Permit CITY TIGARD MECHANICAL PERMIT
4
;� PERMIT #: MEC2005 -00409
DEVELOPMENT SERVICES DATE ISSUED: 9/13/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S12600 -00300
SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: HVAC Value: 18,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS: 1
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: 1 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [TAX] 8% State Surchar€ 9/13/200E $27.16
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 9/13/200: $84.88
TIGARD, OR 97223 [MECH] Permit Fee 9/13/200E $339.50
Phone: 503 639 - 8865 Total $451.54
Contractor:
BEWLEY MECHANICAL
7911 NE 33RD. DR. #250 REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97211
Phone: 626 - 8986
Reg #: LIC 63582
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- 2 -23
•
Issued B • , Q Permittee Signature:
2-
Call 503 - 639 -4175 by 7:00 a.m. for inspections th 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.
wecA S#
Mec arica Permit App11 lion � FOR OFFICE USE 0 LY
City Si' ' r Date/By: ®0 5.��/ PermrtNo �Q ' 0O`
13125 SW Hall Blvd., Tigard, OR 97223 , 1 Y ` L Plan Review j r'r/
Phone: 503.639.4171 Fax: 503.598.1960 DateBy:') Other Permit
Inspection Line: 503.639.4175 ry ■ 4- -41 Date Read !g Juris 53
Internet: www.ci.tigard.or.us d L. ) 7 2005 - Notified/Method :� pctlos ' r - SSuppllementalInformation
4 Ai
l i r t COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees are based on the v clue 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.
CATEGORY OF CONSTRUCTION Value: $ $18,000.00
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9368 SW WASHINGTON SQUARE Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: R03 I Project name: JANIE & JACK Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I Lot no.:
Flue /vent for any of above 10.00
Other: 10.00
Tax neap /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
INTERIOR REMODEL OF EXISTING RETAIL TENANT SPACE FOR NEW Gas fireplace 10.00
Flue vent for water heater or gas
TENANT "JANIE & JACK" fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
PROI'l.R 11 O11\I:R - I l.\ 1\ f
Other: 10.00
Name: JANIE & JACK Environmental exhaust and ventilation
Address: 500 HOWARD STREET Range hood/other kitchen
equipment 10.00
City/State/ZIP: SAN FRANCISCO, CA 94105 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (415)278 -7157 Fax: (415)278 -7550 toilet compartments, utility rooms) 6.80
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: JANIE & JACK Fuel piping
Contact name: SARAH NIELSEN $5.40 for first four; $1.00 for each additional
Address: 1120 EAST 80 STREET -SUITE 211 Furnace, etc.
Gas heat pump
City /State /ZIP: BLOOMINGTON, MN 55420 Wall /suspended/unit heater
Phone: (800) 541 -0821 Fax: : (952) 854 -4909 Water heater
Fireplace
E -mail: sarah @elderjones.com Range
CONTRACTOR Barbecue
. , /)/ i e. 1-4 . Clothes dryer (gas)
Business name: `.L ['[
Other
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal
Minimum permit fee ($72.50) 332 co
Phone: ( ) Fax: ( ) _ Plan review (25% of permit fee) 56;
CCB lie.: ' b 1, , State surcharge (8% of permit fee) 22/6
1111111111111111111111111 ‘ TOTAL PERMIT FEE �S S 4
This p ermit application expires if a permit is not obtained within 1
�� / days after it has been accepted as complete.
)� P N N P ,// / /�� /
O - (1 / , ,.) • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \Permits\MEC- PermitApp.doc 12/03 ( 440- 4 617T( M/M/
11 /02/COWEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 1I...
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7:09AM PAGE: 50
SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANIE 8 JACK
DESCRIPTION: HVAC Value: 18,000
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: BEWLEY MECHANICAL PHONE #: 626 -8986
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 020823 -01 971 - 227 -3613 N
Corrections /Comments /Instructions:
It I _ 7
air"
j
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ( ` ( ( #: (503) 718-
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 AA
Inspection Requests (24 Hrs.): (503) 639-4175 _..' WILL
INSPECTION WORKSHEET FOR • DATE: 11/8/2005 TIME: 7:00AM PAGE: 113
SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANIE & JACK
DESCRIPTION: HVAC Value: '18,000
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639.8865
CONTRACTOR: BEW..EY MECHANICAL PHONE #: 626.8986
Inspection Request Scheduled For: . Date: 11/8/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 020534 -01 971 -227 -3613 N .
Corrections /Comments/ Instructions:
1 - air - C
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
I i l Inspector: ` s l `� Date: \ Phone #: (503) 718-
.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00409
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/13/2005
Phone: (503) 639 -4171 A . �� '
Inspection Requests (24 Hrs.): (503) 639 - 4175 °_L
INSPECTION WORKSHEET FOR DATE: 10/6/2005 TIME: 7:02AM PAGE: 64
SITE ADDRESS: 09368 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: JANIE & JACK
DESCRIPTION: HVAC Value: 18,000
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503- 639 -8865
CONTRACTOR: BEWLEY MECHANICAL PHONE #: 626 -8986
Inspection Request Scheduled For: Date: 10/6/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
625 Duct work 017619.01 503-626 -8986 N
Corrections /Comments/ Instructions:
0 A Pa, 14 44 7 1 ----
❑ PASS eARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-
o