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Permit C ITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00474 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/8/2008 PARCEL: 1 S136CD -02200 SITE ADDRESS: 07850 SW DARTMOUTH ST ZONING: C - SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: COSTCO Project Description: Walk - in cooler and freezers. Valuation: $259,000.00 CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS: STORIES: 1 BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS: GAS PRESSURE: 50 + HP: WOODSTOVES: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2 FURN > =100K BTU: <= 10000 cfm: > 10000 cfm: GAS OUTLETS: Owner: FEES COSTCO WHOLESALE CORPORATION Description Date Amount ATTN: EXCISE TAX DEPT 111 999 LAKE DR [MECH] Permit Fee 10/8/200E $3,145.50 ISSAQUAH, WA 98027 [MECPLN] Plan Rev 10/8/200E $786.38 [TAX] 12% State Surch 10/8/200E $377.46 Phone: Total $4,309.34 Contractor: KEY MECHANICAL CO 13477 SE JOHNSON RD MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS Contact #: PR! 503- 231 -0731 FAX 503- 236 -5848 Reg #: LIC 93479 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days ATTENTION Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344 Issued By: LLB /mss i Permittee Signature:.- 4 4 Call � .. 9.4175 by 7:00 a.m. for inspections that bus nes This permit card shall be kept in a conspicuous place on the job s'te u it co •I-tion •' the project. Approved plans are required on the job site at the time o each i pectio • . CITY OF TIGARD BUILDING DIVISION �fl PERMIT #: _�,200£i o 174 13125 SW Hall Blvd., Tigard, OR 97223 , DATE ISSUED: 10/8/2008 Phone: (503) 639 -4171 1 Inspection Requests (24 Hrs.): (503) 639 -4175 s . 6 1' if INSPECTION WORKSHEET FOR DATE: 1/13/2009 TIME: 7 :00AM PAGE: 1R SITE ADDRESS: 11/050 SW DARTMOUTH ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: COQ TCO DESCRIPTION: Walk-in cooler and freezers. Valuation: $259,000.00 OWNER: COSTCO WHOLESALE CORPORATION, PHONE #: CONTRACTOR: KEY MECHANICAL CO PHONE #: 50:231 -0731 Inspection Request Scheduled For: Date: - 01:4,2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 1". line 07962401 503 -519 -5334 N Corrections /Comments /Instru tions: arc, / `� //) — ......_____ C PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ` A Inspector: \� 0 Date: )1d Phone #: (503) 718- P y CCTrr*-, 7 ,, �fxj --&ci t` Adi, 111∎ _. Mechanical Permit Application : A; ,- .'FOR OFFICE,�USE ONLY '. „ ; � � y .' R e ceived City of Tigard ! Permit No !�' ° 13125 SW Hall Blvd ,Tigard, OR 97223 Date/By - `l M UlllI - - Phone 5 639.4171 Fax 503 598 19 0 R ' � D a t e /B V1e v,t v 1 Other Permit ,. y ��/ . Inspection Line 503.639 4175 at 't...• a y ��w� TL RD. . \::(?) Date Ready /By i s See Page 2 for Internet www tigard -or goV ` .A Notified Method /0 fit ��� S upplemental Information 0GQ b eA s : .� 0 , e od, C ' TYPE OF WORK.. ,;,"c\ �� 1 , �a ,, OMMERC (F EE"t SCHEDULE, = USE CHECKLIST � iN it Mechanical permit fees* are based on the value of the work CI New construction Addition /alteratio i t l�c el ���wr performed indicate the value (rounded to the nearest dollar) of all CI Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit - ,CATEGORY OF ' CONSTRUCTION Value $ Z-5 �� ', RESIDENTIAL E /SYSTEMS 'FEES *. " ❑ 1 - and 2 family dwelling Commercial /industrial ID Accessory building ' . ` 0 - ' ` For special n use checklist ❑ Multi- family ❑ Master builder ❑ Other: Description Qty Ea Total " , -, , ,. —: JOB SITE INFORMATION AND: LOCATION. . ' - ,, ' - n Heating/cooling Air conditioning or heat pump Job site address: 7 f 5`w 2) 4 uT ►t- ST (requires site plan showing placement) 14 00 City /State /ZIP: 174 Ad zi bp_ / 7 L23 Furnace 100,000 BTU (ducts /vents) 14 00 Suite/bldg. /apt. no.: Project name: ZG Furnace 100,000+ BTU (ducts /vents) 17 90 C�v ST, CO 10 Gas heat pump 14 00 Cross street/directions to job site: Duct work 10 00 Flydronic hot water system 14 00 Residential boiler (radiator or hydronic) 14 00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc 14.00 Flue /vent for any of above 6 80 Subdivision: Lot no.: Other 10.00 Tax map /parcel no.: Other fuel appliances ' # , • DESCRIPTION OF WORK r ' - - Water heater 10 00 Gas fireplace 10 00 G(//Lr.X - i) C°e2 t FfLfCZ(5f7ts Flue vent for water heaterpr gas fireplace 10 00 Log lighter (gas) 10 00 Wood /pellet stove 10.00 Wood fireplace /insert 10 00 Chimney /liner /flue /vent 10 00 ' ' ❑ PROPERTY OWNER % , - ; -a ` t❑ TENANT , Other 10 00 Name: Environmental exhaust and ventilation Address: Range hood /other kitchen equipment 10 00 City /State /ZIP: Clothes dryer exhaust 10 00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6 80 ' °: APPLICANT' -, .. • ,� , , ; ❑, C ONT ACT PERSON 'r , . Attic /crawlspace fans 10.00 Other 10 00 Business name: (^,0,y, t( Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater G'�L Water heater Phone: (!�' ) 5 l f r O 1.7 3 Fax: ( ) - , Fireplace E - mail: m"14 l f.4.) �" ' ' A t C.A-L , 60,9„ Range . `CONTRACTOR" _ , , , Barbecue Business name: 1b`'I w� i �t Clothes dryer (gas) if Other Address: t (t'7 7 c6 3-e,110 $'J s .MECHANICAL PERMIT FEES* , City /State /ZIP: at a , wp., - 6- oR. cl 7 7"1, -1 Subtotal Minimum permit fee ($72.50) Phone: (s'y ) L3 ( - 0 3 I Fax: (SJ3) Z'3 b_ 5 Plan review (25% of permit fee) CCB lic.: go 9 3 I/ -7.7 ; iL, State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: R Nm sew 144 Date: 9 _ - p g ' Fee methodology set by Tn- County Building Industry Service Board 1 \Budding\Permns \MEC- Perm¢App doc 01/19/07 440 -4617T (I1 /02 /COM/WEB) • Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information L Commercial Fee Schedule: .'TotarValaation: , 'Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof; to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1 \Building \Permlts\MEC - PermitApp doc 01/19/07 2 MAYES TESTING ENGINEERS INC Portland 9 7911 NE 33rd Drive Suite 190 f._ .> rtVei tc. A'E;Ch M, r • `. ,. Portland OR 97211 oh 503.281.7515 CONCRETE LABORATORY TEST REPORT fax 503.281.7579 Project Name: Costco- Tigard #111 Racking Installation Project No: P08227 Site Address: 7850 SW Dartmouth Issued on: 02/17/09 Tigard, OR Sample Set ID: 10987 Client: Key Mechanical Co of WA Permit # (s): MEC 2008 -00474 Original: I'9 Engineer: Revised: El Contractor: Key Mechanical Co of WA FIELD DATA ASTM C31 and C172 Air Temperature: 30 °F Actual I Mix Proportions: Weather: Inside Product: Concrete Ingredient Weight (per cu.yd) Supplier: Glacier Northwest A/E Admix 1.5 oz Ticket Number : 208193 Cement - -Type I & 11 607.9 lbs MixDesign ID : 1750 Coarse Aggregate 1,847.6 lbs Fine Aggregate 1,182.8 lbs • Sample Temp. - Initial Storage Temp. - Entrained Air - PolyHeed 997 73.3 oz (ASTM C1064) (ASTM C31) (ASTM C231) Water 216.4 lbs 58 °F NR NR Water /Cement Ratio: Slump (ASTM C143) Sample(s) Rec'd: 0.356 6.5" 02/11/09 Required Strength (fc): Placement Location and Notes: 4000 psi © 28 days Column footings at grid 9/J & H. COMPRESSION TEST RESULTS (ASTM C39, C1231, and C617 when applicable) Type of Date Made Sample # Lab # Date Tested Age Size (in) Load (Ibs) Dia (in) Area Strength (psi) Fracture 02/10/09 0001 1485 02/13/09 3 6 x 12 100090 5.99 28.18 3550 Type 3 02/10/09 0001 1486 02/16/09 6 6 x 12 124840 6.00 28.27 4420 Type 5 02/10/09 0001 1487 02/17/09 7 6 x 12 126020 5.99 28.18 4470 Type 5 * 02/10/09 0001 1488 03/10/09 28 4 x 8 0.00 0.00 NA 02/10/09 1 0001 1489 03/10/09 28 4 x 8 0.00 0.00 NA 02/10/09 0001 11 1490 03/10/09 28 4 x 8 0.00 0.00 NA Remarks: / Technician(s): Strobehn, Jr, D. Reviewed by: A!