Permit (74) I'
CITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit#: MEC2017-00825
Date Issued: 10/23/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S1260000300
Jurisdiction: Tigard
Site address: 9461 SW WASHINGTON SQUARE RD Al 3
Project: Lids Subdivision: None Lot: None
Project Description: Ductwork and VAV Box.
Contractor: GREY WOLF HVAC INC. Owner: PPR WASHINGTON SQUARE LLC
7306 NE 37TH AVE PO BOX 847
VANCOUVER,WA 98665 CARLSBAD, CA 92018
PHONE: 360-635-6117 PHONE:
FAX: 360-326-8506
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/23/2017 $277.46
Class of Work: ALT Type of Const: Plan Review 10/23/2017 $69.37
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 10/23/2017 $33.30
Stories: Info Process/Archiving-Lg$2.00(over 10/23/2017 $2.00
11x17)
Project Valuation: $7,500.00
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 $382.13
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: (1)VAV box
Duct Work: 1
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 not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow he\ rules adopted by the Oregon
Utility Notification Center. Those rules ar set forth in OAR 952-001-0010 through OAR 952-411-00•a You may obtain a copy of the rules
or direct questions to OUNC calling 503.23 987 or 1. 00.33 .2344.
Issued By: / Permittee Signature: A • t 'Of r.
..11111
Call 503.639.4175 by 7:00 a.m.for the next available inspectio
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 FOR OFFICE USE ONLY
City of Tigard I? d �!, Permit No.:
13125 SW Hall Blvd.,Tigard,OR 97223 /,V r��/�� ' " `�V/ [/[/ �
' _ Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Other Permit: � C/✓"
TIGARD Inspection Line: 503.639.4175 OCT 2 3 20 pate/By: �)l)�� ��
Date Ready/By: turfs: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TI GA.blotified/Method: Supplemental Information
BUILDING D 'i)),
..,a ..., .. ���,�.�._z... .�..�......_ _.._.__ 3 .E, vco ; €�..,.� .,.. w- ,s.�.. , t'?,,t2 1 - vim .,, .,. fit' "'-2 J .a' ( T i
_. - Mechanical permit fees*are based on the value of the work
❑New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
y e k{ aI . ,,Ts (c (�'r ^ `d lL k u. k, " t' Val (' ' 'e $ L......"
❑ 1-and 2-family dwelling "Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
a ` "�'i ,c'' 3 � litre Heating/cooling:
Job site address: Air conditioning 46.75
L'�'qG3c,..Stitii z-�5 ii., 2t.,r'2. ✓�el Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: P"Y 1-. .,,,,_,,l. 0 i r •7 . Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldgiapt.no.: t�-1 3 I Project name: L et S __ 1�` . 7s.`_�'>,_ 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: l Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
;. ; , );•=,',"; Jill' r °,i- 1°.,: °<'. • ,-. 33.39
� .:_., � _ . �' Gas firep
lace/insert
/ _ /4 ()�ci Flue vent for water heater or gas
V!� `-'' S 6 ,tn fireplace 23.32
V
t / -v S� Log lighter(gas) 23.32
V Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other�;'1ia `��`Y'` ���°p P=
. ' ��y ''1,` 23.32
_.. Environmental exhaust and ventilation:
Name: L.—; S Range hood/other kitchen
Address: equipment 33.39
1 5 S s W oc d\e-'—r', c. %>r, Clothes dryer exhaust 33.39
City/State/ZIP: `��.t c ��� ' J i. Lc 3--j Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(E..0_,c) 5(t,y U a. -I Fax:( ) Attic/crawlspace fans 23.32
.,; 1 � � ...ti . 1d ` v€.. I s � Other: 23.32
Fuel piping:
Business name: ti �,� ic� Ac_. 4 v0
` I $14.15 for first four;$4.03 for each additional
Contact name: ,l 0-,I r ./ \ f.s co-i -,,,Y1-k_- Furnace,etc.
Address: 1'1J p to 1L) 3'1--� 0.,./.—e.._ Gas heat pump
waivsucpp.vd/uri,heater
City/State/ZIP: Jc t_c.,0vim-( �l9� 1, k
Water heater
Phone:(3bo ) 4,- S lD‘\'7 Fax::(3„(,)3a4:, , eaSb to Fireplace
Range
E-mail:
Barbecue
s, 1tt, r T Clothes dryer(gas)
� - aOtherBusiness name: (:,,,i-,e,..,„) `W"a ),q' _�V A`-�— / 1v, C •
¢ Q� C u , 6't$�
Address: 130 t,„ �$_,,„ � 1.j�,� ,.�
Subtotal
City/State/ZIP: �C�L a-�-✓ n t, Minimum permit fee($90.00)
"hone: �R Plan review(25%of permit fee)
(3c°) �' � .- (,) I i 'Fax:( +�) 3 L:s . SCJ l., State surcharge 12%of
g ( permit fee)
._,CB lie.: TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
rl �_.. days after it has been accepted as complete.
Authorized sign1
ature: dr.4
• ,.�J ._. / * Fee methodology set by Tri-County Building Industry Service Board
Print name: lJ�)F a c2s p, )f Date:t 0/2,3 t/
I:\BuildingWermits�MECt_Pee"rmTitApp_040I13.da; �P' 440-4617T((((11//0OM/WEB)