Permit r �
C ITY OF TIGARD MECHANICAL PERMIT
AL-1411P' SERVICES
PERMIT #: MEC2006 -00157
A ��I DATE ISSUED: 5/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1512600 -00300
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC -4 ZONING: C -G
SUBDIVISION: WASHINGTON SQUARE LOT: JURISDICTION: TIG
Project Description: T.I. Valuation: $6500.(listed type I hood w /exhaust system)
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 1
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: B VENTS W/O APPL: VENT SYSTEMS: 1
STORIES: BOILERS /COMPRESSORS HOODS: 1
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 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: 1
> 10000 cfm:
GAS OUTLETS: 3
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [MECH] Permit Fee 5/18/200E $168.50
TIGARD, OR 97223 [MECPLN] Plan Rev 5/18/200E $42.13
[TAX] 8 %SS!,.e Surcha 5/18/200E $13.48
Phone: 503- 639 -8865 yf' - Total $224.11
Contractor:
PACIFIC STAINLESS PRODUCTS
10100 SW ALLEN BLVD -
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact #: PM 641 -7060
Reg #: LIC 63640
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 req. ires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR '. ' 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
•
O',
Issued B� Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that b\iness day.
This permit card shall be kept in a conspicuous place on the job site u ;*I completion of the project.
Approved plans are required on the job site at the time of each inspection.
1
e .hanica! Permit ' „, I - t y ,� ^ I ���.
.'
Cit it ' Received
y of Tigard Date/By Permit NoA -
13125 SW Hall Blvd., Tigard, OR 97223 y / DO /
J ` c a K ov /r
Plan Review /
Phone: 503.639.4171 Fax: 503.598.1960 Al' o a -,y I Date/By `)I ti o 1r' t g Other Permit
Inspection Line: 503.639.4175 f I 1 Date R ady/By i i tuns Ell See Page 2 for
Internet: www.ci.tigard.or.us
CITY Of t
AO ' w Non ethod - ? /+�' S ----- I Supplemental Information
N
}'- ` I WORK ' � �� ,... COM ERCIAL F E• 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, an9rofit.
CATEGORY OF CONSTRUCTION Value: $ 4S ^0 0a
El 1 - and 2- family dwelling Commercial/industrial El Accessory building RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ?a, 3 -Z 4,4/AL S I2 Igo( Air conditioning or heat pump
(regwres site plan showing; placement) 14.00
City /State /ZIP: 2 9 7 .z � 3 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: o
I Project name' 6 Jee9Oo B D � Furnace 100,000+ BTU (ducts/vents) 17.90
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
/(11971/6 , , - � e g Go `e r Unit h ic) 14.00
{/� r �Y Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: I 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
T p-c E ,e1 c .- /4 n � 5r � Gas fireplace gas
t / / rc Y Flue vent for water heater or g
// 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
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans - 10.00
OOther: 10.00
Business name: ,rc <�/17��es s /O</tt, / C Fuel piping
Contact name: / , $5.40 for first four; $1.00 for each additional
Address: /0/ Furnace, e �2x e � efi�I� Furnace, etc.
Gas heat pump
City /State /ZIP: .1„Q3"..) (9 7 2- v r Wall/suspended/unit heater
Phone: J ) 0/ 2o6 0 Fax: : (5 �9 4 3 ¢( Water heater
/�� /� 6 . p / �s { /,, Fireplace
E-mail: # U zs/ 'r,,, / ,c/ C J /7f7A/ less . e' <A7 Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES"
City /State /ZIP: 2,7 . A g Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: 6 2 4 f State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signs This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: ,._! G/ gzr .e...- I Date: 1 / 7 D • Fee methodology set by Tri- County Building Industry Service Board
r\ Building \Pennits\MEC- PermitAppdoe 12/03 440-4617T (11/02/COM/WEB)
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 R
fraction thereof, to and including
$100,000.00. VSC)
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or yl„�
fraction thereof. S
Note: All new commercial buildings require 2 sets of plans. S '
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0
i:\ Building \Permits\MEC- PermitApp.doc 12/03 2 •
CIT.OF TIGARD r
, BUILDING DIVISION PERMIT #a _ Z S D /5- 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE I SSUED:
Phone: (503) 639 -4171 �v' ,,,ii
Inspection Requests (24 Hrs.): (503) 639 -4175 °_
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 76, 3 3 Q} 4 , S 0 . CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: �e� 0 �' _ f Doi_
DESCRIPTION: t
OWNER: PHONE #:
CONTRACTOR: PHONE #: j
Inspection Request Scheduled For: Date: 6 - / 6 -4 1f Pour Time:
Code # Inspection Des ription Confirm # Contact # Message
( 1 9 Corrections /Comments /Instructions:
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ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDIT •NAL FEES ASSESSED
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0 :14 \ I Inspector: I / Date: .4 !� �' AN Phone #: (503) 718 -
0-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00157
13125 SW Hall Blvd.; Tigard, OR 97223 DATE ISSUED: - /1E3J2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 e 1
INSPECTION WORKSHEET FOR DATE: 6/13/2006 TIME: 7 : PAGE: 96
1
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC-4 CLASS OF WORK: 1
SUBDIVISION: WASHINGTON SQUARE LOT #: • TYPE OF USE:
PROJECT NAME: GOOD DOG BAD DOG
DESCRIPTION: T.I. Valuation: $6500.(listed type 1 hood w /exhaust system)
OWNER: WASHINGTON SQUARE LLC, ' PHONE #: 503 -639 -8865
CONTRACTOR: PACIFIC STAINLESS PRODUCTS PHONE #: 641 -7060
Inspection Request Scheduled For: Date: 6113/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 , Mechanical rough -in 031586 -01 503-961-2467 N
Corrections /Comments /Instructions: •
ill
il di - MOWS
.� � ASS ❑ PARTIAL APPROVAL CANCEL ❑ NO ACCESS
❑ FAIL .❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: dr 114 '\ Date: bita_laQ Phone #: (503) 718- ��
_ . • _ - ,