Permit CITY OF TIGARD MECHANICAL PERMIT
11 4 � COMMUNITY DEVELOPMENT Permit #: MEC2009-00140
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/08/2009
Parcel: 1S136DC04500
Jurisdiction:
Site address: 7501 SW DARTMOUTH ST 100
Subdivision: Lot: 0
Project: WINCO
Project Description: Bakery Department - TI - Install new exhaust fan, relocate duct, new grilles, relocate pan washer
hood, extend exhaust drops.
Owner: FEES
WINCO FOOD, LLC Description Date Amount
ATTN: SUSAN BUSCHE, PO BOX 5756 Permit Fee 04/01/2009 $197.30
BOISE, ID 83705 Plan Review 04/01/2009 $49.33
PHONE: 12% State Surcharge 04/01/2009 $23.68
Contractor:
HVAC INC
5188 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222
PHONE: 503 - 462 -4822
FAX: 503 - 462 -6555
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 $270.31
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
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
issuanc- • • - s suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification Cen -r. To •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a . • oft e rules
I- ued By: �� / Permittee Signature: -.tivaii) I
Al
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 comp -tio of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicationRECEIVED ED FOR OFFICE USE ONLY
City of Tigard - 1 Rece ved •1 D9 K4.G�o� l
1 Permit No.:
a 13125 SW Hall Blvd., Tigard, OR 97223 APR 209
Plan P. 4( �� Other Permit:
Ins � ��� . Phone: 501639.4171 Fax: 503.598.1960 Date/B
Inspection Line: 503.639.4175 y
T I G A R D p CITY OF TIGA Date Ready : y: Ions: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified/Method: i 7, OS V] /\ , ''Cl I Supplemental Information
Z- A - CDC ■ . III _1
R .. .
' COMMERCIAL FE • , SCHE ;10 USE - CHECKLIST
s , _ TYPE OF'.W . K�
ID New construction 1K Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
',. `' ' CAT '' Value: $ i� Q
���� � r - ..RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
"'-' It 'e . ' JOB INFORMATION, AND LOCATION' _ '
t ; Heating/coolmg
Job site address: S O D @\A J+ S \A) Air conditioning e ing plan ho i g placement) pump
(requires site Ian or he p 14.00
City/State /ZIP: T 1 0\ j V \ 0 (1 -- -3 Furnace 100,000 BTU (ducts /vents) 14.00
'n Furnace 100,000+ BTU (ducts/vents)
Gas heat pump 17.90
Suite/bldg. /apt. no.: Project name: '� iV (� �l 6 c\ km Q Jan 14.00
Cross street/directions to job site: ( l Duct work 10.00
Hydronic 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
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
'i" , v .. : 4 , .- .. DESCRIPTION "' OF WORK ' Water heater 10.00
�.ihs R,� V-eAA) - (- - kin 1 l ft 7 0 c -e D�1.1 ck V\ V i/) Gas fireplace vent 10.00
Flue vent for water heater or gas
I �/�� p �� p \, our) fireplace 10.00
\J I V > l 1 a.� c a,k, V V ti {... A eAk . O D hi j t Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner /flue /vent 10.00
,.. >`;.;( • lial PROPERT,Y'OW.NER r , 'I '. LL TENANT Other: 10.00
Name: W 1. 1 (10, 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
/', IX ' APPLICANT ; . ❑ CONCT' TA PERSON ° ' Attic /crawlspace fans 10.00
Q Other: 10.00
Business name: V C 1 L _" j '� c..- Fuel piping
Contact name: J 1 k n W " $5.40 for first four; $1.00 for each additional
Address: 11 f ' & Furnace, etc.
l� C� ` O ) ���T( �� L I
Gas heat pump
City /State /ZIP: h \ J Ole,_ C A:l'o) -- 3 Wall/suspended/unit heater
Phone: (S ) LCbtD 14sry%> I Fax: : (5)3) q (D- -6 Water heater
Fireplace
E -mail: : s c mc4Ir , COV ) Range
q ... CONTRACTOR , Barbecue
Business name: 5 t t» - ' 1A)
Uv 1 Clothes dryer (gas)
Other:
Address: ., ,_ PERMIT FEES *. ' ' '
City /State /ZIP: Subtotal
Phone: ( ) I Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: AS-10 % '/ 3 - 1 ' 31 Yp ' State surcharge (12% of permit fee)
TOTAL PERMIT FEE
Authorized signature: / 1 ' This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: N I A (kU i 1 Date: tI/ I /0 O * Fee methodology set by Tri -County Building Industry Service Board
1:\ Bui lding\Permits\MEEC- PermitApp.doc • /19/07 440-4617T (11 /02/COM/WEB)