Permit CITY OF TIGARD MECHANICAL PERMIT
$ COMMUNITY DEVELOPMENT Permit #: MEC2012 -00145
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/20!2012
Parcel: 151260000300
Jurisdiction: Tigard
Site address: 9611 SW WASHINGTON SQUARE RD L03
Project: Jos A Bank Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 108
Project Description: Install new package terminal units and ducting.
Contractor: WATTS HEATING & COOLING INC Owner: PPR WASHINGTON SQUARE LLC
580 PORTLAND AVE. BY THOMSON PROPERTY TAX SERVICES
GLADSTONE, OR 97027 ATTN HILARY RAYMOND
2235 FARADY AVE, STE 0
CARLSBAD, CA 92008
PHONE: 503 - 786 -2858 PHONE: •
FAX: 503 - 786 -2807
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/20/2012 $728.71
Class of Work: ALT Type of Const: IIB Plan Review 03/20/2012 $182.18
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 03/20/2012 $87.45
Stories: 1 Info Process /Archiving - Sm $0.50 (up to 03/20/2012 $3.00
11x17)
Project Valuation: $25,000.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm: 4
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 $1,001.34
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units: •
Gas Outlets: Other Desc:
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 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 1.800
Issued By: Permittee Signature:
Call 51 • 5 by 7:00 a.m. for the next available inspection — e.
This permit card shall be kept in a conspicuous place on the job site until corn , =tio of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard M4 DateiBy: � �
Inspection Line: 5036394175
It/LG� o 't -Gtr/ 5
1114 Date/By: �/ �J Permit No.:
° 13125 SW Hall Blvd., Tigard, OR 97223
P lan Revie
Phone: 503.718.2439 Fax: 503.598.1 JTy OF TIGARD D t Other Permit: ' "AW -20 ,251
T I G A R D Date Ready
p.. BUILDING Ready/By: Juris: RI See Page 2 for
Internet: www.tigard or.gov SI 2 Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 25000
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use check list.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 9611 SW Washington Square Rd (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: L03 Project name: JAB Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
install new package terminal units and ducting to entire space as per plans Gas fireplace /insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ® TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Jos. A. Bank Environmental exhaust and ventilation:
Address: 9611 SW Washington Square Rd Ste. L03 Range hood/other kitchen
equipment 33.39
City/State /ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax:
( ) toilet compartments, utility rooms) 23.32
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Watts Heating & Cooling, Inc.
Fuel i in
P P g:
Contact name: Loren Watts $14.15 for first four; $4.03 for each additional
Address: 580 Portland Ave Furnace, etc.
Gas heat pump
City /State /ZIP: Gladstone, OR 97027 Wall/suspended/unit heater
Phone: (503) 786 -2858 Fax: : (503 -) 786 -2807 Water heater
E -mail: loren @wattsheating.com Fireplace
Range
CONTRACTOR Barbecue
Business name: Watts Heating & Cooling, Inc. Clothes dryer (gas)
Other:
Address: 580 Portland Ave MECHANICAL PERMIT FEES*
City /State /ZIP: Gladstone, OR 97027 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 786 -2858 Fax: (503 -) 786 -2807 Plan review (25% of permit fee)
CCB lic.: 134602 State surcharge (12% of permit fee)
TOTAL PERMIT FEE jovi
This permit application expires if a permit is not obtai d within 180
Authorized signature -
p���� days after it has been accepted as complete.
Print name: Loren W s Date: 3/8/12 * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 03/07/12 440-4617T (I1 /02/COM/WEB)