Permit A �� . ; CITY OF TIGARD MECHANICAL PERMIT
" ' I'' COMMUNITY DEVELOPMENT Permit #: MEC2010 -00325
1• Date Issued: 07/14/2010
;II G AR)D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
k r4 a,.,. Parcel: 1S136DC04500
Jurisdiction: Tigard
Site address: 7501 SW DARTMOUTH ST 100
Subdivision: Lot: 0
Project: Winco
Project Description: Replace cheese island cases.
Owner: FEES
WINCO FOOD, LLC Description Date Amount
ATTN: SUSAN BUSCHE, PO BOX 5756 Permit Fee 07/14/2010 $1,879.14
BOISE, ID 83705
Plan Review 07/14/2010 $469.79
PHONE: 12% State Surcharge - Mechanical 07/14/2010 $225.50
Contractor:
SOURCE REFRIGERATION
5506 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222
PHONE: 800 - 677 -2688
FAX: 503 - 652 -0449
Type of Use: COM
Class of Work: ALT Type of Const: IIB
Occupancy Grp: M Occupancy Load:
Stories: 1
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: 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: Vent Systems: Total $2,574.43
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Refer Cases
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, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility N• ' cation Cente . Those les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or d' -ct questions to OUNC calling 514.'46.6699 or 1.800.332.2344. / . ..
/ I sued By: , / ' / Permittee Signature:
N
_ Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 Apnlicatio 4 p O12 c)i.► lcl: USE oNl y
City of Tigard r r: 1 1 �' L) Received , / y / Permit No.: g ��»tt �� s� i o ` k Date/By: tit e �GIO. OD 3z, 5
13125 SW Hall Blvd., Tigard, OR 97223
: ' C Plan Revie pu f
11 Ph one: 503.639.4171 Fax: 503.598.1960 Other Permit:
J U L 1 2010 Date/By: ,
"Iii G ,\ It r) Inspection Line: 503.639.4175 Date Rea 7y : y: Juris: ® See Page 2 for
• Internet: www.tigard Notified/Method: 7 /7/10 7 Supplemental Information
CITY OF i IGARiD
• TYPE OF iCLD 'tG !11 V i COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
• CATEGORY OF CONSTRUCTION 7
• ,16a� - Value: $ „
R SIDENTIAL 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
Job site address: � ( `1/�f�.� 9(
Air conditioning
l � „�► � ”' , � (requires site plan showing placement) 46.75
City /State /ZIP: '/ -, /4 , O 7 2 2;2, Furnace 100,000 BTU (ducts/vents) 46.75
` � � `, A C Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: A 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
Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
gf C / ` D /�� Cc , Gas fireplace 33.39
r '�� ' `�/� 7CJ 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
Chimney /liner /Flue /vent 23.32
• 2PROPERTY OWNER I ❑ TENANT .
Other: 23.32
Name: 101,M W recd 5 Environmental exhaust and ventilation
Address: Pv (50 ( 5 Range hood/other kitchen
Y ` _ equipment 33.39
City /State /ZIP: Cjoi 51, , l ‘63-1(35 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( 2 a) 377 . O ((6 Fax: (c 337 _ c6 `f14_ toilet compartments, utility rooms) 23.32
)APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: CI � / � � / j- dill F uel piping
J ""t ^ y "" I �+ P P g
Contact name: 0, GE O ar-5014 $14.15 for first four; $4.03 for each additional
Address: ,,l!��,,�� f T? n 112 Ale. Furnace, etc.
�.C> `�� 61(J�C1' �C Gas heat pump
City /State /ZIP: kNlk l"` 11-3U Wall/suspended/unit heater
Phone: (5631 qt et _GI Z47 Fax: : ( 5( (. ), g2_ - (h/ t/4/ Water heater
I c,, n om, Fireplace
E-mail: 0 i)001-5000 CPC.., 420. (p 6.4k Range
. . CONTRACTOR ' ' Barbecue
Business name: 174'1 b'L P /4 c
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 lic.: 1641 gO C) 0,11 1 ( State surcharge (12% of permit fee)
V TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signatur . d ays a it has been accepted as complete.
Print name: T`c /�� A p ,1Aja Date: - / 0 ' Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \Permits\MEC- PermitAp 10/01/09 44 46 1 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi- Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1_•\ Building \Permits\MEC- PertnitApp.doc 10/01/09 2