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Permit CITY TIGARD MECHANICAL PERMIT l DEVELOPMENT SERVICES PERMIT #: MEC2002 -00080 -- 11 1 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/26/02 PARCEL: 1 S126C0 -01107 SITE ADDRESS: 09619 SW WASHINGTON SQUARE RD L -4 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: 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: > 10000 cfm: GAS OUTLETS: Remarks: Duct and drops, registers and grills. Owner: FEES PPR WASHINGTON SQUARE LLC Type By Date Amount Receipt P.O.BOX 21545 PRMT CTR 2/26/02 $72.50 2720020000 SEATTLE, WA 98111 5PCT CTR 2/26/02 $5.80 2720020000 Total $78.30 Phone: Contractor: PROTEMP ASSOCIATES INC 807 NE COUCH PORTLAND, OR 97232 REQUIRED INSPECTIONS Phone: 233 -6911 Reg #: LIC 38868 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 -0080. Y.0 may obtain •pies of these rules or direct questions to OUNC by calling Mr1117dR -A 9 Re Issue By: / Permittee Signatu0 Call (503) 639 -4175 by 7:00 P.M. for inspections need d the next business day Mechanical Permit Application _ Date received: 6 Z Permit no.: nil e( U,9- -oa '"� i i City of Tigard Pro;ecdappl. no.: Expire date: Add 13125 SW Hall BI;':',' t�.�d I?'_: VE City of Tigard Date issued: Bce,?) I Receipt no.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Fig 2 6 2002 Case file no.: Payment type: Land use approval: Building permit no.: Cu Y Uhl tJE4 " 11'PrC 01.. f' :RMIT ' ❑ 1 & 2 family dwelling or accessory ❑ Commercial/industrial ❑ Multi - family ,enant improvement ❑ New construction ❑ Addition/alteration/replacement ❑ Other: JOB SITE INFORMATION ._ ' - COMMERCIAL VALUATION SCHEDULE Job address: vl e. 9 5, a . i v.4b 5:I /ie/l. ro xJ SU.Br.L AI. Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: I Suite no.: L - ix/ value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ nc t 'SO C Lot: (Block: I Subdivision: *See checklist for important application information and Project name: Pc; p- 4 y B A / jurisdiction's fee schedule for residential permit fee. City /county: T9.�-yem I Z IP: 97a g / 1 & 2 FAMILY DWELLING PERMIT FIT SCHEDULE Description and location of work on premises: pi5Ta;Burm J AND COMMERICAL /INDUSTRIALEQU IPMENTSCIIEDULE .O i AA./,t) Sp r2r LGC'S Fee(ea.) Total Est. date of completion/inspection: Description Qty. Res. only Res. only Tenant improvement or change of use: HVAC: Air handling unit CFM Is existing space heated or conditionedVarYes ❑ No Air conditioning (site plan required) Is existing space insulated ?'Yes ❑ No Alteration of existing HVAC system / 1\'IECI - I AN I CAL CONTRACTOR Boiler /compressors Business name: State boiler permit no.: �K ATFMP �55o& .. t cat' . HP Tons BTU/H Address i n 7 AJ G B Fire/smoke dampers/duct smoke detectors City: / �I Z72.A../D I State) I ZIP: 97x3 a Heat pump (site plan required) Phone:a _// I Fax:g, c, E - mail: Install/replace furnace/burner BTU /H ' Including ductwork/vent liner CI Yes U No CCB no.: '''3.- G' Install/replace/relocate heaters City /metro lic. no.: ySs-- wall, or floor mounted Name (please print): J6.." — / , i Vent for appliance other than furnace Refrigeration: Absorption units BTU/H Name: .' A2c/►7 �) ,44_,A,7 Chillers HP Address: 7 Compressors HP Environmental exhaust and ventilation: City: I State: I ZIP: Appliance vent Phone3 ..e,9/ ) F. ; ; •97G E -mail: Dryer exhaust OWNER Hoods, Type 1/ 11/res. kitchen/hazmat hood fire suppression system Name: Exhaust fan with single duct (bath fans) Mailing address: Exhaust system apart from heating or AC City: I State: I ZIP: Fuel piping and distribution (up to 4 outlets) Type: LPG NG Oil Phone: Fax: E -mail: Fuel i ing each additional over 4 outlets - ess piping (schematic required) Name: Number of outlets Other listed appliance or equipment: Address: Decorative fireplace City: I State: I ZIP: Insert - type Phone: Fax: E -mail: Woodstove/pelletstove A Applicant's si nature ,, , Other: pp g ,/������ � Dateo7 � s_. Other. Name (print): , E - 4 L t Not all jurisdictions accept credit cards, please call jurisdiction for more information Permit fee $ '7<a. .-70 Notice: This permit application ❑ Visa ❑ MasterCard Minimum fee $ ex if a permit is not obtained Credit card number. / / Plan review (at %) $ Expires within 180 days after it has been State surcharge (8%) .... $ / Name of cardholder as shown on credit card accepted as complete. $ TOTAL $ Cardholder signature ' Amount , 440-4617 (600/COM) ----- - c MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: Description: • Price Total $1.00 to $5,000.00 Minimum fee $72.50 Table 1A Mechanical Code Qty (Ea) Amt $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and 1) Furnace to 100,000 BTU $1.52 for each additional $100.00 or including ducts & vents 14.00 fraction thereof, to and including 2) Fumace 100,000 BTU+ $10,000.00. including ducts & vents 17.