Permit CITY OF TIGARD MECHANICAL PERMIT
11111 11 11 COMMUNITY DEVELOPMENT Permit#: MEC2015-00689
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/29/2015
TIGARD Parcel: 1S 136CD02200
Jurisdiction: Tigard
Site address: 7850 SW DARTMOUTH ST
Project: Costco Subdivision: PALMER ACRES Lot: 3
Project Description: Replacement of(2)25 ton RTU's and installation of(1)3 ton split system for pharmacy.
Contractor: STREIMER SHEET METAL WORKS INC Owner: COSTCO WHOLESALE CORPORATION
740 N KNOTT STREET PROPERTY TAX DEPT 111
PORTLAND, OR 97227 999 LAKE DR
ISSAQUAH,WA 98027
PHONE: 503-288-9393 PHONE:
FAX: 503-288-3327
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 10/29/2015 $1,262.11
Class of Work: ALT Type of Const: VB Plan Review 10/29/2015 $315.53
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 10/29/2015 $151.45
Stories: 1 Info Process/Archiving-Lg$2.00(over 10/29/2015 $4.00
11x17)
Project Valuation: $46,000.00 Info Process/Archiving-Sm$0.50(up to 10/29/2015 $12.50
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 $1,745.59
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 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 503.232.1* • 1.800.332.2344.
Issued By: •rmittee Signature: •„a1:25=2e,...._ ��
Call V.7639.4175 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.
1
Mechanical Permit Application -�ij1 FOR OFFICE USE ONLY
City of Tigard �`/�
Date/By: ry ANIMA Permit No.: _ �_ ,i fry
y:
171
• 13125 SW Hall Blvd.,Tigard,OR 972 Plan Revie r�+l•
Phone: 503.718.2439 Fax: 503.598.1960 + c�`�Q�S Date/By: AN / ' • ►
Inspection Line: 503.639.4175 t 1 - -
TIGARD OC\ a��\ Date Ready El See Page 2 for
Internet: www.tigard-or.gov ii ii t_' 39�■Notified/Method: t. Supplemental Information
.i
TYPE OF WO R AN\41, 1 , COM R .L E* SCHEDULE - USE CHECKLIST
���L Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alterati7teplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$46,000.00
CATEGORY OF CONSTRUCTION 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:
Air conditioning 46.75
Job site address:7855 SW Dartmouth Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(duets/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name:Pharmacy 4Phiceitephreemeifr Ce,s Duct work 23.32
Cross street/directions to job site:Hwy 99 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
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
Replacement of(2)25 ton RTU's and installation of(1)3 ton split system HP fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39 .
City/State/ZIP: 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:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) I Fax: :( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:SSM Mechanical Services Other:
MECHANICAL PERMIT FEES*
Address:740 North Knott street 415—.-RtYUntZ ") Subtotal 1,363.
M p, Lti ,lcyco Minimum permit fee($90.00)
City/State/ZIP:Portland,OR 97227 ,V, "-�"V6
Plan review(25%of permit fee) 340.92
Phone:(503)943-6006 Fax:(503)288-3327 State surcharge(12%of permit fee) 163.64
CCB lie.:2365 TOTAL PERMIT FEE 1868.27
This permit application expires if a permit is not obtained within l80
days after it has been accepted as complete.
Authorized signature: t * Fee methodology set by Tri-County Building Industry Service Board
Print name:Jerry Rudolf Date:10/09/15
I:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7850 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00689
Jeff Grove
Violation Summary:
Inspector Contractor