Permit CIT OF TIGARD MECHANICAL PERMIT
�^ DEVELOPMENT SERVICES PERMIT #: MEC2005 -00631
8 � III 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/6/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: HVAC Value: $14,500
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 10/6/200: $299.00
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 10/6/200: $74.75
TIGARD, OR 97223 [TAX] 8% State Surchaq 10/6/200E $23.92
Phone: Total $397.67
Contractor:
ACCURATE HEATING, INC.
P.O. BOX 2276 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Phone: 650 - 1229
Reg #: LIC 88423
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: . f , r Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that bus ness day.
This permit card shall be kept in a conspicuous place on the job site unti completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard DReceived ate/By 0 !r7 , j Permit No. 1. CD .
13125 SW Hall Blvd., Tigard, OR 9722 Plan Review Other Permit
Phone: 503.639.4171 Fax 503.598.1960 , 1 � Date/By
Inspection Line: 503.639.4175 OCT 0 6 200
6. Date Date Ready/By El See Page 2 for
Internet: www ci.tigard.or.us Notified/Method NMI Supplemental Information
$U [71(J(a s 'SION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
® 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $ $14,500.00
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: 9378 SW WASHINGTON SQUARE ROAD Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP: TIGARD, OREGON Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17 90
• Suite/bldg. /apt. no.: Project name: DUCK SHOP 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: Lot no.: Flue/vent for any of above 10.00
Other 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
ADD (1) CHILLED WATER AIR HANDLER W/ 10 KW STRIP HEAT Gas f 10.00
Flue vent for water heater or gas
AIR DISTRIBUTION fireplace 10.00
Log lighter (gas) 10 00
910 CEILING MOUNTED EXHAUST FAN Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER ® TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: DUCK SHOP Environmental exhaust and ventilation
Address: 9378 SW WASHINGTON SQUARE ROAD Range hood/other kitchen
equipment 10.00
City/State/ZIP: TIGARD OREGON 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: ACCURATE HEATING Other: 10 00
Fuel piping
Contact name: MICHAEL BLACKMON JR $5.40 for first four; $1.00 for each additional
Address: PO BOX 2276 Furnace, etc
Gas heat pump
City /State/ZIP: CLACKAMAS, OREGON 97015 Wall/suspended/unit heater
Phone: (503) 650.1229 Fax: : (503) 650.4845 Water heater
Fireplace
E- mail: MBLACKMONJR@ACCURATEHEATING.COM Range
CONTRACTOR Barbecue
Business name: ACCURATE HEATING Clothes dryer (gas)
Other:
Address: PO BOX 2276 MECHANICAL PERMIT FEES*
City /State/ZIP: CLACKAMAS, OREGON 97015 Subtotal
Phone: (503) 650.1229 Fax: (503) 650.4845 Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 88423 State surcharge (8% of permit fee)
kFTOTAL PERMIT FEE
Authorized signature: This permit application expires if a permit is not obtained within 180
I days after it has been accepted as complete.
Print name: MICHAEL BLAC I Date: 10.01.05 • Fee methodology set by Tn- County Building Industry Service Board
i.\ Building\PernitAMEC- PeminAppdoe 12/03 440- 4617T(II /02/COM/WEB)
._._ _ -
CITY. -OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005-00631
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2005
Phone: (503) 639 -4171 � .Ro i � l r
Inspection Requests (24 Hrs.): (503) 639 -4175 F_
INSPECTION WORKSHEET FOR DATE: 11/9/2005 TIME: 7 :09AM PAGE: 1
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DUCK SHOP
DESCRIPTION: HVAC Value: $14,500
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ACCURATE HEATING, INC. PHONE #: 650-1229
Inspection Request Scheduled For: Date: 11/9/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 020863-01 503-317-9097 Y
Corrections /Comments /Instructions: 4 5 0 3 - 3( - 1 7 ?T
tV , I ! . . k - - ' . 07
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c 1 , : \ , A SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ( CALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /
?f Da te: ` �j Phone #: (503) 718-
/ I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 -00631
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2005
Phone: (503) 639 -4171 �9F
Inspection Requests (24 Hrs.): (503) 639 -4175 ".
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 86
SITE ADDRESS: 09378 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: DUCK SHOP
DESCRIPTION: HVAC Value: $14,500
OWNER: WASHINGTON SQUARE LLC, PHONE #:
CONTRACTOR: ACCURATE HEATING, INC. PHONE #: 650 -1229
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021107 -01 603-317 -9097 N
Corrections /Comments/ Instructions:
.----- . .
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F.R INSPECTION ❑ ADDITI NAL F ES ASSESSED
kr 1
(t Ins ector: : 03 p Date. #: (5 ) 718 -