Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00333
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/24/2013
Parcel: 2S 102AA00906
Jurisdiction: Tigard
Site address: 12080 SW MAIN ST
Project: Rite Aid Subdivision: PAYLESS SHOPPING CENTER Lot: 4
Project Description: Installation of (6) refrigerated cases and (3) rooftop condensing units
Contractor: REFRIGERATION UNLIMITED INC Owner: BSM REALTY LLC
6102 N 9TH ST SUITE 100 BY RITE AID
TACOMA, WA 98406 -2097 PO BOX 3165
HARRISBURG, PA 17105
PHONE: 253 -474 -3100 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/18/2013 $594.09
Class of Work: ALT Type of Const: VB Plan Review 06/18/2013 $148 52
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 06/18/2013 $71.29
Stories: 1 Info Process /Archiving - Lg $2.00 (over 06/24/2013 $2.00
11x17)
Project Valuation: $19,604.00
Fuel Air Handlers
Fuel Types. Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 - 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 $815.90
Hoods: Comm Incinerators.
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units
Gas Outlets Other Desc 6 Refer units
Duct Work and 3 •
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 No • :. - • 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 dir- ' questions to 3 UNC • calling 503.232.1987 or 1 800.332.2344. -
Issu By: I ` 1 Permittee Signal 4* • :r-ir •
r •
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 completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic ? anCEilVED i FOR OFFICE USE ONLY .
City of Tigard Date /By (Q / / / ,3 , 7 Permit No • ge ,l6/3_�333
71 n 13125 SW Hall Blvd., Tigard, OR 972 1 7 2013 (((///ffl
Phone: 503.718.2439 Fax. 503 598. Plan Review I t
C Date /By ( \q ( Other Permit. •/6u P X0/ -456
TIGARD
Inspection Line: 503 4175 C ITY OFT /GARD Date Read /B Jun ® See Page 2 for
Internet: www.ligard - gov Notified/Metho Y Y �(f � � r Supplemental Information
BUILDINGDNISION - /)
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, an p rofit.
- Value: $ t(///L/0 2
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2- family dwelling J Commercial /industrial ❑ Accessory building For special information use checklist.
I=1 Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea I Total
JOB SITE INFORMATION AND LOCATION ' , Heating/cooling:
�►n 1 Air conditioning 46.75
Job site address: 100 t_ `ain S 1 reef' Fumace 100,000 BTU (ducts /vents) 46.75
City/State /ZIP: T;`5 rc co q7 .2 Fumace 100,000+ BTU (ducts/vents) 54.91
JJ i
Suite/bldg. /apt. no.: I Project name: T ii A 4 $ 53511 tebsteael Heat pump 61 06
Duct work 23.32
Cross street/directions to job site: 1 1 ' 1 g hmpp; Ce fe(` Hydronic hot water system 23.32
0 r t Corner of Ski M AID std. 4,.. 44 & P 4 Residential hydronic) boiler (radiator or
W 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46.75
Flue/vent for any of above 23 32
Subdivision: I Lot no.: Other: 23 32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
• DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Trsiallateen of (6) Helm tefrte,rktet .6 tees ti (i) fireplace 23.32
1 Log lighter (gas) 23.32
rb0 Ib Cp VeA AS) v143 IAeti4S. Wood/pellet stove 33.39
•1 Wood fireplace/insert 23 32
Chimney /liner /flue /vent 23.32
. ❑ PROPERTY OWNER I %TENANT • • Other 23.32
Environmental exhaust and ventilation:
Name: R } A; d Range hood/other kitchen
Address: (o 16X 31 4) 5 Clothes dryer 33.39
Clothes dryer exhaust 33 39
City/State /ZIP: NAFri s 664.5 PA 1 '1 '0 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23 32
Phone: (7I 1 7) 761-.20 g 3 Fax: ( ) Anic /crawlspace fans 23.32
IR APPLICANT ❑ CONTACT PERSON Other 23.32
I 1 , A , Fuel piping:
Business name: R t ii j d A 14 h M tit =tom. $14.15 for first four; $4.03 for each additional
Contact name: gr0.tx 0. r>^ Rt. 4;,.. Furnace, etc.
Address: trsl as I (ph JH4e /Do Gas heat pump
A pp Wall/suspended/unit heater
City/State /ZIP: To, k/A 98 (M G Water heater
Phone: (0753) rig. 310 Fax: : (2 65 ) y riy . 1.401 Fireplace
Range
E -mail: °9 10142 g m. rbt' I✓lC .C6 p1 s Barbecue
CONTRACTOR l .r Clothes dryer (gas)
Business name: R Q fr t Se - 41 e Yl 0VI IIlM tT t4 . char MECHANICAL PERMIT FEES*
Address: MO Al (1h S Ni 3 e. 100 Subtotal sly .01
1
City/State /ZIP: C.DWIA WA ('1D `!0(0 Minimum permit fee ($90.00)
- Plan review (25% of permit fee) IV. 5.2
Phone: (?4,) !pi .3100 Fax: (255) TM -q0-3091 State surcharge (12% of permit fee) 7;. 079
CCB tic.: Ar. 75/ 5 TOTAL PERMIT FEE 813. a iR
This permit application expires if a permit is not obtained within ISO
X days after it has been accepted as complete.
Authorized signature: eQ f� * Fee methodology set by Tri -County Building Industry Service Board
Pnnt name: Wratta 1 it 0 1 , 6ir� S ���t Date: 6)-1A- Q013
1 \Budding \Permits \MEC_PermitApp_040113 doe 440 -46I7T (I 1 /02 /COM/WEB)