Permit CITY OF TIGARD MECHANICAL PERMIT
: ■ . COMMUNITY DEVELOPMENT Permit#: MEC2021-00339
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/24/2021
Parcel: 1 S 136C D02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: PALMER ACRES Lot: 3
Project Description: Replacing(3)exhaust fans and duct work in bakery and installing(3)new exhaust fans and duct.
Contractor: SEATTLE MECHANICAL Owner: COSTCO WHOLESALE CORPORATION
899 WEST MAIN ST PROPERTY TAX DEPT 111
AUBURN, WA 98001 999 LAKE DR
ISSAQUAH,WA 98027
PHONE: 253-939-9495 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/25/2021 $982.71
Class of Work: ALT Type of Const: VB Plan Review 05/25/2021 $245.68
Occupancy Grp: M Occupancy Load: 12%Stale Surcharge-Mechanical 05/25/2021 $117.93
Info Process/Archiving-Lg$2.00(over 06/22/2021 $12.00
Stories: 11x17)
Project Valuation: $35,000.00 Info Process/Archiving-Sm$0.50(up to 06/22/2021 $6.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 5 Vent Systems: Total $1,364.32
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
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. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ttf0Uy vGLW L7Pi1.11P.9e Permittee Signature: OniAph to-vi
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.
1. -
Mechanical Permit Application_���EL 1E FOR OFFICE USE oNL,.
City Of Tigard V 'eceived
g Dare B S/�s�t, !_yPen it No: Mv'e aoa!-ar�33�• I3125 SW Hall Blvd.,Ti a OR 97223PlanRevie
zPhone: 503.718.2439 Fax: 503.598.1960 jl��l( 2 5 ZD21 Date/By: f'7-a iOther Permit: /�
TIGARU Inspection Line: 503.639.4175 _ /JjA�t���i3'ITO�
Date Ready/By: //uns- rgl See Page 2 for
Internet: www.tigard-or.gov I Supplemental Information
CITY OF TIGAR HetiF_-. •eniod
-i
TYPE OF WO' u 1 T' 'C A *SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑ New construction O,Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S r 00
CATEGORY OF CONSTRUCTION -�).1
RESIDENTIAL EQUIPMENT/gYSTEMS FEES*
❑ 1-and 2-family dwelling YCommercialIindustrial 0 Accessory building Far special infermatinn use checklist.
❑Multi-family 0 Master builder 0 Other: Description p Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address:- p } 11 t_
Air conditioning 46.75
7�.h r✓ .�!1r t.(�ljt �ri Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: r'/yam r O p rl Furnace 100,000+BTU(ducts/vans) 54.91
-`Jl fn 11 ? Heal pump 61.06
Suite/bldg./apt.no.: Projectname:COS.�.CQ axQ(' r R 4oa Ductwork
`� 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
qq ) , 1 Residential boiler(radiator or
x.� (� 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
Other:
Subdivision: Lot no.: 23.32
p Other fuel appliances:
Tax map/parcel no.: l S ( 3 C tJ )
_. \ .. ] C Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
R�> Flue vent for water heater or gas
t.o ace (3) boom) Ex v-ws+ F(u-,5 a tO fireplace 23.32
dltp 1_)At��,�� r Log lighter(gas) 23.32
( u, T l Wood pellet stove 33.39
T54-uI 11 (3') ne u Ti\1 t 6 xhn u�E- fit\s a n Wood fireplace/insert 23.32
t (A_l 1 t Chimney/liner/Flue/vent 23.32
Other: 23.32
)Wi PROPERTY OWNER I 0 TENANT
,F Environmental exhaust and ventilation:
Name: 005+1'C� ) µ•3 r .. , Range hood/other kitchen
qQ� LJK 11 I CI-.
i equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: 3 7 Single-duct exhaust s,
�� � ) O toilet compartments,utility rooms) 23.32
Phone:(4 - :3iGL Fax:( ) Attic/crawlspace fans 23.32
•
a APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:, +fiero s Fuel piping:
�'�� n L.h��� �4 "'• i CJ $14.15 for first four;S4.03 for each additional
Contact name: fla Livia
j la hi.;6 1" Furnace,etc.
Address: gq(� ia.V1 C 1 r Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:e/q auto r A 1�y 1 I I1 CI G e,,)0 I / p Water heater
Phone:(A53"l ?_q T% 5-l j� Fax::(A'7�� q j'q t,i 11 Fireplace{^� 11�� M,7 y� Range
E-mail: cia tJl: t'1Gl I t 512c,4-4- k IT �s.hR (cal t C0r t 1 Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: `W u8"��- Other:
��� � "' "^•e 1"� 1 1 MECHANICAL PERMIT FEES*
Address: jj q ,, 11
�� 1 r ...avail_ S7 Subtotal
City/State/ZIP: Lgy t..ir) y l q soot Minimum permit fee(S90.00) ( ,7
."i Plan review(25%of permit fee) �, -.(pg
Phone: 5�( _Q 3(.�-( ��r� Fax:( f ( i/y /'_ zt d State surcharge(12%of permit fee) i (7 (?r
CCB lic.: 23 l l Y rV) L t° TOTAL PERMIT FEE i�_23 a
�v. _ This permit application ysafter
it expires if a permit is not plot e. within 180
`q/.TI�-Cn5�I��_ days after it has been accepted as complete.
Authorized signatur p p * Fee methhoodology set by Tn-County Building Industry Service Board
Print name: IA)tut e f-�. Date:5--J b �r y'h i✓�pra if i$ C .. ( _ 6
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