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Permit i h CITY OF TIGARD MECHANICAL PERMIT t , r DEVELOPMENT SERVICES PERMIT #: MEC2000 -00331 Ai! DATE ISSUED: 8/16/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S 110CD -07600 SITE ADDRESS: 15705 SW 116TH AVE SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 5 TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: 5 COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 0 > 10000 cfm: Remarks: Refrigeration for grocery store Owner: FEES TOBIAS INVESTMENT CO Type By Date Amount Receipt 300 SE SPOKANE ST PLCK DEB 8/16/00 $34.81 0004528 PORTLAND, OR 97202 5PCT DEB 8/16/00 $11.14 0004528 PRMT DEB 8/16/00 $139.25 0004528 Phone: Total $185.20 Contractor: REFRIGERATION CONTRACTORS, INC P.O. BOX 661 GRESHAM, OR 97030 REQUIRED INSPECTIONS Mechanical Insp Phone: Cooling Unt Insp Reg #: LIC 47971 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 01 through OAR 952 - 001 -0080. You may obtain copies of these ru es or direct questions to OUNC by calli (503)246-918'. / '' / , 4,,, Permitt Signature: , ‘ - '61 Issu By: , ,!a0 , _ Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next Plan Che CITY OF TIGARD Mechanical Permit Application Rec'd By 13125-SW HALL BLVD. Commercial and Residential Date Rec'd 8 TIGARD, OR 97223 Date to P.E. (503) 639 -4171, x304 Date to DST Print or Type Permit M . Dry Do3 j P,ed -0oSi(p Incomplete or illegible applications will not be accepted Called /2)14/4 P C(.. i�" Name of Development/Pro' f Description (Z91... /�� �= coce( cU_f (e Table 1A Mechanical Code Qty Price Amt Job Street Address Suite# A) Permit Fee VP_ 16.00 / Address (6 '() l t 6 A" 1) Furnace to 100,000 BTU including ducts & vents see footnote 1,2 9.65 Bldg# City /State Zip 2) Furnace 100,000 BTU+ 617 ZZq including ducts & vents see footnote 1,2 12.00 Name (or name of business 3 ) Floor Furnace Owner c rOC ✓ .4 uU - ( - including vent see footnote 1,2 9.65 Mailing Address ( 4) Suspended heater, wall heater I� or floor mounted heater see footnote 1,2 9.65 ?COO C l t4� J l 5) Vent not included in appliance permit 4.75 City/State Zip Phone S 1 0 Check all that apply: *Boiler Heat Air &rke(e CA 4( `7oc( - 6Szc( For items 6 -10, see or Pump Cond Qty Price Amt Name (or name crousiness) footnotes 1 , 2 Com i1 6) <3HP;absorb unit to • v 100K BTU 9.65 Occupant Mailing Address 7) 3 -15 HP;absorb unit r 100k to 500k BTU J 5 17.65 ' S City/State Zip Phone 8) 15 -30 HP; absorb unit .5 -1 mil BTU 24.15 Contractor Name 9) 30 -50 HP; absorb l /' unit 1 -1.75 mil BTU 36.00 ee rt 1. ercrhO V1 CE:V traC +ors 10) >50HP; absorb unit / Prior to permit ailing Add �� I >1.75 mil BTU 60.15 issuance, a copy n 11 Air handling unit to 10,000 CFM of all licenses city/state Zi Phone ..503 7.00 are required if cIrcstilawl OP R D 25 `F3b 12) Air handling unit 10,000 CFM+ expired in COT Oregon Const. Cont. Board Li . Exp. Date 1 1.85 database q7 7 ( (9 ''(Zb / O L 13) Non - portable evaporate cooler 5 c Architect Name 7.00 35 14) Vent fan connected to a single duct or Mailing Address 4.75 15) Ventilation system not included in appliance permit 7.00 Engineer City /State Zip' Phone 16) Hood served by mechanical exhaust 7.00 Describe work to be done: 17) Domestic incinerators -- 12.00 New: Repair 0 Replace with like kind: Yes O No O 18) Commercial or industrial type incinerator Residential 0 Commercial 0 48.25 19) Repair units Additional information or description of work: 8.40 20) Wood stove /gas FP /other units /clothe dryer /etc. 7.00 NOTE: For Commercial projects only; Units over 400 lbs. require 21) Gas piping one to four outlets structural gas calcs. See footnote 1 L�{ 3�T6 Type of fuel: oil 0 natural gas 0 LPG 0 electric O 22) More than 4 -per outlet (each) .75 Minimum Permit Fee $50.00 SUBTOTAL _ -. I hereby acknowledge that I have read this application, that the information 8% SURCHARGE given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL = " ; Required for ALL commercial permits only ' the owner, that plans submitted are in compliance with Oregon State laws. TOTAL' «"' Sign ture of Owner /Agent Date 2 r/' ` 8 /z7 J Other Inspections outside and Fees: �i 1 .1 1. Inspp ections outside of normal business hours (mininum charge -two Contact Person Name Phone hours) $50.00 per hour ' / 2. Inspections for which no fee is specifically indicated (minimum _ (.c. oerFl (n! TO4 S3 /Z -861ce charge -half hour) $50.00 per hour Foonotes for commercial projects only: 3. Additional plan review required by changes, additions or revisions to 1. Provide full schematic of existing and proposed gas line and pressure. plans (minimum charge -one -half hour) $50.00 per hour 2. Provide drawings to scale showing existing and proposed mechanical el e eft '/34, Qf t t t •Stae Contractor Boiler Certification required units. - , Il, I V 1 + ** Residential A/C requires site plan showing placement l I:Ur,echperm.doc rev 7/19/99 i 4tt.. L- T � CITY OF TIGARD BUILDING INSPECTION DIVISION 6 /).) 