Permit CITY OF TIGARD MECHANICAL PERMIT
11111 = COMMUNITY DEVELOPMENT Permit #: MEC2011 -00177
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2011
Parcel: 1 S136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: Lot: 0
Project Description: Install new produce cooler, retro existing produce cooler.
Contractor: KEY MECHANICAL CO OF WASHINGTON Owner: COSTCO WHOLESALE CORPORATION
19430 68TH AVE SO PROPERTY TAX DEPT 111
KENT, WA 98032 999 LAKE DR
ISSAQUAH, WA 98027
PHONE: 503 -231 -0731 PHONE:
FAX: 503 - 236 -5848
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/29/2011 $5,528.71
Class of Work: ALT Type of Const: IIB Plan Review 04/29/2011 $1,382.18
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 04/29/2011 $663.45
Stories: 1 Info Process /Archiving - Lg Sheet (over 04/29/2011 $14.00
11x17)
Project Valuation: $200,000.00
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 $7,588.34
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Walk in
Duct Work: cooler -
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 Notific- • -nter. 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 • -stions to O► C b : Iling 503.232.1987 or 1.800.332.2344.
Issued y: / / #/,.,j - d j / Permittee Signature: 4
Call 503.639.4175 by 7:00 a.m. for the next available inspecti • • .
This permit card shall be kept in a conspicuous place on the job site until completion o e project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Received
City of Tigard nn �/ e,a 7
! J
.iih _ " 13125 SW Hall Blvd., Tigard, OR 9722( Date /By: Permit No.: � � _ `
Phone: 503.718.2439 Fax: 503.598.19���400 ((((( Plan Review w
Date /By: r' � 4 o ( Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /By: . y � 6 .t
/ urfs: El See Page 2 for
Internet: www.tigard- or.gov APR 2 2 2011 No'fied/Method: / 7 // Supplemental Information
t h�
TYPE OF WQ K,_, 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, labor, overhead, and profit.
Value: $ gOa
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 I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 7 85 O w ` ^ p . k - -t (requires site plan showing placement) 46.75
City/State /ZIP: n 2 �` 2 Furnace 100,000 BTU (ducts /vents) 46.75
T( (4J2 - t 1 Q G 2Z. J Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: C Project name: --c--\ c A.2 L. Co �'� «' Heat pu p 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
n
''jamP' TA4 c Gas fireplace 33.39
` - rI; l a - k)�u PP6 f b' l X n -
1 , / _ _ TM ,, -- � lie I 5:TfAt Flue vent for water heater or gas
PeD [a11(t� Q t Ti ? N \ (� tw (1-� fireplace 23.32
`- ` r " l 1 Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
R PROPERTY OWNER ( ❑ TENANT Chimney /liner /flue/vent 23.32
Other: 23.32
Name: C- (? S l cro (,tj . t_ps - 0.0 r
Environmental exhaust and ventilation:
Range hood/other kitchen
Address:
CC/ L4 K F t 1:,,c2l0 e ' equipment 33.39
City/State /ZIP: I. S ..#0 , ,c1? , k A c(�oO Clothes dryer exhaust 33.39
Phone: t� Single -duct exhaust (bathrooms,
( ) Fax: ( ) toilet compartments, utility rooms) 23.32
„APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: K -t J V I �. (O Co ` Fuel piping:
l� 111 P ip g:
Contact name: Q (n A CEZL D3 S7Q IS-P3 3 $14.15 for first four; $4.03 for each additional
Address: 4 5---se �. E ` NCH L A Nr Gas etc.
b l - 1 Gas heat pump
City/State /ZIP: l ��T Il i ' 91 a () Wall/suspended/unit heater
Phone: ( ! . a�� 1 _ D 3 l F ax:: (s-z _ c 95 (O - ss Li S Water heater
Fireplace
E - mail: Range
CONTRACTOR Barbecue
�1 Clothes dryer (gas)
Business name: gc:N hpeisi , l A •
Other:
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: S•06. E Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lie.: ( 3 cfn State surcharge (12% of permit fee)
` � TOTAL PERMIT FEE
Authorized signature: v "�J This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: STA do M A t 5 Date: 41 /2 -LI 1 , * Fee methodology set by Tri- County Building Industry Service Board
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l:Building \Permits MET- PermitApp.doc 09/09/10 440.4617T(I1/02 /COM/WEB)