Permit (104) CITY OF TIGARD MECHANICAL PERMIT
� ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00225
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/30/2016
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9516 SW WASHINGTON SQUARE RD H05
Project: Ben Bridge Jeweler Subdivision: None Lot: None
Project Description: New VAV boxes and diffusers.
Contractor: ARROW MECHANICAL Owner: PPR WASHINGTON SQUARE LLC
10330 SW TUALATIN RD PO BOX 847
TUALATIN,OR 97062 CARLSBAD, CA 92018
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/30/2016 $398.51
Class of Work: ALT Type of Const: Plan Review 03/30/2016 $99.63
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 03/30/2016 47.82
Stories: Info Process/Archiving-Lg$2.00(over 03/30/2016 $4.00
11x17)
Project Valuation: $12,000.00
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 $549.96
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: VAV Boxes
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 taw. 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: • rmittee Signat �`
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 g�� FOR OFFICE USE ONLY
City of Tigard tc.) ' D y 3/ go /37+eT Permit No.: �! �n 13125 SW Hall Blvd.,Tigard,OR 972% v� 10
Phone: 503.718.2439 Fax: 503.598.1 Plan Review p/�
I Date/By: Other Pernit: /�t�/I{t7 �,
Ti G A R D Inspection Line: 503.639.4175 e5 Q . \U Date Ready/By: 1�: See Page 2 for
Internet: www.tigard or.gov M�� JIli Notified/Method: - -,e Supplemental Information
❑New construction �� -> Mechanical permit fees*are based on the value of the work
Addition/alterat'� 4 > . - ent performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
w� F s
Valu $I2 C•C:5(....
.. t, . ...<....< �'3' .✓j illit7 Moi i:lff t 6�, ,�'`a...,,,.:...s...A ."x•',.... , , t ' �,..34 al f e mss'. 4W4tifliftgaail
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
z J Heating/cooling:
/coolin
Air conditioning 46.75
Job site address: 9 SSS 560 G)lq 5!><J,-)(T 6x3 54J44-r. /ZIA C) Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: T<a-izz)/ Oz' 5723.3 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: h/ 7 Jr Project name430A.1 'aRID6 JT daegS Heat pump 61.06 _
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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
"' t .�OS.f O rO Gas fireplace/insert 33.39
s s �-.. <M.., �,W-PI:..�... ,.M... . .xF:. .. .,, -
Flue or water heater g
/� Fl vent f or as
Naw V41/ S / Ajtii.J D,`1-�(f�/2S fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. '.;
• Other: 2332
>�� " g� ka �
. ,, ,s t . r � .,. .. s,� r -. .f g . . . .
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
L Wi ` µ .r. ' .. ..- ::s ' y',,,jtx hitt* l 'u taegt Other: 23.32
Business name: /,,� nJ n` Fuel piping:
� bj kt c.o.11� ( "CetL x,07-rz,4C:/vl�+�,, hoe ' $14.15 for first four;$4.03 for each additional
Contact name: kc,.a;Ai KRB,szi J s K1 Furnace,etc.
Gas heat pump
Address: /O330 csS rdittarA) 4J)
4. l
Wall/suspended/unit heater
City/State/ZIP: -r04.44-7'AJ/ d 97oC Z Water heater
Phone:(5)3 )69.2 15-c 5 Fax::(5 )j97 /g 7 y Fireplace
a ref' Range
E-mail: II-gi
Al� � Fi�atvT r'2 s`�7 Ci1^-�i Barbecue
alasenewassiattolw*o11111111111111:111111111
Clothes dryer(gas)
/J Other
Business name:41�,2f;,4..� /t`L1s�l lit(4L evAx�jder ,�i hoe- .r:t l 'r�>r:: s : ?.
Address: /o3'5 U Ste, .7ii liC.f¢fl by iii¢[3 Subtotal
City/State/ZIP: p� 067
Minimum perniit fee($90.00)
Tv � l Plan review(25%of pennit fee)
Phone:(50 3),(;72_l6-‘S Fax:(3-03) ‘. /- /87/ State surcharge(12%of permit fee)
CCB lic.: 5113 TOTAL PERMIT FEE f Sif q,16
This permit application expires if a permit is not obtained within 180
{_ days after it has been accepted as complete.
Authorized signature: i �Z< * Fee methodology set by Tri-County Building Industry Service Board
i
Print name:/45.-v, d&.4--c-i S zip c ciSS (� Date: 6,3v y
1:\Building\Permits\MEC_PemmtApp_040113.doc 440-4617r(I1/02/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
9516 SW WASHINGTON SQUARE RD H05,
TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00225
Jeff Grove
Violation Summary:
Inspector Contractor