Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00092
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/8/04
PARCEL: 1S12600-00300
SITE ADDRESS: 09633 SW WASHINGTON SQUARE RD FC -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: B VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS: 1
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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: 1 OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install (1) class 2 hood & duckwork to new fan on roof, remodel existing HVAC $52,000 Valuation
Owner: FEES
PPR WASHINGTON SQUARE LLC Description Date Amount
BY THE MACERICH COMPANY [MECH] Permit Fee 3/8/04 $145.10
9585 SW WASHINGTON SQ. RD.
PORTLAND, OR 97223 [MECPLN] Plan Rev 3/8/04 $36.28
[TAX] 8% State Surcharl 3/8/04 $11.61
Phone: Total $192.99
Contractor:
GOHMAN MECHANICAL INC
412 S BEAVERCREEK RD., STE 602
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: 503 Mechanical Insp
Hood Inspection
Reg #: LIC 119952 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Spec'., Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will - xpire 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. Thos: rules . e s. t fort in OA: ' - 001 -00
i . �
Issued By: / l /Z� Permittee Signature: 4 ..s. � �
7
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
/ FOR OFFICE USE ONLY
Mecha Permit Application Receive Mechanical
Date/B �7 ,/
. Permit •
City of Tigard D to / B y pproval Building �U rue -OD f
Y g T est Form Date/By: Permit No
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: 3 • S 'UT t Permit No :
Phone: 503-639-4171 Fa 9 A Post - Review �9 , j Land Use
�1� " ° - r I MF Date/By: G L Case No.:
Internet: www.ci.tigard.or.0 e!1 I Contact ph ov„,e (6 , a Juris.: ® See Page 2 for
24 -hour Inspection Request: 503 -639 4175 20 ( Name/Method: �. ( l (� Supplemental Information.
�I R A i�n
TV OF TIGARn
TYPE IVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Demolition Mechanical permit fees* are based on the total value of the work
Er Addition /alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
CATEGORY OF CO■S RUCTION • mechanical materials, equipment, labor, overhead and profit.
❑ I & 2 - Family dwelling Q C ommercial/Industrial Value: $ t� i OCR See Page 2 for Fee Schedule
El Accessory Building ❑ Multi Family RESIDEPTIAL EQUIPMENT /SYSTEMS FEE* SCHEDULE
Description I Qty I Fee(ea.) I Total
['Master Builder ❑ Other: Heating/Cooling
q (33JOB SITE INFORMATION and LOCATION Furnace - add -on air conditioning 14 00
fob site address: j L;. th,vEjTb3 644..1.1 Gas heat pump 14.00
Suite #: - c . C.1-1 Bldg. /Apt. #: Duct work 14.00
Project Name: w1RTZCI . t Hydronic hot water system 14.00
Residential boiler
Cross street/Directions to job site: u 5-r-tl n1G-ira.J (for radiator or hydronic system) 14.00
.3V At 1 Gt1h iZT Unit heaters (fuel, not electric)
(in wall, in -duct, suspended, etc.) 14.00
Flue /vent (for any of above) 10.00
Repair units 12.15
Subdivision: Lot #: Other Fuel Appliances
Tax map /parcel #: Water heater 10.00
DESCRIPTION OF WORK Gas fireplace 10.00
/rA1 I (J) Cl- -? -Z tilts, -r'acri,‹Iza -e.4-2. , Flue vent (water heater /gas fireplace) 10.00
Wood/Pellet t�l n Log lighter
/Pell et (gas) 10.00
\�2 , �P.I✓1DIJi� I. ��ce`'� d/Pell stove 10.00
t V K - Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
PROPERTY OWNER IJTENANT Other: 10.00
Name: Environmental Exhaust & Ventilation
Range hood/other kitchen equipment 10.00
Address: Clothes dryer exhaust 10.00
City/State/Zip: Single duct exhaust
Phone: Fax (bathrooms, toilet compartments,
[
❑ APPLICANT C PERSON utility rooms) 6.80
Name: Mark Gohman Attic /crawl space fans 10.00
Other: 10.00
Address: 412 S. Beavercreek Rd. #602 Fuel Piping
City /State /Zip: Oregon City, OR 97045 ($5.40 for first 4, $1.00 each additional) **
Phone: 503- 650 -1588 Fax: 503 - 655 -0514 Furnace, etc. **
Gas heat pump **
E -mail: mgohman@gohmanmechanical.com Wall /suspended/unit heater **
CONTRACTOR Water heater **
Business Name: Gohman Mechanical, Inc. Fireplace **
Address: 412 S. Beavercreek Rd. #602 Range **
City /State /Zip: Oregon City, OR 97045 Clothes dryer (gas) **
Phone: 503 - 650 -1588 Fax: _503-655-0514 Other: **
CCB Lic. #: 1 9952 Total:
Mechanical Permit Fees*
Subtotal: $ / Sa /0
Authorized Minimum Permit Fee $72.50 $
Si azure: ' Date: 3 / h Plan Review Fee (25% of Permit Fee) $ 36 . MO
Sig State Surcharge (8% of Permit Fee) $ 1/ . t I 4 k �� alb. yl • V3 2_ TOTAL PERMIT FEE $ I Q j. e .
(Please print name) Notice: This permit application expires if a permit is g ot obtaine w hin
180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175 MST f 1,
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
4
Received :7 6 Date Requested w 1 AM PM BU
Location ( (t (3 W A . — S uite _ G' < Fa.
Contact Person Ph ( 603) �c�D PLM -
Contractor Ph ( ) SWR
BUILDING Tenant/Owner 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
MECHANICAL
Post & Beam
(RoughhIn') CkniC/L
Gas Line
Smoke Dampers
Fi
PART FAIL
RICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final El 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 O Otsi
-
Approach/Sidewalk Date Inspector �� " Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD 24 -Hour `f —drrcg ?az
BUILDING Inspection Line; (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST 420 CO?
Received l6 to Date Requested 4 /— / ---- 0 V AM PM BUP
Location 94-3 _ Suite 6 9 y
Contact Person u Ph ( ) 6 16 - 7- /.3 v g PLM
Contractor tracto Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing 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
PART FAIL
P I MBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
• e a Dampers
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 0 Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA 7�,�
Approach/Sidewalk Date / t/ f / / Inspector 7 ' " ' " ` Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL