Permit CITY OF TIGARD MECHANICAL PERMIT
.: COMMUNITY DEVELOPMENT Permit #: MEC2012 -00093
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/17/2012
Parcel: 1 S136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: Lot: 0
Project Description: Add refrigerated island display cases.
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 02/17/2012 $601.71
Class of Work: ALT Type of Const: Plan Review 02/17/2012 $150.43
Occupancy Grp: Occupancy Load: 12% State Surcharge - Mechanical 02/17/2012 $72.21
Stories:
Project Valuation: $20,000.00
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 $824.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
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
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 • ' • is suspended for more the 180 days. ATTENTION: Oregon law requires you • allow the rules adopted by the Oregon
Utilit otification Cente . Those ules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 •090. ( You may obtain a copy of the rules
or . rect questions to OUNC - ing 50 2.1987 or 1.800.332.2344.
Iss ed By: �A ,/f Permittee Signature: ` , ���„
Call 503.639.4175 by 7:00 a.m. for the next available inspectio date. _
This permit card shall be kept in a conspicuous place on the job site until com • letion , f the roj
Approved plans are required on the job site at the time of each insp.. '.n.
Mechanical Permit Application FOR OFFICE USE ONLY G �/ �jh
City Tigard RECEIVE/ i / EdieV f ��r tJ
CI of Ti and ate/By: ,� - ✓ Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 FEB D an Review Other Permit:
1 7 � � ; � ate/By:
TI G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov CITY Notified/Method: Supplemental Information
TYPE OF WORK
R�IIL DING DIVISION COMMERCIAL FEE* SCHEDULE – USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ID Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ AD 64,00 o�
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYS FEES*
❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
�
* Air conditioning
i
Job site address: / g-D S0 �.-!tl 5--� (requires site plan showing placement) 46.75
1 n Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: fl /� (4A ail. Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: "L Project name: Ce S-7 li i 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:
n - DESCRIPTION OF WORK Water heater 23.32
�I
R1cRit OT 4LA-pD 1)(s'r tp O Gas fireplace 33.39
,� WO Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
❑ PROPERTY OWNER ❑ 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
Fax: Single -duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility rooms) 23.32
[APPLICANT 50 CONTACT PERSON Attic /crawlspace fans 23.32
_ Other: 23.32
Business name: f(f r
" � 1 (," L � Fuel pip
Contact name: P� �'�' �,1� � � 1 "'r � m $14.15 for first four; $4.03 for each additional
i
Address: t, IA Furnace, etc.
Gas heat pump
City/State /ZIP: ftra C.440 Oil__ 'Ti i b Wall /suspended/unit heater
Phone: Water heater
(� ) 1 � N /,
N . 0 3/ Fax: : ( L26 , -f'
R f�'l l -ARy m A ®kL1 IM 'f�-,v, t&L , Range
E- mail: ` Range
CONTRACTOR Barbecue
) Clothes dryer (gas)
Business name: ��
04 'N
la
5 NI e- 1 g 40 Other:
Address: S MECHANICAL.PERMIT FEES*
City /State /ZIP: 1)94/0- ( J t 0 P £_ 2-3 0 Subtotal 60/. 7/
Minimum permit fee ($90.00) 1 Phone: ( l/
� �l Cl Cl 3 ) Gr — ( p ) /St�•Y3
1 Fax: ( ? .�3 �' � , B
r7 Wi P_lan.review_ 25!°.of ermit.fee _— __
CCB lie.: CI3/a"g State surcharge (12 %ofpermit fee) 7 0 ,/
1 TOTAL PERMIT FEE ga 3 S
Authorized signature: T his permit application expires if a permit is not obtained within 180
d ays after it has been accepted as complete.
Print name: Atis,..1 ( eR( Mpv.i Date: 'Z— (,'j -- (L * Fee methodology set by Tri- County Building Industry Service Board
I. \ Building \Permits\MEC- PermitApp.doc 09/09/10 440 -4617T (11/02 /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.
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