Permit CITY OF TIGARD MECHANICAL PERMIT
F t COMMUNITY DEVELOPMENT Permit #: MEC2013 00056
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/24/2013
T IGARD' Parcel: 1S134BC00300
Jurisdiction: Tigard
Site address: 12240 SW SCHOLLS FERRY RD
Project: Rite Aid Subdivision: WINDSOR PLACE Lot: 32
Project Description: HVAC modification for TI. 1/31/13, reprint to correct project description and ASI info
Contractor: JET INDUSTRIES INC Owner: FW OR- GREENWAY TOWN CENTER LLC
1935 SILVERTON RD NE PO BOX 790830
SALEM, OR 97303 SAN ANTONIO, TX 78279
•
PHONE: 503 - 363 -2334 PHONE:
FAX: 503 - 363 -2622
•
FEES •
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/24/2013 $90.55
Class of Work: ALT Type of Const: '12% State Surcharge - Mechanical 01/24/2013 $10.87
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $1,135.00
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 $101.42
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, or • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No 'cation Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direc • uestions to OUNC • ' • i ;'.232.1987 or 1.800.332.2344.
Issue. By: I Permittee Signatu�
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
•
CITY OF TIGARD MECHANICAL PERMIT
>s • COMMUNITY DEVELOPMENT Permit#: MEC2013-00056
Ti G AR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/24/2013
Parcel: 1S 134 BC00300
Jurisdiction: Tigard
Site address: 12240 SW SCHOLLS FERRY RD
Project: Rite Aid Subdivision: WINDSOR PLACE Lot: 32
Project Description: TI for new consultation room,reorganize shelving,upgrade restroom accessories.
Contractor: JET INDUSTRIES INC Owner: FW OR-GREENWAY TOWN CENTER LLC
1935 SILVERTON RD NE PO BOX 790830
SALEM,OR 97303 SAN ANTONIO,TX 78279
PHONE: 503-363-2334 PHONE:
FAX: 503-363-2622
FEES
Specifics: Description Date Amount
Type of Use: Permit Fee 01/24/2013 $90.55
Class of Work: Type of Const: 12%State Surcharge-Mechanical 01/24/2013 $10.87
Occupancy Grp: Occupancy Load: •
Stories:
Project Valuation: $1,135.00
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 $101.42
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 if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. 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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /r
Issued By: ' /1 Permittee Signature: Okc /�-PPLI6Ai7O a
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
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.
01-24-13; 14: 36 # 1/ 3
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVE il!Date/B)^. At, /i PermitNo.: •' I e4,443Ae,
• 13125 SW Hall Blvd.,Tigard,OR 97223
114 I
Date/By:Review Other Permit: q
Phone: 503.718.2439 Fax: 503.598.1960 Y 64_4,6.23 •
Date/By: �'� I
Inspection Line: 503.639.4175 JAN 2 4
1 '!GAR 1� ,.),.3 Date,Ready/By:
RI Page 2 for
Internet: www.tigani-or.gov
CITYNotified/Method: Supplemental Information
TYOFTIGARn
.,44:i, 4.2j n.. •r+ - ire ] _'i5a o- :v ,. M{ :if 0 p i - •1 C' 1 0 ..L&Ll.11l� �l�tl�,•
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:S$1,135.00
Ti - ,-4-I•� „iCATF/.CyO '"O•Fit's o NS'PR 0.,P .)1!2,17.-f.,.., '- .. t33L FnV ItAL Q' P.ME_; i`X t _,.
❑ I-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
:: ., -, ::� °:�3.5, » e ,ra s,;,�. Hcating/cooling:
^1• V��; •1" "4SKO"'�SLTF1t b V TIU_? _ ^ iOCATC,�: `ti'` �'. i " ';J`
�' r:.5'i.+��n'Fr7`�'�`'9::`%tAt.�b4'�� se•�ey.�-_s. K- x:�.,:,:a-_-- -- � =-� '- Air conditioning
Job site address:12240 SW Scholls Ferry Road (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 5353 Heat pump
(requires site plan showingplacement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 2.3.32
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:
4 R@of is ya' ,`�r--,: ��.. ; _`+,-_:>"
Water heater;S1T�F��St`� �" O E u, U �0YM, ,,..W,Ifrk. ri!; _ ,:v.P: C1f u M:::I.^.. 2332
Gas fireplace/insert 33.39
Add supply and transfer duct
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
WA-r"!.. ®f P DEER VV E ' ®;, �5, `�` }, ;rti'r Chimney/liner/flue/vent 23.32
.E,7.1, ,,--- y-�+-:. =aC� � '`. 't.Rt.`._':�'_'_ . _s Other: 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:( ) Fax:( ) toilet compartments,utility rooms) _ 23.32
M �Ca'Ah•!lia. -4 i -?M"1'ED reo?�_ j i-ri-'1;g :4 Attic/crawlspace fans 2332
Business name:Jet Industries Other: 23.32
Fuel piping:
Contact name:Rena Eubanks $14.15 for first four,$4.03 for each additional
Address: 1935 Silverton Road NE Furnace.etc.
Gas heat pump
City/State/ZIP:Salem,OR 97301 Wall/suspended/unit heater
Phone:(503)798-4430 Fax::(503)363-8908 Water heater
Fireplace
_E_mail:.rcna.egletindustries,net_• ._... ._........._ _ ._.._....___._.
..._. ...... ... ..Ra n g e-...... .. . .... ..... . ... . . .. ...... .. ...... ..
c.°®1 '. - .._ Barbecue
Business name:Jet Industries Clothes dryer(gas)
Other.
Address: 1935 Silverton Road NE
City/State/ZIP:Salem,OR 97301 Subtotal 90.55
Minimum permit fee(S90.00)
Phone:(503)798-4430 Fax:(503)363-8908 Plan review(25%of permit fee)
CCB lic.:3944 State surcharge(12%of permit fee) 10.87
TOTAL PERMIT FEE 101.42 -
This permit application expires If a permit Is not obtained within 180
Authorized signature: _ days after it has been accepted as complete.
Print name:Rena Eubanks I Date:1/22/13 • Fee methodology set by Tri-County Building Industry Service Board
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