Permit CITY OF TIGARD MECHANICAL PERMIT
$ COMMUNITY DEVELOPMENT Permit#: MEC2014-00076
T IGARO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/06/2014
Parcel: 1 S134BC00100
Jurisdiction: Tigard
Site address: 12100 SW SCHOLLS FERRY RD
Project: 7-Eleven Subdivision: GREENWOOD TERRACE CONDO Lot: 17
Project Description: Installing a push-pull freezer case.
Contractor: SOURCE REFRIGERATION Owner: ATLAS GREENWAY LLC
5506 SE INTERNATIONAL WAY 333 NW NINTH AVE, STE 1009
MILWAUKIE, OR 97222 PORTLAND, OR 97209
PHONE: 800-677-2688 PHONE:
FAX: 503-652-0449
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/06/2014 $297.13
Class of Work: ALT Type of Const: VB Plan Review 03/06/2014 $74.28
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 03/06/2014 $35.66
Stories: Info Process/Archiving-Sm$0.50(up to 03/06/2014 $2.50
Project Valuation: $8,185.00 11x17)
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 $409.57
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units.
Gas Outlets: Other Desc: reach in
Duct Work: frozen food
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 Notific- - -nter. 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• -stions to O C b ailing 503.232.1987 or 1.800.332.2344.
Issued B Permittee Signature: S
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 Application FOR OFFICE USE ONLY
City of Tigard
Received Permit No.:
`J g �� Date/By: i -t------ .• .
• 13125 SW Hall Blvd.,Tigard,OR �y r
Prill
rr O'�� Plan Review ,k � Other Permit
Phone: 503.718.2439 Fax: 503.59: +r Date/By: ����
T I GARD Inspection Line: 503.639.4175 c`� `: O Date Read�'' luris, ® See Page 2 for
Internet: www.tigard-or.gov C O.*`(csP�o Notified/method: 3(,e ily Q J) r 7`! Supplemental Information
TYPE OF W `V vCO/M-MERCCIA/L'FEE* SCHEDULE - USE CHECKLIST
Mechanical permit tees*arc based on the value of the work
❑New construction ® Addition alteration/t placement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S$8,185.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ l-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:
Air conditioning 46.75
Job site address: 12100 SW Scholls Ferry Rd Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:7-11#22057
, Duct work 23.32
Cross street/directions to job site: 9 W 12 I 5-+- c Hydronic hot water system 23.32
` ' 1 Residential boiler(radiator or
c�QCJLS '- ?4—C hydronic) 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: 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
push pull reach in frozen food and ice freezer cases fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 ,
Oth
❑ PROPERTY OWNER ❑ TENANTS' 23.32
Environmental exhaust and ventilation:
Name:7-11 #22057 Range hood/other kitchen
equipment 33.39
Address: 12100 SW Scholls Ferry Rd Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ® CONTACT PERSON Other: - 23.32
Fuel piping:
Business name:Source Refrigeration
$14.15 for first four;$4.03 for each additional
Contact name:Ben Boyer Furnace,etc-
j Address:5506 Se International Way Gas heat pump
1 Wall/suspended/unit heater _
I.
City/State/ZIP:Milwaukie OR 97222 Water heater
Phone:(503)209-4634 Fax::( ) Fireplace ,
Range
•
E-mail:bboyer�dsourcerefrigeration.com Barbecue
CONTRACTOR Clothes dryer(gas)
Other:
Business name:Source Refrigeration MECHANICAL PERMIT FEES*
Address:5506 Se International Way Subtotal
City/State/ZIP:Milwaulkie OR 97222 Minimum permit fee($90.00)_
Phone:(503)209-4634 Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:149200 TOTAL PERMIT FEE
W2 This permit application expires if a permit is not obtained within 180
( / days after it has been accepted as complete.
Authorized signature: v s Fee methodology set by Tri-County Building Industry Service Board
Print name: 1/\ 051 e Date: 2-1-1,41 l
I:Building Permits\MEC_PermitApp_040 I l3.doc 440-46171(1 I/02iCOM,WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I: Building\Permits'.M EC_PermitApp_040 I l3.doc 2
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12100 SW SCHOLLS FERRY RD, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
2014-03-12 00:00:00
MEC2014-00076
PASS - No C of O
Violation Summary:
Inspector Contractor