24-Hour Inspection Line: 639 -4175 Business Li e: 6 :-4171 Date Requested qC / PM UP BLD Location I ?O S sui !/t Al Suite EC - 35( Contact Person / < ft Ph Sc? -g(4 e PLM Contractor Ph SWR BUILDING Tenant/Owner a ro 'C -Jt-/ ?�,� ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Y C� ` Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm ��\ Susp'd Ceiling 1 Roof Misc: Final PASS PART FAIL ( Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL CM eam Rough In Gas Line Smoke Dampers ' ' ART FAIL • ICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Date i' ` / /s & Inspector , v Ext 5 1 ` Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. A Ee - 2000 - oc REFRIGERATION CONTRACTORS INC. Temperature Controlled Systems/General Contractors 5031257 -8668 FAX 5031255 -4581 Sales Office: Mailing: 17246 NE San Rafael PO. Box 661 Portland Or 97230 Gresham Or 97030 September 28, 2000 Rick Bolen, Ext 319 City Of Tigard Development Services 13125 SW Hall Blvd Tigard OR 97223 RE: Letter of Declaration or Refrigeration work at the Grocery Outlet — King City Store As per our discussion the following is my letter of declaration on Refrigeration work at the Grocery Outlet — King City Store located at 15705 SW 116'" Ave, King City OR. i, Scott R Worthington, due here by declare by way of this letter that I have met or exceeded the requirements set forth for the pressure testing of the refrigeration piping as set forth n Chapter 11 of the Mechanical Code. For our testirg process we used nitroger and tested the piping, both low and high, at 400 lbs. PSIG for a minimum cf 24 hours. The refrigerant used within this system is R -404A (Pentafluoroethane.1, 1 1,Trifluoroethane, 1 1, 1 2 — Tetraflucroethane) • On 8118100 — The Underground piping for System A -4 & A-5 were tested and inspected the pressure in the piping was 400 lbs and was maintained within the piping until the additional overhead piping was connected to the portion of piping On 9/1800 — The overhead piping, the refrigeration unit. discharge piping and the cases for System A -1 a & b. was pressurized to 400 lbs with dry nitrogen. After this system passed our tests, we called for and had an inspect:on done by your office, having passed both inspections we then removed the nitrogen and evacuated the system and charged the unit with 65 lbs R -404A and started system. On 9!1800 — The overhead piping, the refrigeration unit. discharge pipirg and the cases for System A -2 was pressurized to 400 lbs with dry nitrogen. After this system passed our tests we called for and had an inspection done by your office, having passed both inspections we then removed the nitrogen and evacuated the system and charged the unit with 100 lbs R -404A and started system. On 9/1800 — The overhead piping, the refrigeration unit, discharge piping and the cases for System A -3 was pressurized to 400 lbs with dry nitrogen. After this system passed our tests, we called for and had an inspection done by your office having passed both inspections we then removed the nitrogen and evacuated the system and charged the unit with 100 lbs R -404A and started system On 9119100 — The overhead piping, the refrigeration unit, discharge piping and the cases for System A -4 vies pressurized to 400 lbs with dry nitrogen. After this system passed our tests, we called for and had an inspection done by your office, having passed both inspections we then removed the nitrogen and evacuated the system and charged the unit with 140 lbs R -404A and started system ;_ . .. On 9/19/00 — The overhead piping, the refrigeration unit and discharge piping for System A -5 was pressurized to 400 lbs with dry nitrogen. After this system passed our tests, we called for and had an inspection done by your office, having passed both inspections we then lowered the nitrogen pressure in the system to 125 lbs as the line -up of cases was deleted for the time being and may still be added at a future date. The unit will be left with the nitrogen holding charge, the unit is not wired electrically and cannot be accidentally started, however the unit is labeled with the holding chare and the date it was