Permit (129) CITY OF TIGARD'111MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT
Permit#: MEC2017-00717
Date Issued: 01/31/2018
"f t G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S126CD00300
Jurisdiction: Tigard
Site address: 9500 SW WASHINGTON SQUARE RD
Project: JC Penney Subdivision: None Lot: None
Project Description: TI for existing tenant:New optical department.
Contractor: BAYLEY CONSTRUCTION Owner: PPR WASHINGTON SQUARE, LLC
8005 SE 28TH ST. BY J C PENNEY 0288-1
MERCER ISLAND, OR 98040-9004 TAX SERVICES
PO BOX 10001
DALLAS, TX 75301
PHONE: 206-621-8884 PHONE:
FAX: 206-343-7728
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/31/2018 $69.06
Class of Work: ALT Type of Const: IIB Plan Review 01/31/2018 $17.27
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 01/31/2018 $8.29
Stories: Info Process/Archiving-Lg$2.00(over 01/31/2018 $6.00
11x17)
Project Valuation: $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 $100.62
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: 3 supply
Duct Work: diffusers,2
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to 0 . C by calling 503. .1987 or 1.800.332.2344.
Issued By: / '''Z' Permittee Signature: g.:/o1---
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FoR 01 I'I( I: 1 St:0y1.)
City of Tigardit, o 1:4t s 2- Received �^ �J
? ° 6 DateBy: ��,7. Permit No.: k/fv./ ��! L �
111111 . 13125 SW Hall Blvd.,Tigard,OR 9722 r ti.t
' Phone: 503.718.2439 Fax 503.598.1960 ' Plan Revie
I ,/— 0 her Permit
r I I Inspection Line: 503.639.4175 Date/By:t ! ee Pag��ot,!,- 241
Internet: www.ti azd-or. ov r Date Rea. /Pag /
g g t y c loris' See Page 2 for
,-$L f" J, i 7()I/ Notified/Method:/ /j. ,a -.. _ Supplemental Information
4 a "_u�; s w o-r * ti �lf�
't-r' 7+ a"'` ,_t ... .r. *7 _ �r Y� ;>.. ,, es � x•,� 'r,"t;i ,tisk. „� --,3` '�. . ul,',;.7---';',.:,..,--,,'.---,,,' ,,--
.
New construction a x 1' x 1 r. ET 1 Mechanical permifees*are based on the value of the ork
❑ ®Addition/al r , , tO k
� :.� performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
,t a ,",i` Value $ 00
.«,ti. �"' "*4�, ,3x ,, ` s,4: . ,t., .-, � -! -r. .., -;...._ ,,N*,: G,.?o`-`�s'*cy 1, s. ,a.;� ✓ t i:.N:...L,;:,:,
a a
'alt.: ,tar' .. .,x ,s f z� ;+� l�m,�;
❑ 1-and 2-family dwelling ®Commercial/industrial c
EI building For special information use checklist.
0 Multi family 0 Master builder
0 Other: Description I Qty. I Ea. I Total
t e Ig t o tt; .',!...„:,•,,,,414' 7,, Heating/cooling:
Job site address:9500 SW Washington Sq.Rd. Air 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.: I Project name:JCP#0288 Optical Remodel 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: I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.z _> 1 -t' t_ 1w _:a wt", a Gas fireplace/insert 33.39
" , `- "' Flue vent for water heater or gas
Installation of(3)new supply diffusers to be connected to existing duct main. fireplace 23.32
Addition of(2)new plenum return grilles Log lighter(gas) 23.32
— Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
..6'''',0;1:10241",::: .,. i # { as Other: 23.32
" N� _ r : . M 14-1 . ".,'" '°,lam);t A 41-; Environmental exhaust and ventilation:
Name:JCPenney Company,Inc. Contact:Elizabeth Vance Range hood/other kitchen
Address:6501 Legacy Dr. — equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Plano,TX 75024 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(972)431-2442 Fax ( ) Attic/crawlspace fans 23.32
4 .: t mc7`� t . �'` Mi
r � . .: m ,�: �� �._,a��- llT Other: 23.32
Business name:SBLM Architects Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Trey Lay Furnace,etc.
Address: 16910 Dallas Parkway Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Dallas,TX 75248 Water heater
Phone:(469)554-7770 Fax::(469)554-7775 Fireplace
E-mail:tlay@sblm.com Range
" Barbecue
. :�-_. ,". �`.., Clothes A. __� : r �� �� �' ��° "?� � ;. �- dryer(gas)
Business name:TO BE DETERMINED p Other
ddress: 11-17) >.5 'G Z„,55St x Y 1
/� Subtotal
City/State/ZIP: �Vl e f-��� /44-7.41(1,- i,i/,i G� y ,./6 Minimum permit fee($90.00)
�� [+ /�(/ / —`7r Plan review(25%of permit fee)
Phone:(.7e6)G Z j --(6� 7 Fax:(6 ) � l 7 Zr{
_ State surcharge(12%of permit fee)
CCB lie.: �� 3 TOTAL PERMIT FEE
—
This permit application expires if a permit is not obtained within 180
"'Ked
days after it has been accepted as complete.
Authorized signature: (/4`/ /...0-‘,...--- * Fee methodology set by Tri-County Building Industry Service Board
Print name:Trey Lay Date:09/13/17
I:\Building\Permits)MEC_PennitApp_040113.doc 440-4617T(11/02/COM/WEB)