Permit 9/7/
Y OF T I GA MECHANICAL PERMIT
i� DEVELOPMENT SERVICES PERMIT #: MEC2003 -00489
`-" �� I ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/17/03
PARCEL: 1 S126C0 -01107
SITE ADDRESS: 09530 SW WASHINGTON SQUARE RD H -10
SUBDIVISION: WASHINGTON SQUARE ZONING: C -G
BLOCK: LOT: JURISDICTION: TIG
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: 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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: 5
> 10000 cfm: GAS OUTLETS:
Remarks: Mechanical tenant improvement
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 8/15/03 $72.50
9585 SW WASHINGTON SQ. RD.
PORTLAND, OR 97223 [MECPLN] Plan Rev 8/15/03 $18.13
[TAX] 8% StateTax 8/15/03 $5.80
Phone: Total $96.43
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 692
Duct Inspection
Reg #: LIC 5193 Final Inspection
•
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 -00 : I I. •u mayatain copies of these rules or direct questions to OUNC by calling
(503 46 -6699. •
Issu. d By: , � i1! 1 %AL �' . Permittee Signature: 1, ..„417/1,,,W0.7/ ,
__ Call (503) ' 9 - 4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR OFFICE USE ONLY
rTh p Received t „ Mechanical Li,
Date/By: g /1/ x, Permit No.: /l ,005 r� � 0 e
Planning Approval Building
City of Tigard Date/By Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No - I ,3 - 60
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
r+l #' f� Date/By: Case No.:
Internet: www.ci.tigard.or.us • e .' I I Contact _4 ® See Page 2 for
'^
24 - hour Inspection Request: 503 639 - 4175 - Name/Method: ) ICO• Supplemental Information.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
® Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CONSTRUCTION mechanical materials, equipment, labor, overhead and profit.
❑ 1 & 2- Family dwelling Ej Commercial/Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi- Family RESIDENTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
❑ Master Builder ❑ Other: Heating/Cooling
JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning ** 14.00
Job site address: 4 53O sko .U14 w rou Gas heat pump 14.00
Suite #: [Ho - I Bldg. /Apt. #: ill Duct work 14.00
Project Name: �Q l9 � Hydronic hot water system 14.00
Residential boiler
Cross street/Dire ions to jdb site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Subdivision: I Lot #: Repair units 12.15
Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
.-,55s � ` ► c p , p p r �( °"' �, Q Flue vent (water heater /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 I 'TENANT Other: 10.00
Name: Environmental Exhaust & Ventilation
�- �� ��e- Range hood/other kitchen equipment 10.00
Address: 13. t A 1..4,0 r Clothes dryer exhaust . 10.00
City /State /Zi s : e .10i. Single duct exhaust
Phone:Ito - L .10(03. )8.10 0 Fax: (bathrooms, toilet compartments,
❑ APPLICANT ❑ CONTACT PERSON utility rooms) 6.80
Other: 10.00
Name:.5�,,,,, �,,p . ,r Attic /crawl space fans 10.00
rr
Address: \ S ski) • t�Auo u 4v .•u► (114.4 Fuel Piping
City/State/Zip. 1, Q72.23 * *($5.40 for first 4, $1.00 each additional)
1
Phone: Cb3 _ IZVV Fax: so-$� ()oo Furnace, etc. ** Gas heat pump
**
E -mail Act t') 17 t, 19 V D\ r�u. A Wall/suspended/unit heater **
Aea
CONTRTOR Water heater **
Business Name: i t2 Fireplace **
**
Address: BBQe **
• City /State /Zip: Clothes dryer (gas) **
Phone: Fax: Other: **
CCB Lic. #: Total:
Mechanical Permit Fees*
Authorized / t, 4 ,4 S� 8 „ Subtotal: $
Signature: � ;: :5 - _• .11 Date: ( Minimum Permit Fee $72.50 $
1I.11 .�rQ_/APPt • Plan Review Fee (25% of Permit Fee) $
(Please print name) State Surcharge (8% of Permit Fee) $
TOTAL PERMIT FEE $
Notice: This permit application expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01/03
Mechanical Permit Application - City of Tigard +" '
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $5,000.00 Minimum fee $72.50
$5,001 00 to $10,000.00 $72.50 for the first $5,000 00 and $1.52
for each additional $100 00 or fraction
thereof, to and including $10,000.00
$10,001.00 to $25,000 00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000 00.
$25,001 00 to $50,000.00 $379 50 for the first $25,000.00 and
$1.45 for each additional $100 00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742 00 for the first $50,000 00 and
$1.20 for each additional $100 00 or
fraction thereof.
Assumed Valuations Per Appliance: -
Value Total
Description: Qty (Ea) Amount
Furnace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955
mounted heater
Vent not included in appliance permit 445
Repair units 805
< 3 hp; absorb unit, 955
to 100k BTU
3 -15 hp; absorb. unit, 1,700 •
101k to 500k BTU
15 -30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30 -50 hp; absorb unit, 3,400
1 -1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU
handling unit to 10,000 cfm rcr 656
Air handling unit >10,000 cfm 1,170
Non - portable evaporate cooler 656
Vent fan connected to a single duct / 446
Vent system not included in appliance 656
permit
Hood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION:
is \Dsts\Permit Forms\MecPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour -'sp
BUILDING Inspection Line: 503) 639 -4175
INSPECTION DIVISION . - Business Line 3) 639 -4171 MST
BUP
Received Date Requested // AM "I/ 6 PM BUP
Location c S3D ING�S r� �5 _ Y Suite /4 — / o 4 3-004k1
Contact Person be, e-k Ph ( ) a — I SAS PLM
Contractor Ph ( ) - SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear •
Framing
Insulation '
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: - - _
Final
PASS PART FAIL
PLUMBING c);1--
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other: - •
Final
S FAIL
M CHANIC
eam
Rough -In p. ✓Q
Gas Line
Sm. - :- mpers 1- 11 9 9 •
• S PART FAIL
TRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line I /� / ADA Approach/Sidewalk Date Inspector V i,& Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site. -
PASS PART FAIL