Permit CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: MEC2011 00001
Date Issued: 01/13/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Target Subdivision: Lot: 0
Project Description: Replacing duct work and diffusers.
Contractor: HVAC INC Owner: DAYTON HUDSON CORPORATION
5188 SE INTERNATIONAL WAY BY TARGET CORP T -0345
MILWAUKIE, OR 97222 PROPERTY TAX DEPT/TPN -0950
PO BOX 9456
MINNEAPOLIS, MN 55440
PHONE: 503 - 462 -4822 PHONE: 612 - 761 -1588
FAX: 503 -462 -6555
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/04/2011 $520.43
Class of Work: ALT Type of Const: IIIB Plan Review 01/04/2011 $130.11
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 01/04/2011 $62.45
Stories: 1 Info Process /Archiving - Lg Sheet (over 01/13/2011 $10.00
11x17)
Project Valuation: $16,800.00 Info Process /Archiving - Sm Sheet (up to 01/13/2011 $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 wlo Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $723.49
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 , les adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. •u ma obtain a copy of the rules
or direct questions to OUNC by callin. 503.232.1987 or 1.800.332.2344.
Issued By: • 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 corn letion •f the project.
Approved plans are required on the job site at the time of each inspe .
12/28/2010 07 :54 5034626555 HVAC INC PAGE 03/03
'Mechanical Permit Application
City Tigard . � ` 't Rec�ivcd ! ����
l t
14 ]:3125 SW W Hall fllvd.,Tigard, OR 97223' �( Dare/r3y' / r �L 1 1 iL
" �
• Phone: 503.639.4171 Fax: 503 598 t'9filj 3 Plan Rcvic }v
I t t :1 r, n Inspection Line. 503 - 634.4175, t " �0 Datn/l cagy y; -� � � 9 � •
Internet: www.tigard- or,goti °'� � vote Ready - y; . `- luris: ra Pe 2 for
q, „C P . f\ Notificd/Method; i/ /1 /9�i r R
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ti, rr � — gnppic,ncrlrai Information
/�
❑ New construction Addil:ion /alt �
. ,„e.,...‘ , �. ,:,:t r. l .. * , 9 0 , LE L1Sil CCEC IS
��yyyy �
�I , toa/r (. " cat - , h Mechanical permit Bees" are based on the value of the work
\ v ) � tral ied. Indicate the value (rounded to the nearest dollar) of all
[] Demoli ❑ Other: , \‘''' '' ^ \\\ mechanical materials equipment, labor, overhead, and profit.
b A es L, in , "� Value $ .) ��
❑ 1- and 2- family dwelling .{T Commercial /industrial J s rY , , , • , . checklist S FED*
0 Multi family ❑ Master builder Other
� �T R ^ k
Description Qty. I F,a , Total
CI O° onryHrr _
i or special information USE checklist .
Job site address: " 10 ° 1 W 4‘, l I V $' ' v Air nditionin or heat pump
rC nire co a s i t? plan showing placement) 14.00
City /state/ZIP: 1 ) D )-- —3 Furnace 10 0,00013TUJancts/vcnts) 14,00
Suite/bldg. /apt- no.: Project name: '-A,� „ w 0,S Furnace 1.00 000+ 13TU SductsJ�cnta) i 17.90
Crds heat urr( l4 -DO
CrOSS street/dircctions to job site: Duct work
10.00
— dronic hot watcr system 14.00
Reaidcntint boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric), '
in-waft, in -duet, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision:
Lot no.:
Tax map /parcel no.: Other: I0.0()
— .. Other fuel appliances
an
DFE$�CItit r1
i i .. Water heater
10.00
` ` 1 Gas fireplace — 10.00
ll I V � �� Flue vent for water heater or gas .
C \ I Q V A 1 / / ` r LI. o ,t fireplace
�D Vi' � � 'L% " � 10.00
htcr (gas) 10.00
woodfpellet stove 10,00
Wood fir lace/inscrt 1 0.0 0
) bP1� Y h' +ty 1!NI�It Chimney/lincdtlue /vent
Name: Other: 10.00
Environmental exhaust and ventilation
Address: Range hood/other kitchen
equmcnt 10.00
City /State/ZJP: Clothes dryer exhaust
10.00
Phone: ( ) Fax: ( ) Single -dud. exhaust (bathrooms.
toilet Ict compartments, utility room 6 80
- 00th](. l`[ "s: jt 1' Atti J —
L." /c l o.oa
Business name: 0 l./ ��
Other; 10 -00
Contact. name:
Fuel piping
' 1 $5.40 for first Poor; $1.00 for each additional
Address: ` � . .. r IA 1W\ ° r A Ai Furnace ctc. _
Ci /State/Zfl : I V t1 Gas heat pum
p
^�. ' l Wall/suspended/unit heater
Phonc; (' S13) 1 .1 �v C! "L b Fax :: (SX2))\(\ f D c � Wine heater
E-mail: i Fireplace
FA 0 A 1) Qk.C,A11 - n r Wi
t a Range
Barfrceue
Ausiness name: _ ( � —X Ciothas d r as
r ,L
Address: r ' Other;
IL'
1411 C 1tW'> fi�1�Y[! ll+T1L
City /State/ZIP: Ai RsT y W / ' —
Phone; ( ) -
Subtotal
Fax: ( ) Minimum permit fee (572.50)
L'CA lie.: ( Plan review (25% of permit fee)
State surchargc (12 °l0 of permit fCC)
TOTAL PERMIT PEE
Authorized si This permit application expires If a permit Is not obtained within IRO
Print name: I � �� • �� 'r days aficr it has hero accept.,( as complete.
Date; Fee mcthodolo y set by Tri County Building industry Service iBocrrd
r;1DuiIdlnR1rmtnita\ , -C.P .itA 17.dna 0 I /10 /e7 4417-46I /COM/wl )
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LETTER OF TRANSMITTAL
TO Name Dan Nelson Date 12/29/10
Company City of Tigard Project Name Target - Washington Square
Address 13125 SW Hall Blvd. Our Job Number 4542
City, State, Zip Tigard, OR 97223
TRANSMIT THE FOLLOWING FOR YOUR
❑ Submittals ® Review
❑ O &M Manuals /1 Approval
❑ Subcontract ❑ Information
® Drawings ❑ File
O Change Order El As Requested
• Other 040 ❑ Other
Sent Via ® Mail ❑ Courier ❑ Will Call ❑ UPS ❑ Fed Ex
Quantity Description
2 Sets of Mechanical drawing
Kl -PA,S 111 cl °i
4 VD
NOTES and /or COMMENTS
Thank you
If enclosures no no a:- to ed, please notify us at once.
By 1 _
Name 1 rdy De-Pew Title Project Assistant
HVAC, Inc.
5188 SE International Way Milwaukie, OR 97222 -4602
(503) 462 -4822 Fax (503) 462 -6555
Email hvacinc @hvacincorp.com
OR -CCB# 50897 WA -L &I# HVACI * *125J6
White — Recipient Canary — Originator
11 /10/04