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Permit a CITY OF TIGARD MECHANICAL PERMIT lig 0 • COMMUNITY DEVELOPMENT Permit 4: MEC2010 -00005 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/14/2010 Parcel: 2S 102AA00906 Jurisdiction: Tigard Site address: 12080 SW MAIN ST Subdivision: Lot: 0 Project: Rite Aid Project Description: Replace existing rooftop unit. Owner: FEES BSM REALTY LLC Description Date Amount 3176 AMERICAN SADLER DR Permit Fee 01/14/2010 $2,359.71 PARK CITY, UT 84060 Plan Review 01/14/2010 $589.93 PHONE: 12% State Surcharge - Mechanical 01/14/2010 $283.17 Contractor: MCKINSTRY COMPANY 12021 NE AIRPORT WAY SUITE G PORTLAND, OR 97220 PHONE: 503 - 331 -2461 FAX: 503 - 331 -6906 Type of Use: COM Class of Work: ALT Type of Const: VB Occupancy Grp: M Occupancy Load: Stories: 1 Fuel Air Handlers Fuel Types: Natural Gas 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 $3,232.81 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 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 ifwetork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility ification Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You • • • fain a copy of the rules or di ct questions to OU k • =Ilin. 503.246.6699 or 1.800.332.2344. Issu By: , ' efLAAA.....4ki Permittee Signature: / i Call 503.639.4175 by 7:00 a.m. for an Inspection that busines • ay. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. _ ,y I__ e7- Mechanical Permit Applica r ` FOR OFFICE USE ONLY 1 rCFlVED Received City of Tiga Permit No.: �y 13125 SW Hall Blvd., Tigard, OR 97 2 Date/By: / / P i N / /� ,..4.0 40 ... ,20,0 Plan Review • C Phone: 503.639.4171 Fax: 503.598.196 N 0 6 0 D a ff y . ) • Inspection Line: 5036394175 l ( ( r Other Per p.. 9AN 0 . 2U10 TIGARD Internet: www.tigard- or.gov Notifi , . � n • 121 .j. . S Supplemental Information CITY OF TIGARD TYPE OF ING DIVISION 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. CATEGORY OF CONSTRUCTION Value: $ 90,000 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. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: 12080 S.W. Main Street Air conditioning (requires site plan showing placement) 46.75 City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: Rite Aid #5354 Heat pump 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), McKinstry Project #9278 in -wall, in -duct, suspended, etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no.: 00906 Other: 23.32 Tax map /parcel no.: 2S102AA Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 Replace (5) existing roof top units with new units. Like for like replacement. 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: Rite Aide Retail Facilities Environmental exhaust and ventilation Address: P.O. Box 1169 Range hood/other kitchen equipment 33.39 • City/State/ZIP: Camp Hill, PA 17001 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility moms) 23.32 ® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32 Other: 23.32 Business name: McKinstry Company, LLC Fuel piping Contact name: Mike Nichols, PM or Diane Parke, Project Cord. $14.15 for first four; $4.03 for each additional Address: 16790 NE Mason Street Furnace, etc. Gas heat pump City/State /ZIP: Portland, OR 97230 Wall/suspended/unit heater Phone: (503) 262.2305 Fax: : (503) 331.6907 Water heater Fireplace E -mail: dianep @mckinstry.com Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: McKinstry Company, LLC - Other: Address: MECHANICAL PERMIT FEES* City/State /ZIP: Subtotal Minimum permit fee ($90.00) Phone: ( ) Ar "( ) Plan review (25% of permit fee) CCB lie.: 172811 State surcharge (12% of permit fee) TOTAL PERMIT FEE 307 ' I Authorized signa IWA Y��� This permit application expires if a permit is not obtained within 180 _ days after it has been accepted as complete. Print name: Diane . �• Date: , • Fee methodology set by Tri - County Building Industry Service Board I:\Building\Permits \NEC- PermitApp.doc 10/01/09 440-461 (11 /02/COM/WEB)