Permit CITY OF TIGARD MECHANICAL PERMIT
1 it COMMUNITY DEVELOPMENT Permit #: MEC2011 -00093
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/09/2011
Parcel: 1S 1260000300
Jurisdiction: TIGARD
Site address: 9640 SW WASHINGTON SQUARE RD G11
Project: Hanna Andersson Subdivision: WASHINGTON SQUARE MALL Lot: 0
Project Description: Replacing existing VAV box and moving ducts and grills.
Contractor: ARROW MECHANICAL Owner: PPR WASHINGTON SQUARE LLC
10330 SW TUALATIN RD 2235 FARADAY AVE STE #0
TUALATIN, OR 97062 CARLSBAD, CA 92008
PHONE: 503 - 692 -1565 PHONE:
FAX: 503 - 691 -1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/09/2011 $221.26
Class of Work: ALT Type of Const: Plan Review 03/09/2011 $55.32
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 03/09/2011 $26.55
Stories: Info Process /Archiving - Lg Sheet (over 03/09/2011 $4.00
11x17)
Project Valuation: $5,500.00 Info Process /Archiving - Sm Sheet (up to 03/09/2011 $3.00
11x17)
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 $310.13
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
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, if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification -•ter. T• . . rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or irect questions to OU • .y callin• 03.!32.1987 or 1.800.332.2344.
Is ed By: / / f / Perm Signature: , - Q
' —
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 `,, OFFICE tiSE ONLY
City of Tualatin
18880 SW Mattinazzi Ave. Date received: ) 1 / Permit # mi?C 11... lgi 3
Tualatin, OR 97062 L4PC)1I - a.) 030
Phone: 503 691 - 3044 Fax: 503 692 - 0147 www.ci.tualatin.or.us Date Issued: By: Re e ipt:
TYPE OF WORK COMMERCIAL FEE SCHEDULE - USE CHECKLIST
0 New construction [' Addition /alteration/replacement Mechanical permit fees are based on the value of the work performed. Indicate
the value (rounded to the nearest dollar) of all mechanical materials,
❑Demolition ❑Other
equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $ 55
❑ 1- and 2- family dwelling [R Commercial/industrial ❑ Accessory building
Ell Multi-family RESIDENTIAL EQUIPMENT / SYSTEMS FEES
y ❑ Master builder ❑ Other.
n� For special information use checklist.
Y JOB SITE INFORMATION AND LOCATION Description I Qty. I Ea. I Total
Job site address: a .r* St j ij t �,..) 5q Z D Heating/cooling
Furnace, incl. ductwork, vent, and liner I l 15.00
City /State/ZIP: 7/‘,14-ED ' 6 -, Air conditioner (site plan required) 15.00
Suite/bldg. /apt. no.: ' l I Project name: fj¢ 4 iti"e 55t'l Heat pump (site plan required) 15.00
Duct work alterations and additions 15.00
Cross street/directions to job site: Hydronic i in system g ystem 15.00
Residential boiler (radiator / hydronic) 15.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 15.00
Flue/Vent for any of the above 15.00
Subdivision: I Lot no.: Other: I
Tax map /parcel no.: Other feel appliances
Water heater 15.00
DESCRIPTION' OF WORK Gas fireplace /insert/stove 15.00
/ DJ�T 4, 4- 6l., / /.S Gas log/log lighter 15.00
Be.)- ool or spa heater, kiln* 15.00
a � 1o'- � ( ./.- - /..59 - '11.34 7 _ v�+r Wood/pellet stove /insert 15.00
L-/ /L� jU2 t-f /G 4- Wood fireplace _ 15.00
Chimney/liner /flue /vent w/o appliance 15.00
Oil tanks/gas /diesel generators 15.00
0 PROPERTY OWNER I ❑ TENANT fi
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen equipment 15.00
Clothes dryer exhaust 15.00
City /State/ZIP: Single -duct exhaust (bathrooms, toilet
compartments, utility rooms) 15.00
Phone: l Fax: Atticicrawlspace fans 15.00
APPLICANT Whole house ventilation or Radon
mitigation 15.00
Business name: 041.3 Atithip) me.... J y 1 TfeSS, /-JC. Other: 1 I I
Contact name:
Itigll`A3 Oc)SZE J, .7S1G Fuel piping
$15.00 for first four, $7.50 for each additional
Address:
bC 33 J 7 . C ) / 4 " ? Furnace
City / State/ZIP: 7 4,�,,J_ 2 jL 97‘,6 Z Wall/suspended/unitheater
a3 - 2 -! S'6 Fax: 4 S, Water heater
Phone: S
so - / - /8 7`1 Fireplace/log lighter /gas log
&mail: 4Zi7r)2 /uPc je l'Zp17,,5T1fi iZ . CC7y'Z Range
CONTRACTOR Barbecue
Business name: , � Clothes dryer
/ 7�f6.e1/y¢,� r 4k. Cam / �/9c!> , /r:, Other: Total Outlets
Address: /a 330 cssJ T(i/GI- 77,--i ge)4 -D MECHANICAL PERMIT FEES
City /State/ZIP: 7 � � ,u Fee Type Amount Date Paid
/ �� Z Permit Fee (minimum $60.00)
Phone: 492_1S Fax: 61/ / e 7 ' Plan review ( 65 % of permit fee)
E -mail: / � e ( C je., ( gt...i117/(2- .c.,-)--‘—' Fire, life safety (45% of permit fee)
CCB lie.: 579 I City or metro lic.: 2i/74 State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized -- /
signatu e' �� �/ G L� This permit application expires if a perndt is not obtained within 180
days after it has been accepted as complete.
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