►.:. Tested by: Schneider, C. ark A. Galu h.., P.E. B anch Manager NOTES Information in this report applies only to the actual samples tested and shall not be reproduced without the approval of Mayes Testing Engineers, Inc. See ASTM C39, for full description of Type of Fracture. All testing performed in accordance with applicable ASTM's except C -31, 10.1.2 - "recording field temperature" MTE 1050 -1C, Rev 3, 07/19/07 MAYES TESTING ENGINEERS, INC. 7911 NE 33rd Drive, Suite 190 Ph 503 - 281 -7515 Portland, OR 97211 Fax 503 - 281 -7579 DATE: 2/17/2009 CLIENT: Costco- Tigard #111 7850 SW Dartmouth, Tigard, OR PROJECT: Costco- Tigard #111 Racking Installation REPORT STATUS: PROJECT # P08227 Original D LAB. # 1600 Amended ❑ SAMPLE DESCRIPTION: Clayey Brown Sand With Cobbles Site Native Date Sample Received: 2/13/2009 TEST RESULTS: Proctor Analysis (ASTM D698, D1557 or AASHTO T99, T180) See attached analysis sheet. Tested By: Charles Schneider Reviewed B : A. Y Y �_,� Date Tested: 2/16/2009 I -'ark a ush:, Branch Manager Information in this report applies only to the actual samples tested and shall not be reproduced exce• in full, without the approval of Mayes Testing Engineers, Inc. Proctor 1600 /2/ 17/2 009 MAYES TESTING ENGINEERS, INC. 7911 NE 33rd Drive, Suite 190 Ph 503 - 281 -7515 Moisture Density Relationship Test Portland, OR 97211 Fax 503 - 281 -7579 Client: Costco- Tigard #111 Report Date: 2/17/2009 7850 SW Dartmouth, Tigard, OR Date Tested: 2/16/2009 Project: Costco- Tigard #111 Racking Installation Project Number: P08227 Test Method: ASTM D -698 Method C / C 127 / D 4718 (if needed) Lab Number: 1600 Wet Preparation Mechanical X Test Results Dry Preparation X Hand Tamper Optimum Water Content % 11.2 Date Received: 2/13/2009 Max Dry Density Corr. Ibs /ft' 128.7 Source of Sample: Site Native Sieve Analysis Description of Sample: Clayey Brown Sand With Cobbles Sieve Size Percent Retained 3/4 10% Zero Void line plotted at Assumed SpG: 2.851 3/8 27% Max. Density Uncorrected: 126.1 I #4 44% 131 is _�I - _ • ••••••• ••••••••••••••••••••••••••••••• • • I- 1 1 I i 1 i _- r •••••••••••••••••••••••P ' • -1 1 1 I H .........11.111111111.11.1 M Dry Density - + --< r I '' r i , 1 _ ■ ■■■ ■■■■■ _ ■■■■■■■■■■■■■■■■■■■ I■■� ry tY �■ T `` - 1 I , F r _ 130 •••••••••••••••••••••••1 + ? (I' ! 7 ._ _I _ Emin.■■ ■■■■■■•■■•■•■•1 128.7 pcf ■ 1_Z ( . C= - •••••••••••••••••••••••• J f 1 � r 1 iu i - iiae ■ _ • ...... ■ ■ ■■■■■■■■■■■■■■■■ ■ ■■ ■ ■■■ ■i .. =� I ■ ki 1 : Li IL - .. ... - - I 1 - 1_., . _ 1 129 ■ ■ ■ ■■■ ■ ■ ■ ■■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■� ■ ■ ■■■ ■ ■■ � ["" ■■ - -, : , _ I 1 =1 l -, i. ±t { F ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■. ■ ■ ■E■m■■ •• u_ i 1 -.. � ; Gi�C G iGi - g_ 7 _ . - I I . -1 _i_ i..l - i I I ' 1 . - -, - : : , -' -!- I - 1 G7GiG. - ■ ■ ■■E■ m• ■■ ■■1= •y r I . + , - . r - i i , - i � i i ■ ■_ ■E_. ■u. 4 . 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Tested By: Charles Schneider Reviewed By: ,,SOIt% �' , Aro° n..r . rshaL anch Manager Information in this report applies only to the actual samples tested and shall not be reproduced e • -pt in full, without the approval of Mayes Testing Engineers, Inc. Proctor1600 /2/17/2009 MTE Form # 149, Rev 2, 6/02