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and 3) Floor Furnace $1.54 for each additional $100.00 or including vent 14.00 fraction thereof, to and including 4) Suspended heater, wall heater $25,000.00. or floor mounted heater 14.00 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional $100.00 or 6 80 fraction thereof, to and including 6) Repair units $50,000.00. 12.15 $50,001.00 and up $742.00 for the first $50,000.00 and Check all that apply: Boiler Heat Air $1.20 for each additional $100.00 or For items 7 -11, see or Pump Co d fraction thereof. footnotes below. Com Minimum Permit Fee $72.50 SUBTOTAL: $ 7) <3HP; absorb unit to 100K BTU 14.00 8% State Surcharge $ 8) 3-15 HP; absorb 25.60 unit 100k to 500k BTU 25% Plan Review Fee (of subtotal) $ 9) 15-30 HP; absorb 35.00 Required for ALL commercial permits only unit .5 -1 mil BTU TOTAL COMMERCIAL PERMIT FEE: $ 10) 30 -50 HP; absorb 52.20 unit 1 -1.75 mil BTU 11) >50HP; absorb unit >1.75 mil BTU 87.20 ASSUMED VALUATIONS PER APPLIANCE: 12) Air handling unit to 10,000 CFM 10.00 Value Total 13) Air handling unit 10,000 CFM+ Description: Qty (Ea) Amount 17.20 Furnace to 100,000 BTU, including 955 14) Non - portable evaporate cooler ducts & vents 10.00 Furnace > 100,000 BTU including 1,170 15) Vent fan connected to a single duct ducts & vents 6.80 Floor furnace including vent 955 16) Ventilation system not included in Suspended heater, wall heater or 955 appliance permit 10.00 floor mounted heater 17) Hood served by mechanical exhaust Vent not included in applicance 445 10.00 permit 18) Domestic incinerators Repair units 805 17.40 < 3 hp; absorb. unit, 955 19) Commercial or industrial type incinerator to 100k BTU 69.95 3-15 hp; absorb. unit, ' 1,700 20) Other units, including wood stoves 101 k to 500k BTU 10.00 15-30 hp; absorb. unit, 501k to 1 2,310 21) Gas piping one to four outlets mil. BTU 5.40 30 -50 hp; absorb. unit, 3,400 22) More than 4 -per outlet (each) 1 -1.75 mil. BTU 1.00 >50 hp; absorb. unit, 5,725 Minimum Permit Fee $72.50 SUBTOTAL: $ >1.75 mil. BTU Air handling unit to 10,000 cfm 656 8% State Surcharge $ Air handling unit >10,000 cfm 1,170 Non - portable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system not included in 656 appliance permit Hood served by mechanical exhaust 656 Other Inspections and Fees: Domestic incinerator 1 170 1 Inspections outside of normal business hours (minimum charge -two hours) $62.50 per hour. Commercial or industrial incinerator 4,590 2. Inspections for which no fee is specifically indicated (minimum charge -half hour) Other unit, including wood stoves, 656 $62.50 per hour inserts, etc. 3 Additional plan review required by changes, additions or revisions to plans (minimum Gas piping 1 - 4 outlets 360 charge -one -half hour) $62.50 per hour Each additional outlet 63 *State Contractor Boller Certification required for units >200k BTU. TOTAL COMMERCIAL ' • $ "Residential NC requires site plan showing placement of unit. VALUATION: All New Commercial Buildings require 2 sets of plans. i:\dstsVorms\mech- fees.doc 12/26/01 CITY OFTIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 c� g INSPECTION''®IVISION Business Line: (503) 639 -4171 BUP Received Date Requested ( t o AM PM BUPA Location � L(J So D, Suite 016 Contact Person D Ph ( ) � 9 6 /n PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner 0L..d41 � . , __ 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 Post & Beam Under Slab Rough -In -- Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole • Storm Drain Shower Pan Other: Final PASS PART FAIL CHAN I Beam Rough -In Gas Line • Smoke Dampers 1 V\ A PART FAIL RICAL 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 reinsp tion RE: Unable to inspect — no access Fire Supply Line ADA • Il /) Approach/Sidewalk Date v (_inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL • CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST • BUP 200 / 4 6 7 Received Date Requested - - AM PM — f )UP e — 61° 0 4? Location 9(.0/ F (1)/i . SC2 . D Suite � -- MEC . O Contact Person 77; Ph ( )P- j - PLM Con x {' 29 2 $ AV-6)14--v Pi Ph( ) SWR UILDI • Tenant/Owner , �!I_J are/ 1 ELC •.ting ELC Foundation 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: a PART FAIL • ING - ? i • Post & Beam / Under Slab - � Rough -In Water Service Sanitary Sewer ----�, Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final P,. =��_ •:� FAIL (1Ixa :r:nI1.411 �� Rough -In Gas Line Smoke Dampers inal SS PART FAIL E RICAL 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 �l ADA Approach/Sidewalk Date V Inspector \ Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL - - — - —