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)