Permit s. s, ti
A lek C ITY OF TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -00192
��' II
DATE ISSUED: 5/9/2006
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: Install gas to hot well and water heater.
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:
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:
> 10000 cfm:
GAS OUTLETS: 2
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY
9585 SW WASHINGTON SQUARE RD [MECH] Permit Fee 5/9/2006 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 5/9/2006 $5.80
Total $78.30
Phone: 503- 639 -8865
Contractor:
PLUMBING CONCEPTS, INC.
PO BOX 1068
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 658 -5232
PRI 503- 658 -5232
Reg #: LIC 95787
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: Permittee i"gnature. -� ' - c_.____
Call 503 - 639 -4175 by 7:00 a.m. for inspect that business da
This permit card shall be kept in a conspicuous place on the job site until comple ion of the project.
Approved plans are required on the job site at the time of each inspection.
•
.i
Mechanical Permit ADDIi alto 't E , F(> Oi:I USE , ONLY -
ry, �?.d R e ce ived
74 City of T igard Plan Re . '7 /4 j Permit NcR4,G/ � I /9
13125 SW Hall Blvd., Tigard, OR 97223 ', f "`~+
Phone: 503.639.4171 Fax: 503 598. / ( ' Plan Revie Other Permit.
� I 0 9 2006 Date/By
TI G A I Inspection Line: 503.639.4175 Date Ready/By runs • ® See Page 2 for
Internet: www.tigard- or.gov } , , Non fied/Method j , yq( Supplemental Information
TYPEI( wRkl( `: )$ 1/ 1 s 101`. COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction 9 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition • ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value $
El 1 - and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
y g 'Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address:
9Cv 3 . 3 ,5-. W i, oashi nsAsvr S arc A (requires site plan showing placement) 14.00
City /State /ZIP: /;9rd / Dg Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.. Project name:() 0;9 / e D
Gas heat pump 14.00
Cross street /directions to job site: Wr7.Y/iM .5 t• a,' 1 d (O r�Y t Duct work 14.00
O 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
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
- - - " ' DESCRIPTION OF WORK Water heater I 10.00
_ / Gas fireplace 10.00
/ !7s/'a // 5,75 1,"%!F to t27/'Xfl rti-: 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: ///A • SI L_LL_ Environmental exhaust and ventilation
Address w 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 P ERSON Attic/crawlspace fans 10.00
Business name: Other: Legi_L. I 10.00
Fuel piping
Contact name $5.40 for first four; $1.00 for each additional
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: j Clothes dryer (gas)
Aim "'" Cnix�J>�. —/ !1C • Other:
Address: / � Gx /66)8 MECHANICAL PERMIT FEES*
City /State /ZIP: C, /acka,nds, 6/2 , 970/5- Subtotal
Phone: Minimum permit fee ($72.50)
(Sb3) (�� - - �- Fax: (5 3 ) C n `� - 5 �3� - Plan review (25% of permit fee)
CCB tic.: 9- L eg —_— State surcharge (8% of permit fee)
TOTAL PERMIT FEE %, 30
Authorized`signature: _- -- o
' ` ff, This permit application expires if a permit is not obtained within 180
s - ` days after it has been accepted as complete.
Print name:r 7 aYnctelt �y o Date. 5 = 9-010 • Fee methodology set by Tn- County Building Industry Service Board
� sd
1 \ Building \Pennits\MEC -PennitApp doe 04/06/06 4404617T(I I /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
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\viEC- PermitApp.doc 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IVMEC200e -00192
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2006
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 ° '� _ i!
INSPECTION WORKSHEET FOR DATE: 6/16/2006 TIME: 7:00AM PAGE: 76
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD F04 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GOOD DOG BAD DOG
DESCRIPTION: Install gas to hot well and water heater.
OWNER: WASHINGTON SQUARE LLC, PHONE #: 503 - 8866
CONTRACTOR: PLUMBING CONCEPTS, INC. PHONE #: 503 -658- 52,12
Inspection Request Scheduled For: Date: 6/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 031811 -02 360- 601 -7934 N
Corrections /Comments/ Instructions:
ow MO
V ,r--. � I. I� �� I, ' •
v' L
PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS.
❑ FAIL CA 1 L FOR INS'ECTION 111 ADDITIONAL F: ES ASSESSED
0 ;�, P G
Inspector: , Date: ■ a 1 t ` hone #: (503) 718- 4Z.---
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IvMEt 2006.00 192
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 319.12006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: fi/16/2006 TIME: 7:02AM PAGE: 1
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC-4 CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE LOT #: TYPE OF USE:
PROJECT NAME: GOOD DOG BAD DOG
DESCRIPTION: 11161211 as to hot well and water heater.
OWNER: WASHINGTON SQUARE LLC, PHONE #: '303.639 - 18665
CONTRACTOR: PLUMBING CONCEPTS, INC PHONE #: 503 - 658 -6232
Inspection Request Scheduled For: Date: 161200E Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 029967 - 01 503 317 - 0864 N •
Corrections /Comments /Instructions:
_vow _ moo,
• i i 1 M
r S Tai_ 'PL _ - ' C� - -- E'er '
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL : U CALL \OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4 6 /� Date: S I ( 0 6 Phone #: (503) 718 - a Li 13