Permit CITY OF TIGARD MECHANICAL PERMIT
:F1 COMMUNITY DEVELOPMENT Permit#: MEC2013 00534
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2013
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9491 SW WASHINGTON SQUARE RD A04
Project: Zumiez Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Add(1)new exhaust fan and(1)new SA grill
Contractor: ARROW MECHANICAL Owner: PPR WASHINGTON SQUARE LLC
10330 SW TUALATIN RD PO BOX 847
TUALATIN,OR 97062 CARLSBAD, CA 92018
PHONE: 503-692-1565 PHONE:
FAX: 503-691-1879
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/23/2013 $96.69
Class of Work: ALT Type of Const: Plan Review 09/23/2013 $24.17
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/23/2013 $11.60
Stories:
Project Valuation: $1,400.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: 1 Vent Systems: Total $132.46
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, - wo 's suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'otification Cente . Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or ect questions to OUNC a ,g 13.232.1987 or 1.800.332.2344.
Is- ed By: i / Permittee Signature: .
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
Mechanical Permit Application roll OFFICE USE ONLY
Eie / Permit No ay ., gar , Pw (L
g .. Phone: 503.718.2439 Fax: 503. 8:f Date/By: Other Permit
TI G A R D Inspection Line: 503.639.4175 Date Ready/By' el See Page 2 for
Internet: www.tigard-or.gov SEP 2 3 2013 Notified/Method: Supplemental information
._::.-. =:::--.::..;":"::::::-:;:.:, ::.::.::;:•-::",";:_:.:.:..::.->.:.."._ ;-.:COMAKEIiCIsil?:Fl-E!i;°$4``fILI)UI1:`-..L3SCCHECKLIST:,
ri f f r 1r flfl f Pr N Mechanical permit fees*are based on the value of the work
❑New construction �dditio tYl l`dTf01t9tt pT C�Y4fe performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials, profit.
.;;.. ;- �ATEGURI' bT�:CONSTT2I�G`TI(3N`:;::°.;
. " •: . :: . •,,gF�SIA Va3ME ' �EMS,FEES•
. . . ...:....:•
❑ 1-and 2-family dwelling ommercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. Ea. Total
s,":•,;-:: :;: , : Heating/cooling:
•"; :::;:-:":;?'r; : :'t -:_; ;.;..JO$;SI�Lt:Y�F1QQ ;A.T�(311 e1NI}=l<+�4'TILCjN".�:;�:. :: �::=::.:<;;'">;;.� c :;
_Air conditioning 46.75 _
Job site address: 7 I Sol 6,,A4-./...), sly • /J.) Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: `-� Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:3J I Project name: 2u.vl 2, Heat
work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
�S I�/ /J�q'TDf ) � hydronic) 23.32
--—
Unit heaters(fuel-type,not electric),
- - in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
Gas fir lace ttlsert 33 39
;�:�:;::;<>:<;:,,;:..-: ;:.:,:,::;;"; . ::.:-.-::-;:< ��sct�rr?tor�:;o»:;wow`.;-: ::::<:::;:.:.:;.<::::;::;::;.-:,.,:,�.;,,.:;::; - -- -
: h
( / �J Flue vent for water eater or gas
itch^^i-/,)A-' f 1;11J
fireplace 23.32
C/ L� S.f� / Log lighter(gas) 23.32
N --v4-' L1-� Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
: : :. -: :: ;:-:--;:;:::: ~; .;:-,,:.: Other: 23.32
.._.. .; ._,;,._,..,_. ...._..-._ ..._-.;;.::;.::,:-•:;a",",:,:_",..� _..._..."_;...<... _.-..._............. Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
'::nS;of'r= -":3.4::::t::/ i;P.l<C fs:::= -:;4gi r g:::rr•:;:in;;;s ;:: Qs..-' ,t4t.01=.1')v70W.:I`:"s:5:i;V:; Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace _ -_
E-mail: Range
Barbecue
Clothes dryer(gas)
Business name: Other:40 I�!Li#AP�JI�AZP1<T; TS"��%?'��:':;<=t:=z">;;;`
Address: /�� ; .:..,.:�.:.:.:...-......�._ .. ...:.. /
o 3 3 vim-t�J'7 A'L/j-"'")A.+ /"� Subtotal '14.4v?
City/State/ZIPs / 4 3-L_ 15 1 ,4-.)b 1,:72., Minimum permit fee($90.00) -
Plan review(25%of permit fee) A 4./7
Phont 6,:i.0. /t�/ � Fax:� � G1/. 1&7/ State surcharge(12%of pennit fee) //•(pv
CCB lie.: ` 0 G� v TOTAL PERMIT FEE /3a.y/D
- This permit application expires if a permit is not obtained within 180
1 days after it has been accepted as complete.
Authorized signature. `. • Fee methodology set by Tri-County Building Industry Service Board
Print name: k— - -i t,.J /2_f2-u 9 2 c )b' Date: _ i . /'i
I:\Building\Permits\MEC_PennitApp_0401I3.doc 440-46171(11/02/COM/WEB)