Permit _ 1Ga
CITY TIGARD MECHANICAL PERMIT
I � DEVELOPMENT SERVICES PERMIT #: MEC2005 -00596
I I I " 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/6/2005
PARCEL: 1S12600-00300
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: HVAC Value: 6680.00
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 1
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:
ELE 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: 1 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 [MECH] Permit Fee 10/6/200E $172.10
9585 SW WASHINGTON SQUARE RD [MECPLN] Plan Rev 10/6/200: $43.03
TIGARD, OR 97223 [TAX] 8% State Surchar€ 10/6/200E $13.77
Phone: 503 639 - 6685 Total $228.90
Contractor:
SALEM HEATING & SHEET METAL INC.
PO BOX 12005 REQUIRED ITEMS AND REPORTS
SALEM, OR 97309
Phone: 503 - 581 - 1536
Reg #: LIC 1505
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 Signature: " ���'
Call 503 - 639 -4175 by 7:00 a.m. for inspections ..t 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.
�` FOR OFFICE USE ONLY
1Vr1.:chanic .al.Permi I_' I, ft -: �;i?l
City of Tigard Date/By: > ig Permit No: (M QC--026 •,
13125 SW Hall Blvd., Tigard, OR 97 t1/ L 2 2005 Plan Review o�
Phone 503 639 4171 Fax: 503.598. `' :1 Date/By D 3 � niir' Ot i r Permit: b .. a _ • , _
Inspection Line 503.639 4175 a c�l 1 Date Ready /By r gillPlj Supplemental Information 121
See 'age 2 for
OF TIGARD Notified/Method -
Internet: wWW.C1.t1g1fC�.OT'.L�3 ITY tia� �� L�'�
BUILDING DIVISION ' r
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TYPE OF WORK COMMIRCIAL FEE* SCHEDULE – USE CHECKLIST
p<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 $ 6 6RQ1�
RESIDENTIAL EQUIPMENT SYSTEMS FEES*
❑ I - and 2- family dwelling Yr Commercial /Industrial ❑ Accessory building
For special information use checklist.
• Multi-family ❑ Master builder ❑ Other: Descnption I Qty I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
(� �j �(�[ /� C Air conditioning or heat pump
Job site address:
'3D y- )W • ' s✓�me►pN ,1Zs1) 1 SP , F R �a (requires site plan showing placement) 14.00
City /State /ZIP: pcsg:ruNgt) 9h2.Z.3 ( R ?) Furnace 100,000 BTU (ducts/vents) 14.00
N Furnace 100,000+ BTU (ducts/vents) 17 90
Suite/bldg. /apt. no.: R1_ J a, go-7 Project name: 4 8vf irafic Gas heat pump 14 00
Cross street/directions to job ste: Duct work 14.00
W 1 Nz*� 5 Q.u M Hydronic hot water system 14.00
Pd>1)111 Residential boiler (radiator or
hydronic) 14 00
Unit heaters (fuel -type, not electric),
to -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
A Gas fireplace 10.00
1'�'.V.{k.C.. fpR. i 'W I Le S PAVE, Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10 00
Wood fireplace /insert 10 00
Chimney/liner/flue/vent 10 00
❑ PROPERTY OWNER 0 TENANT
Other: 10 00
Na C e Environmental exhaust and ventilation
J Range hood/other kitchen
Address 241 S + 1 � ST'. $t equipment 10.00
City /State /ZIP: c f i, I"1 . q^?307 Clothes dryer exhaust 10.00
s Single -duct exhaust (bathrooms,
Phone (611'N 391 _ a 1 Fax: ( ) toilet compartments, utility rooms) 6 80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other 10 00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additiona
Address. Furnace, etc.
Gas heat pump
City /State /ZIP• Wall /suspended /unit heater
Phone• ( ) Fax:: ( ) Water heater
Fireplace
E - mail:
Range
CONTRACTOR Barbecue
Business name: 5 ti"\ -A+�� NI 6. 4 51,..-6-1-- M � Clothes dryer (gas)
,l c Other:
Address )L.25' – 22 $1 % 5 € MECHANICAL PERMIT FEES*
City /State /ZIP: skier-%\ 612, , 913o z. Subtotal
Minimum permit fee ($72.50) Ill,
Phone. (Sb3) S8 1-Is 3b Fax. ( 5 3
3 310 1 Q O
3
Plan review (25% of permit fee) 9 3 3 ,03
1 CCB lic : ' State surcharge (8% of permit fee) 13.1 T
• TOTAL PERMIT FEE ZZ$ 3o
, l — This permit application expires if a permit is not obtained within 180
Authorized signature:
�r, J'—"".. days after it has been accepted as complete.
Print name: 7.V 11 kL 'r i F. ` GN Date: q...-1.15-0s • Fee methodology set by Tn-County Building Industry Service Board
i \Budding \Permns \MEC- PermnApp doc 12/03 440 -4617T (11 /02/COM/WEB)
I MBUE TIGARD
BUILDING DIVISION • PERMIT #: MEC2005 -00596
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2005
Phone: (503) 639 -4171 a i '
Inspection Requests (24 Hrs.): (503) 639 -4175 F'I •
INSPECTION WORKSHEET FOR DATE: 11/2/2005 TIME: 7:04AM PAGE: 60
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE SHU
DESCRIPTION: HVAC Value: 6680.00
OWNER: WASHINGTON SQUARE LLC, PHONE #: 603. 639.6685
CONTRACTOR: SALEM HEATING & SHEET METAL INC. PHONE #: 503- 581 -1536
Inspection Request Scheduled For: Date: 11/2/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 020100-02 503- 463.4500 N
Corrections /Comments /Instructions:
•
tom` V
•
• ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
• Inspector: ' • Date: � '• L _ ' Phone #: (503) 718-
CITY „QF TIGARD
BUILDING DIVISION PERMIT #: MEG200S 00596
13125 SW Hall Blvd., Tigard, OR 97223 , ,I r ' DATE ISSUED: 10/6/2005
Phone: (503) 639 -4171 t 1 • ` ”'
. .
Inspection Requests (24 Hrs.): (503) 639 -4175 ': li�l
INSPECTION WORKSHEET FOR DATE: 11/16/2005 TIME: 7:03AM PAGE: 82
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: (R UI1 RBUG
DESCRIPTION: Value: 6 680.00
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 639.6686
CONTRACTOR: SALEM HEATING & SHEET METAL INC. PHONE #: 503 -581 -1536
Inspection Request Scheduled For: Date: 11/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 021388.01 603-702 -2827 N
Corrections /Comments/ Instructions:
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I
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•;. _ .
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL .
❑ NO ACCESS
❑ FAIL ❑ •CALL FOR INSPECTION ❑ ADDITI NA FEES ASSESSED
Inspector: Oa% Date: L ( ( hone #: (503) 718 -
CITY,,,QF TIGARD
BUILDING DIVISION PERMIT #: MEC2005.00596
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/6/2005
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 64
SITE ADDRESS: 09384 SW WASHINGTON SQUARE RD CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: THE SHUTTERBUG
DESCRIPTION: HVAC Value: 6680.00
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503-639-6685
CONTRACTOR: SALEM HEATING & SHEET METAL INC. PHONE #: 503 - 581 -1536
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # , Contact # Message
699 Mechanical final 021131 -02 503.702 -2827 N
Corrections/Comments/Instructions:
,
E,
• OT-6 .� _ ekt l 1 1_
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: j/� Date: I ((th #: (503) 718-
•