Permit CITY OF TIGARD MECHANICAL PERMIT
14-. . COMMUNITY DEVELOPMENT Permit#: MEC2018-00474
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/19/2018
T t C;A It.D g Parcel: 2S103DD01100
Jurisdiction: Tigard
Site address: 13939 SW PACIFIC HWY
Project: Providence Retail Clinic Subdivision: None Lot: None
Project Description: New fan coil,condenser unit,duct work,grills,and(1)two ton heat pump for TI.
Contractor: ARJAE SHEET METAL CO, INC. Owner: WALGREEN CO#5780
8545 SE MCLOUGHLIN BLVD. PO BOX 901
PORTLAND, OR 97222 DEERFIELD, IL 60015
PHONE: 503-231-7717 PHONE:
FAX: 503-230-4888
FEES
Specifics:, Description Date Amount
Type of Use: COM Permit Fee 06/29/2018 $398.51
Class of Work: ALT Type of Const: VB Plan Review 06/29/2018 $99.63
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 06/29/2018 $47.82
Stories: Info Process/Archiving-Lg$2.00(over 06/29/2018 $2.00
11x17)
Project Valuation: $12,000.00 Info Process/Archiving-Sm$0.50(up to 06/29/2018 $7.50
11x17)
Fuel Air Handlers
Fuel Types: Electricity 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: 1
Appliances
Vent Fans: Vent Systems: Total $555.46
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: fan coil unit
Duct Work: 1
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 952-001-0 90. You may obtain a copy of the rules
or direct questions to OUNC by calling 03.232.1987 or 1.800.332.2344.
Issued By: VI 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.
r
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received ��]J,/�.)��
`J g I)at 'By: it/ix
i/`/ Permit No.: �/y1;Ci 6,jivi�i`,.rbv�Jj 7,
13125 SW Flail Blvd.,Tigard,OR 97 3 l��`3/ /f" l / V
-07E1)
Plan Review
S" Phone: 503.718 2439 Fax 503.598 _ac �,) Other Permit ,f /t et)fs1
Date, rU
TIGARD Inspection Line 503.639.4175 Date Ready By.r✓/��( rids. Q( See Page 2for
Internet: www ttgard-or.gov Notified/Method. ( Supplemental Information
ill
,1U 1 t
I"YPE (3E =t a< K 'TIt7 R� COM IE.RC'IAL, FEE' SCf1EI7t LE, .- LSE(7I -ISI'
Mechanical permit fees*are based on the value of the work
❑New construction !ll ''Addition/alto i.i�e ' ij '7 aP 1 F'1SAOr` performed. Indicate the value(rounded to the nearest dollar)of all
O Demolition E3 Other: 3�Ii+yy t�1�rryy j mechanical materials,equipment,labor,overhead,and profit.
Value:S fl-,,Qoo
G.iTEC C)N4' ()f CONSTRICTION IIES1DENTI5L EQI[PMLENT/SI'S' EMS FEES'
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. "total
JOB:SITE INFORMATION AND LOC.VT10N Ileat5ng/cooling:
= .
_Air conditioning 46.75
Job site address: 13/3/ SW T�.c.I IC GuyFurnace 100,000 BTU(ducts;vents) 46.75
City/State/ZIP: Furnace 100.000+BCU(ducts;vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
5 Ductwork 23.32
Cross street/directions to job site: Hydropic hot water system 23.32
Residential boiler(radiator or
hydropic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdiv ision: 1 Lot no.: Other: 23.32
Other fuel appliances:
fax map/parcel no.: Water heater 23.32
DESCRIPTION OF �'`ORK ; Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
�e(,� �f�-�/I �0 1 �� cQi���l s `'�� ��� f Log lighter(gas) 23.32
i-'1YL�? ����� SCS' J uhP Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0 PROPERTY, OWNER. , Teti 4 ti'T
t Environmental exhaust and ventilation:
Name: f�,,�/ ,/�p�rr��N Range hood/other kitchen
L t� 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
Other: 23.32
❑';A.PPLIC AN`F ❑ CT/NTACT PER. )`v
Fuel piping:
Business name: A C�A��,,��
r Q �PLCJC�
S14.15 for first four;S4.03 for each additional
Contact name: P„t n(`d Furnace.etc.
J/�YGas heat pump
Address: SS q5 J
�Q(1 /1;1 _Wall/suspended/unit heater
1�l
City/State/ZIP: 7f tV LJ 1Fe( c)IT Water heater
Phone:(S03) 2...._ (— 731.7 Fax: :{ ) FireplaceRange
C-mailc
d�V) (QTJ/'�.t' (�4�i .G�Vh Barbecue
�' CON 1C'TOR! Clothes dryer(gas)
: ���/eSI
Business nameSL C Lfe. Other
CLECfLSNICE PERMITFEES*
Address:
Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25°A of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: ‘p 35 TO-LAI,PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized Signature: ,I * Fee methodologl set by Tri-County Building Industry Service Board
Print name: Id ,5GI it Date: „94(/ /75-
i
( /75-
t:Building Permits;MEC_Per nut App_0401 13_doc 440-4617T(I t(2 COM kVEB)