Permit r-
CITY TIGARD MECHANICAL PERMIT
I � DEVELOPMENT SERVICES PERMIT #: MEC2006 -00106
J� .. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 2/21/2006
PARCEL: 1S12600-00300
SITE ADDRESS: 09625 SW WASHINGTON SQUARE RD FC -1 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: Replacement of walk -in cooler /freezer. 1 piece unit.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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:
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: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 21211200E $72.50
9585 SW WASHINGTON SQUARE RD [TAX] 8% State Surchar€ 2/21/200€ $5.80
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
WOODBURN CONSTRUCTION
PO BOX 129 REQUIRED ITEMS AND REPORTS
WOODBURN, OR 97071 •
Contact #: FAX 503- 981 -8821
PRI 503- 981 -9504
Reg #: LIC 238
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: �)a Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that busin .- • 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.
r
Mechanical Permit ' r 1 t % FOR OFFICE USE ONLY
City of Tigard - t Received
.- / A U` I// �"�`
� t
Date/By Pemut No.I` <_ A _
�l
13125 SW Hall Blvd., Tigard, Olit+9'7" ' ' r
Y
Other Permit: /O! ,/ p
' [ �
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Ga„ ; I ; ?, Date/By.
FE B Inspection Line: 503.639.4175 21 2006 ,, tt �
- •tom I Date Ready/By. 3mis ® See Page 2 for
Internet: www.ci.tigard.or.us " Noh fed/Method .� /(c Supplemental Information
OF rrai
t , � SION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction �'C' on/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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ig Commercial/industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
. JOB SITE INFORMATION AND LOCATION Heating/cooling
G" / 1 Air conditioning or heat pump
Job site address:
.�' w� ) ,( �} �� (requires site plan showing placement) 14.00
City / State/ZIP: ��_ _. '1 Furnace 100,000 BTU (ducts/vents) 14.00
‘' I ` - ' �- � Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: - a , \ Project name: -spt "' n 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
�� v _ Gas fireplace 10.00
P Alif --MERT t: ��c- v�C.�t— �1 ( G (-4 /(.jj 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
❑ PROPERTY OWNER - , I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: ( ' C' AAL- ",,m Fuel piping
Contact name: t z-( e $5.40 for first four; $1.00 for each additional
Address:` F. gar
Furnace, etc.
l Gas heat pump
City /State/ZIP: .c. ti . ,. \ cx 'Z q - R > �_/ WalUsuspended/unit heater
Phone: (6) %U/ -,:::?0.47/ Fax: : () C , i3 1 Water heater
Fireplace
E -mail: Range
CONTRACTOR - Barbecue
/(� ,L 7 � / --- Clothes dryer (gas)
Business name: f.� i t'�2at/ C
Other:
Address: MECHANICAL PERMIT FEES* '
City /State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone:( ) Fax:( )
Plan review (25% of permit fee)
CCB lic.: (Q?.fit5 Ar1 --/6 Q State surcharge (8% of permit fee)
/ TOTAL PERMIT FEE
Authorized signature This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name:
.Anor r � � , Date: a , 1 , • Fee methodology set by Tri- County Building Industry Service Board
i\Building\PermnsVMEC -Pe nitApp.doc 12/03 440.4617T(11/02/COM/WFB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total - Valuation: - Permit Fee: -
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 1 , M ��
BUILDING DIVISION � y PERMIT #: ?OO�q - CO /a 6
13125 SW Hall Blvd., Tigard, OR 97223 ( d, , DATE ISSUED:
Phone: (503) 639 -4171 j - „..,, _.;• a
Inspection Requests (24 Hrs.): (503) 639 -4175 . �! +L ^ .. ./c A "1
INSPECTION WORKSHEET FOR DATE: . /0/ TIME: PAGE:
SITE ADDRESS: Q, �,S !/V i D '
CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: ,
OWNER: PHONE #:
CONTRACTOR: 6/N, PHONE #: 4 /.- 7 / T7
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Descri tion Confirm # Contact # Message
• & S `n,. cam‘ L. 7Z-"^ 0._
Corrections /Comments /Instructions:
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S S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/J s `/
Inspector: \ ✓' �I Date: W5/ Phone #: (503) 718 - Z � �7