Permit CITY OF TIGARD MECHANICAL PERMIT
1111111 , COMMUNITY DEVELOPMENT Permit #: MEC2011 -00060
"TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02116/2011
Parcel: 1 S 126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Target Subdivision: Lot: 0
Project Description: Install RTU's & refrigeration cases.
Contractor: SOURCE REFRIGERATION Owner: DAYTON HUDSON CORPORATION
5506 SE INTERNATIONAL WAY BY TARGET CORP T -0345
MILWAUKIE, OR 97222 PROPERTY TAX DEPT/TPN -0950
PO BOX 9456
MINNEAPOLIS, MN 55440
PHONE: 800 - 677 -2688 PHONE: 612- 761 -1588
FAX: 503 - 652 -0449
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 02/16/2011 $11,193.51
Class of Work: ALT Type of Const: Plan Review 02/16/2011 $2,798.38
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 02/16/2011 $1,343.22
Stories:
Project Valuation: $394,000.00
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: Vent Systems: Total $15,335.11
Hoods: Comm Incinerators:
Required Items and Reports (Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
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
applica aw. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issu ce, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Uti y ,Notification Center. : e r. - , are set forth in OAR 952 - 001 -0010 throug : • - • . '-ii !!L90. You may obtain a copy of the rules
or direct questions to OUNC ailing .03. 32.1987 or 1.800.332.2344.
Is ed By: / i . 0 I Permitte- Signature: �_ /�, �I /�� / 6�
Call 503.639.4175 by 7:00 a.m. for the next available inspect• d
This permit card shall be kept in a conspicuous place on the job si e completion of the project.
Approved plans are required on the job site at the time of each inspection.
(�, �1 ( te e r a• �'z; tlr� 0 �' ,•- ` '
` EIVE j'1 �� d1 ( /
Mechanical Permit Applicat i % FOR OFFICE USE ONLY
Received } G /(P O „ �/I,p �/_ 1
City of Tigard FEB 9 2011 Date/By: / 7 // / Permit No.. ie iv , C/ w
9 U Y
q
13125 SW Hall Blvd., Tigard, OR 9 plan Review
M Phone: 503.718.2439 Fax: 503.598 ,/ Other Permit.
PX OFTIGARD Date/By:
M (GJ a -!!I-
T I G A It D Inspection Line: 503.639.4175 D ate ReadyBy: lur s ® See Page 2 for
Internet: www.tigard or.gov )3 ILDING DIVISION Notified/Method: /0 /I g:^ Supplemental Information
TYPE OF WORK t. of COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, la r, overh d, and proms
Value: $ 3yg
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 I ir c
A Heating/cooling:
Air conditioning
Job site address: 47400 9 91/ ,_ 8LvD (requires site plan showing placement) 46.75
Fumace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP:
T,L'64 _, Q/Z 97.233 Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: 774/e? 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
2WSMe& Gas fireplace 33.39
AiNii net PL , e6 - 1-/-4:-.3&X.472- t- lijF S 7b .�'7a.e Flue vent for water heater or gas
�y U . / , it/Z f 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
Phone: Single -duct exhaust (bathrooms,
( ) Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: q vieC& / firG
",,,, v--Atot. Fuel piping:
Contact name: CAM ,c)4/6/2). $14.15 for first four; $4.03 for each additional
Address: 55cx S� t�fT�r�,A ., 444.Y
Fumace, etc.
Gas heat pump
City /State /ZIP , 4 eye 9,7 02.2.2 Wall /suspended/unit heater
Phone: ax:: Water heater
( SO7) 713 �? 7 `� Fax: ( ) Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: S - R67 /2 .. 17,.f►7
Other:
Address: 5 ' ) 5 T MA . "� ). MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal I/; / T +$sJ
�Z' «ikr -� OI 47.t��
Phone: ( ) F ( �S) Minimum permit fee ($90.00)
G 77 - o�b� t: 512 " O W7 Plan review (25% of permit fee) apiss.'3e
CCB lie.: / 4 . 7 _ State surcharge (12% of permit fee) i
TOTAL PERMIT FEE /4 -1 ; i9
Authorized signature: N I
This permit application expires if a permit is not obtained w /thin 180
days after it has been accepted as complete.
..
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -46I7T (I I /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.
ZSO CE Chad Fowers
�'`` Installation Foreman
Refrigeration & HVAC, Inc.
Cell 503 - 793-8379
Fax 503- 652 -0449
5506 SE International Way cfowers @sourcerefrigeration.com
Milwaukie, OR 97222 www.sourcerefrigeration.com
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