Permit CI TY OF TIGARD MECHANICAL PERMIT
"'�IT� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00643
� ,.� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/27/2004
PARCEL: 1S12600-00300
SITE ADDRESS: 09650 SW WASHINGTON SQUARE RD G -15
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:
ELE 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: 1 GAS OUTLETS:
> 10000 cfm:
Remarks: Replace existing terminal unit, modify ductwork, add (2) fire /smoke dampers.
Project Value: $5,795
Owner: FEES
WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 9/27/200 $155.90
9585 SW WASHINGTON SQ RD [MECPLN] Plan Rev 9/27/200 $38.98
TIGARD, OR 97223 [TAX] 8% State Surchart 9/27/200 $12.47
Phone: Total $207.35
Contractor:
RELIABLE HVAC
5915 NW 78TH ST.
VANCOUVER, WA 98665 REQUIRED INSPECTIONS
Mechanical lnsp
Phone: 360 - 693 - 7379
Duct Inspection
Reg #: LIC 145234 Fire Damper Insp
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 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)2 9J� /1
Issue By: CAPX. lLr4 Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business da
J Me�hanical Permit Application ". .> ;FOR OFFICE USE ONLY. ..
City of Tigard Received ^�� .. Date /By 7 Permit No t/(/ A.
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review
Phone 503 639 4171 Fax 503 598 1960 '1, Date /By. v.-1 704• Ay Other Permit
ection Line 503.639.4175 ;1 1 Date Ready /By M El See Page 2 for
net: www ci.tigard.or us Notified /Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* 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, and profit -
CATEGORY OF CONSTRUCTION
Value: $ $5,795
El 1 - and 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ® Commercial/industrial ❑ Accessory bu ilding
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9650 SW Washington Square Rd Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name: Friedlander' Jewelery Furnace 100,000+ BTU ( ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Washington Square 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
Gas
'lace existing terminal unit. Relocate/modify ductwork fireplace
�� D� 2 F //c /SHO /CG Flue veent nt 10.00
for or water heater or gas
pin yL A fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
❑ PROPERTY OWNER ❑ 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
Business name:
Other: 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: Reliable HVAC, Inc Clothes dryer (gas)
Other:
Address: 6600 NW Whitney Rd. Suite C MECHANICAL PERMIT FEES*
/State /ZIP: Vancouver, WA 98665 Subtotal /SS 70
Minimum permit fee ($72.50)
ie: (360) 693 -7379 Fax: (360) 693 -7784 Plan review (25% of permit fee) 313
t 8
CCB lie.: 145234 State surcharge (8% of permit fee) / Z . I/7
TOTAL PERMIT FEE 1-0.,7 3 Y
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Joseph W. Martin Date: 9 - - * Fee methodology set by Tri-County Building Industry Service Board
■Buildinp/Permns'MEC- PermnApp doc 12/03 440 -4617T ( I UO2 /COM'WE13)