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $833.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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 e a ion -• -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtai a copy of the rules
or•• ect questions to OUN •y c- ••• 503.232.1987 or 1.800.332.2344.
Issued By: / - 6_ e Permittee Signature: `
Call 503.639.4175 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 1.0 O1 11( I. l SI. ()NI.)
City of Tigard ‘NtiVi Received
Date/By: 1 i Permit No.: ry��1s '
71
13125 SW Hall Blvd.,Tigard,OR 972 Plan Review) --- .9015:-
V
Phone: 503.718.2439 Fax: 503.598.1 Date/By: ( ,�•1 (O �4 l Other Permit. 019020/5—�' ]
1 I G A R[� Inspection Line: 503.639.4175 sis�__ 1C' Date Ready/By: Juris 6i See Page 2 for 1
Internet: www.tigard-or.gov I $ 2� Notified/Method: / / Supplemental Information
in allro r /t!m •
TYPE o i FEE* SCHEDULE- USE CHECKLIST
A ■ • Mechanical permit fees*are based on the value of the work
❑New construction IA Addition/alteratio 14 a u v performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: 3 mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Q U
Value:$f®
rKtfFlALE. UIPMENTiSY FEEARI, IF-
,
❑ 1-and 2-family dwelling IA Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
' ''" JOB SITE INFORMATION AND LOCATION ' Heating/cooling:
Air conditioning 46.75
Job site address:q6 j y 51 ) w A4i„_-'L a 64. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -r;yA 1 OR �iTiT2'z3 Furnace 100,000+BTU(ducts/vents) 54.91
�" J Heat pump 61.06
Suite/bldg./apt.no.: Project name: Newt eo Dia/1044s 20 Duct work 23.32
Cross street/directions to job site: J 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
Subdivision: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
li 5ph
i < II r Flue vent for water heater or gas
1ASkaiI � S,/Yi 444 eroc1n4r)dA14-(rJ) fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood tireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER J ❑ TENANT Other: 23.32
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,
toilet compartments,utility rooms) _ 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
1�f Fuel piping:
Business name: c op, S.IPe4- me 1
IM 514.15 for first four;$4.03 for each additional
Contact name: /,life &0r'syl Furnace,etc.
Gas heat pump
Address: �c ,)g SE M _ , n VC Wall/suspended/unit heater
City/State/ZIP: M illiajih t l 6-1/ 'i 7 22 Z Water heater
Phone:(93 )231- 7117 Fax::(503 )230-1 g Fireplace
Range
E-mail: /Y1 i li e Q )a c Jtf r 0/'1 Barbecue
��JJ CONTRACTOR Clothes dryer(gas)
Other:
Business name:5a MECHANICAL PERMIT FEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( )
State surcharge(12%of permit fee)
CCB tic.: 66 g35-- TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: / • Fee methodology set by Tri-County Building Industry Service Board
Print name: ry1i� S�ot./l Date: /D/�S' ,5
I.\Building\Permits\MEC_PermitApp_040113.doc 440-461 (II/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9618 SW WASHINGTON SQUARE RD G05,
TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00681
Jeff Grove
Violation Summary:
Inspector Contractor