Permit CITY OF TIGARD MECHANICAL PERMIT
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''1 ' ' COMMUNITY DEVELOPMENT Permit#: MEC2015-00447
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2015
Parcel: 1 S 1260000300
Jurisdiction: Tigard
Site address: 9422 SW WASHINGTON SQUARE RD K06
Project: The Duck Store Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: Replace ceiling fan in restroom,duct modifications.
Contractor: HVAC INC Owner: PPR WASHINGTON SQUARE LLC
5188 SE INTERNATIONAL WAY PO BOX 847
MILWAUKIE,OR 97222 CARLSBAD,CA 92018
PHONE: 503-462-4822 PHONE:
FAX: 503-462-6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/09/2015 $347.71
Class of Work: ALT Type of Const: Plan Review 07/09/2015 $86.93
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/09/2015 $41.73
Stories: Info Process/Archiving-Lg$2.00(over 07/09/2015 $2.00
11x17)
Project Valuation: $10,000.00 Info Process/Archiving-Sm$0.50(up to 07/09/2015 $0.50
11x17)
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 $478.87
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
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, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 Yo 'ay obtain a copy of the rules
or direct • - •ns s . NC b calling 503.232.1987 or 1.800.332.2344. n
Issu=d By: I �� Permittee Signature:
/
Call 503.639.4175 by 7:00 a.m.for the next available inspectio da =.
This permit card shall be kept in a conspicuous place on the job site until corn. ion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic i I%Ep FOR OFFICE t'SE ONIX
City of Tigard Received ^
II • 13125 SW Hall Blvd.,Tigard,OR 97 Date/By `l� % �� Permit No.: �C:� 5:4,364
,1 Date/By:eview Other Permit: �t �� —.
Phone: 503.718.2439 Fax: 503.598 '! 9 2015
T I G A R D Inspection Line: 503.639.4175
Internet: www.tigard-or.gov CITY OF TI Date fied/Method: l��s. Supplemental
Information
))j (�AKIU
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Z Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$10,000.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address:9585 SW Washington Square Rd. (requires site plan showing placement) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000 BTU(ducts/vents) 46.75
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:K06 Project name:Duck Store Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75 ,
Subdivision: Lot no.: Flue/vent for any of above 23.32_
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Replace ceiling fan in restroom,duct modifications Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32
Other: _ 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Business name:HVAC,Inc. Other: 23.32
Fuel piping:
Contact name:Jody DePew $14.15 for first four,$4.03 for each additional
Address:5188 SE Internaitonal Way Furnace,etc.
Gas heat pump
City/State/ZIP:Milwaukee,OR 97222 Wall/suspended/unit heater
Phone:(503)462-4822 Fax::(503)462-6555 Water heater
Fireplace
E-mail:jodyd @hvacincorp.com
Range
CONTRACTOR Barbecue
Business name:HVAC,Inc. Clothes dryer(gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal
Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
CCB lie.:50897 ir' State surcharge(12%of permit fee) Q'
TOTAL PERMIT FEE 0,V
This permit application expires if a permit is not obtained within 180
Authorized signature:
0 \
'('l� �� days after it has been accepted as complete.
is es
Print name:Jody DePew Dat # I • Fee methodology set by Tri-County Building Industry Service Board
I:1 BuildingWe+mits1MEC-PermitApp.doc 03/07/12 440-46177(11/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9422 SW WASHINGTON SQUARE RD K06,
TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00447
Jeff Grove
Violation Summary:
Inspector Contractor