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Permit CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00194 'I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/25/2005 PARCEL: 1S126CA-01000 SITE ADDRESS: 09009 SW HALL BLVD 142 ZONING: C -G SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT: JURISDICTION: TIG Project Description: 150 ft. gas line Value: $2650.00 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES WASHINGTON SQUARE PLAZA Description Date Amount BY THE CAFARO COMPANY [MECH] Permit Fee 4/25/200E $88.60 P OR PARK, NJ 07932 [MECPLN] Plan Rev 4/25/200E. $22.15 [TAX] 8% State Surchaq 4/25/200: $7.08 Phone: Total $117.83 Contractor: NORTHWEST WATER WORKS 40110 SE MEADOWSON RD. REQUIRED ITEMS AND REPORTS SANDY, OR 97055 Phone: 668 - 0375 Reg #: LIC 113197 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344. Issued By: ` _ . _ Permittee SignatureX Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day. 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. 04/22/2005 07:29 FAX 5036680375 NORTHWEST WATER WORKS Z1003 # 04/14 /� _ 11; 44 FAX 5035981960 CITY OF TIGARD 11001 Mechanical Permit A `'V � . • Isok (tr-FIC E l"�>•: (p�1.1 City of Tigard ' ztecelved p it No.: Tigard Dal y: . , 8 ` IY)��_ 90 ,vial 13)25 SW Hall Blvd., Tigard. OR 97223 plan ltcv[sv. r ' p5 Phone: 5113.639.4171 Fax: 507.5 - 1940 P PR ._2 2 , r1121'11 ., ,, fat/s : OtherPornusW —a el lnspeeeian Line: 503.639.417S Or 1 , f . ., - � Oar Rad By: Internet: '►t+Uw.ci.tigatd.or.t' GM .; Nonntul✓Methed: pIV DING _ • OF WO>BK . .ctotMERCIAL'.FEE "SCHEDULE r ts.Ci1 Q New construction SI AdditioNstlterstioNreplacement Mechanical permit rase are based on the value of the work performed. Indicate the value (rounded to the neatest daliar) of all 0 Demolition © Other: roc On:titll materials. ...ul.mem, labor. wKr ;rid •Rfr_ • __• CA TECORY OF COIYSTRUCUON • a lie: • .. rr1 • : -. spisip NT (AL EQUL1pMENT: /' SYSTEMS,FICEs* o 1- and 2-family dwelling hI! Comtttctcittl/industrial 0 Accessory building For special in ormatlon um 4hecid/sr. 0 Multi - family ❑ Master builder ❑ Orher, ocserintiat MEM Total JOB SITE JNFORMATDX!i AND LOCATION :. . � Air condition1n4 07 11031 pomp 1. -• 111IG •Ian showin _ Glace nom 11111 14.00 City'siardZT1'; •.. . A. - , 0/2- Fu ni ee 100 D00 BTU duc srvents) IIIIIIIM111111111. Furnace 100,000# BTU (W,) 17.90 suite/bldg./apt /apt. S1a.: Project tie: �/ Gas heat •µ • 14.00 Cross affect/directions to job silo: Ductwork 14,00 • H • tunic hat water ssystem 14_00 Residential boiler (radiator or hydronie) 14.00 unit hoatets (fuel -t rpm not electric), In vrelL in - 1u t, su "ti c . 10.00 Flue/vent far any of above 10.00 IIII Subdivision: . Othce 1040 Tax mop/parcel no,: .� 1 L 4. A A . I , l' Other fuel a iStnet5 • DES : I • • . , Q • ,` - Water heater 10.00 - 1 r / ��1 � Ga ti - lace 10.00 MI Log li4lterigas 00 IIII • Wood/pellet stove 10-00 Wood fireplacs/I "at , 10.00 .Chirnne lira/flue/vent 10.00 in PROPERTY OWNER 0" 'TENANT Other: 10.00 Name: Env[ronmeorat Oshawa and entlat on J. Adder- Rao hood/orher kki hen 10.00 j City/Sum/ZIP: Clothes dryer exhaust '10.00 Single -duct =liana (Itathroonis. Phone: ( ) Fax; ( ) toilet compartments, utility teems) 1 6.80 Q APPLI[CAIY'[ CONTACT PERSON Attieterewlspaea fan& 10.00 Other 10.00 Business name; r 7/7. 17 / `'CiW ?/rZ / 8tlolDittiec ., J Conrad sortie• - ; airI • � . j7 S ISA0 for first rant OM for eaely addhaal ,of S r ern Furnace, etc. ,IMIZMINMI �� y+ !: ' r7 `1l f / t s heat Dump t Ci y ty/Sta / `" te /Z1P: f l i7 7 , c0/2- �' -/q ( _ Wall /s • ended/Unit heater (5 Phone: 0 ) 56. 0 4 6 0 Fax : ( ) `f ; - &/ :1 r RaillIMINIMIll E- trwil: Ran •a e' U 's CONTRACTOR Barbecue Business agate: Clothes dryer tars ► P�7� ■il /�I�r Oth er: r / L 4 SO - � � MECHANICAL PERMIT FEES* • �yy���w 1� -.77 • Subtotal • i10iI// f Minimum permit fen ($7350) hon { Fax ( e3 /1 �' ' ��' Pl an moles/ QS% feel ' Style sutcltarge MA of permit fee) TOTAL PERMIT FEE c e• 'reds permit application capital if a permit IS not obtained bitnie Mr Authaei d sign / . :C_ ji.) ti _ - ' • 9 V " AV MS R� metho daylatler it nag lxlro secepted ntit voitokte. taint name: gl .! ` Duty: �'► �MS doioyy x,a by Tt4 -Countr B.i0dinZ; lodusrt. Sur-4 Bann CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005.00194 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/25/2005 Phone: (503) 639 -4171 A , Inspection Requests (24 Hrs.): (503)639 -4175 ��&W INSPECTION WORKSHEET FOR DATE: 6/13/2005 TIME: 7:08AM PAGE: 32 SITE ADDRESS: 09009 SW HALL BLVD 142 CLASS OF WORK: SUBDIVISION: WASHINGTON CIRCLE PLAZA LOT #: TYPE OF USE: PROJECT NAME: BAJIO DESCRIPTION: 150 ft. gas line Value: $2650.00 OWNER: WASHINGTON SQUARE PLAZA, PHONE #: CONTRACTOR: NORTHWEST WATER WORKS PHONE #: 668 -0375 Inspection Request Scheduled For: Date: 6/13/2005 • Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 009084-02 503 - 3141471 Y Corrections /Comments /Instructions: 'flirt Ala �. to Mire' Z ASS❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL fl CALL FOR INSPECTION ❑ ADDITIO AL FE S ASSESSED Inspector: , Date: a / v .. � Phone #: (503) 718-