Permit _ CITY OF TIGARD MECHANICAL PERMIT
,1 COMMUNITY DEVELOPMENT Permit#: MEC2015-00794
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/29/2015
Parcel: 2S 101 BA00101
Jurisdiction: TIGARD
Site address: 7500 SW DARTMOUTH ST 190
Project: Which Wch Subdivision: WEST PORTLAND HEIGHTS Lot:
Project Description: Installing(2)RTU's and gas piping.
Contractor: PROTEMP ASSOCIATES INC Owner: WAL-MART REAL ESTATE BUSINESS TR
9788 SE 17TH AVE BY PROPERTY TAX DEPT STORE 5935-00
PORTLAND, OR 97222 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 503-233-6911 PHONE:
FAX: 503-238-9767
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/29/2015 $411.21
Class of Work: ALT Type of Const: VB Plan Review 12/29/2015 $102.80
Occupancy Grp: A-2 Occupancy Load: 12%State Surcharge-Mechanical 12/29/2015 $49.35
Stories: 1 Info Process/Archiving-Lg$2.00(over 12/29/2015 $6.00
11x17)
Project Valuation: $12,500.00 Info Process/Archiving-Sm$0.50(up to 12/29/2015 $5.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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 $574.36
Hoods Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 2
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 80 33223 4.
Issued By: e ature:
Call SD3.639.4175 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
City of Tigard ReceivedDme/By: �/ � �5- 7PermitNo.:13125 SWHall Blvd.,Tigard,OR 97223�������® Plan Re J '
Phone: 503.718.2439 Fax: 503.598.196 Date/By: ermit:Inspection Line: 503.639.4175Date Re y 'y: ® See Page 2 for
Internet: www.tigard-or.gov N 0 V 19 2 015Notified/Method: 7 Supplemental Information
"TYPE OF WOGITY OF I IGARD 'to-mvilctAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alte 1 n , e performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$12,500.00
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 STFE INFORMATION AND LOCATION Heatin coolie :
Air conditioning 46.75
Job site address:7500 SW Dartmouth St 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.:#190 Project name:Walmart Which Wich Duct work 23.32
Cross street/directions to job site: H dronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/ventfor 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
Install 2 curbs and two RTU'S and drops with gas piping fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove I t 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER ❑ 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/crawls ace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name:Protemp Associates Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Bruce Butner Furnace,etc.
Address:9788 SE 17'h ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portaland Water heater
Phone:(503)519-6199 Fax::(503)238-9767 Fireplace
Range
E-mail:bruce@protmp.com Barbecue
CONTRACTOR Clothes dryer as
Business name:Same as above Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Phone:( ) Fax:( ) Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lic.:38868 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature:9_ • Fee methodology set by Tri-County Building Industry Service Board
Print name:Bruce Butner Date: 11/18/15
1:tBuilding\Permits\MEC_PermitApp_040113.doe 440-4617T(I1/07JCOM/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
7500 SW DARTMOUTH ST 190, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00794
Jeff Grove
Violation Summary:
Inspector Contractor
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.ti arg d-or.gov
TO: h4 DATE RECEIVED:
DEPT: BUILDING DIVISION nECEIVE
DEC 2 2015
FROM: , CITY OF TIGARD
COMPANY: �� /J BUILDING DIVISION
PHONE: By:
RE: 7``U� �� �J`�. �GDC17ga 2015—C.�i/i�l Lf
(Site Address ermit Number)
�/ti,M
rqect name or subdivision ivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Description: Copies: Description:
Copie7s.
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis.
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain):
REMARKS:
FOR qfflE USE ONLY
Routed to Permit Technicia Date: Initials: 1
Fees Due: ❑ Yes o Fee Description: Amouii ue:
Special
Instructions:
Reprint Permit (per PE): ❑ Yes JoNo I ❑ Done
Applicant Notified: I Date: Initials:
I:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012