Permit CITY TIGARD MECHANICAL PERMIT
I� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00565
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/12/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09330 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: TI - Project Value: 820,941
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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 LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 9/12/200: $380.00
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 9/12/200 $95.00
TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/12/200E $30.40
Phone: 503 639 - 8865
Total $505.40
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97222
Phone: 503 462 - 4822
Reg #: LIC 50897
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 - 44.
Issued a _____ 4,(, Permittee Signature: k .5
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.
Mechanical Permit Application FOR E: usl ONLY
Received
City of Tigard Date/By Petm;t 00 ....06 ,
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /h,� -,.= Other Permit
1 I ` Date/By
Inspection Line: 503.639.4175 _J J _' ! Date Ready/By Juris 55 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction AAdditi Olteratio placement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY _ OF CONSTRUCTION Value: $ Cg)
4 1 /, �
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwellirtr rstrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklrsr.
Description 1 Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
I Air conditioning or heat pump
Job site address. 9 30 31,0 Weal, �
�� r1
(requires site plan showing placement) 14.00
City /State/ZIP: Tc avy-d , n to n Furnace 100,000 BTU ( ducts/vents) 14.00
� J J Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: -�+ Project name' ` �, d , r , yt a -'
Gas heat pump 14.00
Cross street /directions to lobe g V �`''` Duct work 14.00
Occupancy Typc Hydronic hot water system 14.00
Auld ytg Residential boiler (radiator or
Construction Type hydronic) 14.00
Rated Corridor Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Enc.' gy Code /17 Flue /vent for any of above 10.00
Subdivision: Accessibility • rd, no.: Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK ' Water heater 10.00
Gas fireplace 10.00
/ 7 p / (, -y pp FF P QQ
am.. l t-1,n a t t,yt ' (_.t/itti, VJ rf l�l c l w ct 1 ��. Flue vent for water heater or gas
' ((�� fireplace 10.00
J' I ! -- v. ..A!...._ t. t•1 K- I C o)• r 4 . ) Log lighter (gas) 10.00
6 f . 1 S Wood/pellet stove 10.00
ro G lfIs PI Pr N G Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address. Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
' - ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: WalUsuspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR '
�' , /� �-7 C � Clothes dryer (gas)
Business name: / �" 1/ L�YI
Other:
Address: t g- 5E - 144' /J Uicui MECHANICAL PERMIT FEES*
City /State /ZIP: M. Ll.& u c'i.t� --it CIZ a(,ea6ry1 CI 7 a x-D— Subtotal
( Minimum permit fee ($72.50) . 4 4gQ
Phone: ( )
1 4CP2- - q &) -� F ax: ( )Li ) Plan review (25% of permit fee) y5.
CCB lic.: Sd. C -7 State surcharge (8% of permit fee) 30 .
TOTAL PERMIT FEE •yO
Authorized signature: S J � ( 4 00Y1
This permit application expires if a permit is not obtain. within 180
r vt days after it has been accepted as complete.
Print name: 'S,‘ en c re— re— R Ob c SGvN Date: 9 ( 9 /� S • Fee methodology set by Tn- County Bwlding Industry Service Board
t \Building\Pennits\MEC- PermitApp doe 12/03 440 -4617T (I1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or a 7-0
fraction thereof, to and including ,, ncriula0
$100,000.00. I onr_7y:!c:;.`J
$100,000.01 and up $1,396.50 for the first $100,000.00 and ,;, .,nrsr27
$1.10 for each additional $100.00 or
fraction thereof. i.1 ^.1
., +iee4�lf1
Note: All new commercial buildings require 2 sets of plans.
•
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY. OF TIGARD
BUILDING DIVISION PERMIT #: MEC200500565
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/12/2005
Phone: (503) 639 -4171
Inspection•Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
9/28/2005 7:08AM 68
I SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 09330 SW WASHINGTON SQUARE RD LOT #: TYPE OF USE:
WASHINGTON SQUARE
PROJECT NAME: SOMA
DESCRIPTION: TI - Project Value: $20,941 Mec2005-00565 and Mec2005 -00566 at 9318 WA SQ RD are on the
OWNER: same set of plans PHONE #:
CONTRACTOR: WASHINGTON SQUARE LLC PHONE #: 503 -639 -8865
HVAC INC 503- 462 -4822 • Inspection Request Scheduled For: Date: 9/2W2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 016815 -01 503-462 -4822 N
Corrections /Comments/ Instructions:
•
•
•
•
l / I
❑ PASS PARTIAL APPROVAL • ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 97.e) CPS hone #: (503) 718-
•
• 1 r
C .
BUILDING DIVISION PERMIT #:� —,2415
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_1.0 I.L. j
INSPECTION WORKSHEET FOR DATE: 11 /' / TIME: PAGE:
SITE ADDRESS: Q ,36 'W Ot)Pc S& CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: cf:s-pN Pr
DESCRIPTION:
OWNER: PHONE #:
, CONTRACTOR: ( lC, PHONE #:
•
Inspection Request Scheduled For: Date: • Pour Time:
•
Code # Inspection Description Confirm .# Contact # Message
699' Ft Vic. tA1lEG _zco 3,4 _ er CI-k is C ? -
Corrections /Comments / Instructions:
Ail _ A
0.
b . I f , i rf'
•
•
[P ASS ❑PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL . CALL FOR INSPECTION - El ADDIT N A FEES ASSESSED
U Inspector: Date: �� Phone #: (503) 718-