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Permit CITY OF TIGARD MECHANICAL PERMIT 1111 COMMUNITY DEVELOPMENT Permit #: MEC2013 00040 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/22/2013 Parcel: 1 S136DC04500 Jurisdiction: Tigard Site address: 7501 SW DARTMOUTH ST 100 Project: Winco Subdivision: 1995 -013 PARTITION PLAT Lot: 2 Project Description: Replace (1) existing refrigerated case Contractor: PORTLAND MECHANICAL CONTRACTORS Owner: WINCO FOOD LLC 2000 SE HANNA HARVESTER DR ATTN: TAX DEPARTMENT MILWAUKIE, OR 97222 PO BOX 5756 BOISE, ID 83705 PHONE: 503 - 656 -7400 PHONE: FAX: 503 - 655 -0620 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 01/22/2013 $191.86 Class of Work: ALT Type of Const: IIIB Plan Review 01/22/2013 $47.97 Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 01/22/2013 $23.02 Stories: 1 Info Process /Archiving - Lg $2.00 (over 01/22/2013 $6.00 11x17) Project Valuation: $4,500.00 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 $268.85 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Refrigerator Duct Work: case 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 Utilit otification enter. • •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or erect questions to • • •y ca in• , 03.232.1987 or 1.800.332.2344. / r I sued By: Permittee Signature: 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. Mechanical Permit A licati ECFi VE FOR OFFICE USE ONLY City of Tigard DateBy ) p "21), Permit No.: //Z/'5 . Q 4, 11-11 _ ° 13125 SW Hall Blvd., Tigard, OR 97223 JAN 2 2 2013 Plan Review Lo. , � Phone: 503.718.2439 Fax: 503.598.1960 Date/By: TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Readyl Juris 10 See Page 2 for Internet: www.tigard- or.gov BUILD Notified/Method: Supplemental Information ING DIVISION TYPE OF WORK 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. Value: $ $4,500.00 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating /cooling: Air conditioning Job site address: 7501 SW Dartmouth (requires site plan showing placement) 46.75 Furnace 100,000 BTU (ducts /vents) 46.75 City /State /ZIP: Tigard, OR 97223 Fumace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Winco #23 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: DESCRIPTION OF WORK Water heater 23.32 Gas fireplace/insert 33.39 Replace existing deli case with like. No external piping. Will electronic leak Flue vent for water heater or gas check the connection. Electrical permit by others. 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: Winco #23 Environmental exhaust and ventilation: Address: 7501 SW Dartmouth Range hood/other kitchen equipment 33.39 City /State /ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 ® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32 Business name: Portland Mechanical Contractors Other: 23.32 Fuel piping: Contact name: Todd Shippen $14.15 for first four; $4.03 for each additional Address: 2000 SE Hanna Harvester Drive Furnace, etc. Gas heat pump City /State /ZIP: Milwaukie, OR 97222 Wall /suspended/unit heater Phone: (503) 806 - 1919 Fax: : (503) 655 - 0620 Water heater Fireplace E - mail: tshippen @pmc -g.com Range CONTRACTOR Barbecue Business name: Same as above. Clothes dryer (gas) Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: 151807 State surcharge (12% of permit fee) TOTAL PERMIT FEE i This permit application expires if a permit is not obtained within 180 Authorized signature:,/ days after it has been accepted as complete. Print name: Todd Shippen Date: 1/22/13 • Fee methodology set by Tri- County Building Industry Service Board I \Budding \Permits \MEC- PermitApp.doc 03/07/12 440 -46177 (I 1 /02 /COM/WEB) Building Division Over- The - Counter (OTC) Mechanical Permit T I G A R D Check List Project Description: ILAC_f -- APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: - Occupancy Group: Type of Construction: %f *Type of Use: Gt,l Oregon Specialty Code: ?Q(cf) Number of Stones: FUEL FURNACES Type: Furnace < 100K BTU Furnaces >= 100K BTU Gas Pressure: Roof Top Unit (RTU) Tons Floor Furnaces Unit Heaters Vents without Appliances Air Conditioning Heat Pump AIR HANDLERS HOODS Units <= 10000 cfm Type 1 Hood Type 2 Hood Units > 10000 cfm Grease Duct 1 Hour Shaft Fire Wrap APPLIANCES Boiler (BTUs) Vent Fans Gas Line Solid Fuel Fireplace/ Clothes Dryers Gas Outlets Woodstove Duct Work Gas Fireplace Fire /Smoke Dampers Other Mechanical Units — Describe: �4=((Z Total Project Valuation: $ l7- FEES DUE $ e Mechanical Permit Fee $ aVj Plan Review $ ' Z?j, D 12% State Surcharge • $ ,©(j Info Proc /Arch, Lg (over 11x17 $2.00) $ Info Proc /Arch, Sm (up to 11x17 $0.50) $ Misc. Admin Fee $ Hourly Rate Fee $ Hourly Rate State Surcharge $ Other: $ Other: Building Staff: Date /Time: $ Z ? TOTAL FEES DUE *OPTIONS: TYPE OF USE: COM = commercial; CMS = commercial manufactured structure. CLASS OF WORK ACS = accessory; ADD = addition; ALT = alteration; FND = foundation; DEM = demo; FND = foundation; FPS = fire protection system; NEW = new; O1R = other (use for fences, decks, retaining walls, signs, awnings or canopies); REP = repair. 1: \Building\Forms \OTC - MEC.docx 01/13/2011