Permit CITY OF TIGARD MECHANICAL PERMIT
71COMMUNITY DEVELOPMENT Permit#: MEC2016 00368
T[GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/19/2016
Parcel: 1S 1260000300
Jurisdiction: Tigard
Site address: 9364 SW WASHINGTON SQUARE RD R01
Project: Blue Nile Subdivision: None Lot: None
Project Description: HVAC modifications
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 07/19/2016 $855.71
Class of Work: ALT Type of Const: IIB Plan Review 05/24/2016 $213.93
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 07/19/2016 $102.69
Stories: 1 Info Process/Archiving-Lg$2.00(over 07/19/2016 $4.00
11x17)
Project Valuation: $30,000.00
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 $1,176.33
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: fan coil unit,
Duct Work: diffusers
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 : 344.
rs ,........._
Issued By: ,A..7„,4_, Permittee Sign(tu e: ,..4- li c� '
Ca .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 ApplicaliECEIVEP
FOR OFFICE CSE ONLY
. iliCity of Tigard Received ® �� /` 0 /
13125 SW Hall Blvd.,Tigard,OR 9722 1 ' DateBy: / Permit No.: GIt
�
�� Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 ,
T I C.A R D Inspection Line: 503.639.4175CITIIyy� Date/By: x� /u= Other Permit:
Internet: Line:www.tigard-or.gov
�F I t b,ARD Date Ready : / Juris: Supplemental See Page 2 for
�}{j Notified/Method:(f(/�
BUILDING DIVISION �y , r Information
r 9 l�
❑New construction _, Mechanical permit fees*are based on the value of the work
®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
" ,= ',7;" _ I 1 Value:$$30 00000
_; • a -VC* i: 'lr f bli6i at ,' m :' ,Y : le
❑ 1 and 2-familydwelling , ,
®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
,,,;,,,- ,i-,..:-
,,. fry i ' 1"err,- Heating/cooling:
Job site address:9364 Washington Square Rd All conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Portland OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:R01 I Project name:Blue Nile 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
Subdivision:Washington Square I Lot no.:R01 Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater l 23.32
-� • ` t' t4444.4 = Gas fireplace/insert I 33.39
Flue vent for water heater or gas
tenant improvement
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
tl„a14*•,' � ,� .+ ,, . : r f l Other: 123.32
7, ‘ Environmental exhaust and vent ration:
Name:Blue Nile
Range hood/other kitchen
Address:411 First Avenue South — equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Seattle,WA 98104 Single-duct exhaust(bathrooms,
Phone:(206)336-6760 toilet compartments,utility rooms) 23.32
Fax ( ) Attic/crawlspace fans 23.3223.32
. ,.,�, .,:. ' � ..,,, „
,_ . . Other:
Business name: Fuel piping:
Contact name:Amy Diekevers $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address:75-60th St SW Gas heat pump
City/State/ZIP:Wyoming MI 49548 Wall/suspended/unit heater
Water heater
Phone:(616)493-9334 I Fax::(616)493-9351 Fireplace
E-mail:amyd@precisionpermitsxom Range
Barbecue
Clothes dryer(gas)
Business name: r..(rr�kl Other:
Address: /0 (s't ,e.„,(• ..
3�3[ Subtotal 855.71
City/State/ZIP:"77_ Ca��/ (f Minimum permit fee($90.00)
Phone:23 ) 04) ( S Fax:( ) Plan review(25%of permit fee) 213.93
State surcharge(12%of permit fee) 102.69
CCB lie.: TOTAL PERMIT FEE 1172.3
X/ / This permit application expires if a permit is not obtained within 180
Authorized signature:- . d .
days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name:Amy Diekevers I Date:5-19-16
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)