pressurized By my signature below I am stating that the information given above is true and factual September 28, 2000 - Scott R Worthington Date Project Manager Refrigeration Contractors, Inc. CITY OF TIGARD BUILDING INSPECTION DIVISION R,,24 -HOur Inspection Line: 639 -4175 Business Line: 639 -4171 M �7 J // BUP Date Requested % —� 0 AM // c < PM B Location / 5 5 �S u' // , i /(..0 Suite 410 -o1l 3 3 / Contact Person Ph z...5-7 0 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear _ _ S I Framing _ _ Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL — Post & Beam Rough In /2e . Gas Line Smoke Dampers Final PASS de FAIL ELECT Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk 9 V a L Other Date / Inspector Ext� Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 Date Requested � / 0 AM PM g Location /570 ) Suite 5 -2' I ir Contact Person Wog, Ph 961 -Z 2 ! Z PLM Contractor Ph SWR _.3.1 Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Insulation Drywall Nailing Firewall // / Fire Sprinkler ?? / ‘ CO s /Pc / Fire Alarm Susp'd Ceiling Roof Misc: F' PASS . PART FAIL *WAGING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final FAIL ICAL ,p Post & Beam a �' �/ c Pl�.4C �J C)!� - ( .,,e� '� v 4 (72 Rough In CO /1-7 O / Gas Line Smoke Dampers ' so/ Fin - 'ART FAIL • - - ICAL Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call f r reinspection RE: [ ] Unable to inspect - no access A 71)--\‘? Apppp roach /Sidewalk Other Date Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • 1 • BUP - Building Permit EL C - Electrical Permit 4 Inspection Description Date Passed By I Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover Footing drain Ceiling cover Waterproof bsmt walls Electrical rough -in Slab Electrical service Crawl drain Electrical final Underfloor insulation Post/beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing . 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry/Reinforcement Framing a — D U 33 I MFG - Structure set -up MrE Mechanical Permit Insulation Drywall nailing - 4 Inspection Description Date Passed By Post/beam mechanical Suspended ceiling Gas line Engineered soils Mechanical rough -in Welding Lab Final Fire damper Concrete Lab Final Duct work Bolting Lab Final Smoke detector Fireproofing Lab Final Mechanical final 9 /�d r) Structural observation -< 1 Final inspection PLM - Plumbing Permit Inspection Description Date Passed By BUP - Fire Protection System Permit Plumbing underslab 4 Inspection Description Date Passed By Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough -in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm fmal Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer 4 Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab Catch basin /Manhole SWR - Sewer Permit Engineered soils Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC, SIT PERMITS CITY OF TIGARD MECHANICAL PERMIT • DEVELOPMENT SERVICES PERMIT #: MEC2000 -00331 DATE ISSUED: 8/16/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S110CD -07600 SITE ADDRESS: 15705 SW 116TH AVE SUBDIVISION: KING CITY NO. 2 ZONING: BLOCK: LOT: JURISDICTION: KIN CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: 5 TYPE OF USE: COM UNIT HEATERS: VENT FANS: OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: 3 - 15 HP: 5 COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 0 > 10000 cfm: Remarks: Refrigeration for grocery store Owner: FEES OBIAS INVESTMENT CO Type By Date Amount Receipt 00 SE SPOKANE ST PLCK DEB 8/16/00 $34.81 0004528 ORTLAND, OR 97202 5PCT DEB 8/16/00 $11.14 0004528 PRMT DEB 8/16/00 $139.25 0004528 Phone: Total $185.20 Contractor: EFRIGERATION CONTRACTORS, INC .0. BOX 661 RESHAM, OR 97030 REQUIRED INSPECTIONS Mechanical lnsp Phone: Cooling Unt Insp Reg #: LIC 47971 Misc. Inspection Final Inspection ri ft This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -9189. w Issue By: Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 8/21/00 Activities for Case #: MEC2000 -00331 _ 3:08:25 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MECC007 Application received 8/2/00 DEB RECD No Hold GWL 8/14/00 MECC008 Permit created 8/14/00 GWL DONE No Hold GWL 8/14/00 MECC011 Routed to Plans Examiner 8/14/00 GWL DONE No Hold GWL 8/14/00 MECC014 Plan checked /Approved by P.E. 8/15/00 8/15/00 8/15/00 GWL DONE No Hold GWL 8/15/00 MECCO50 (F) Ready to issue 8/15/00 GWL DONE No Hold GWL 8/15/00 MECC706 Mechanical Insp No Hold GWL 8/15/00 MECC720 Cooling Unt Insp No Hold GWL 8/15/00 MECC799 Final Inspection No Hold GWL 8/15/00 MECC090 (F) Issue permit 8/16/00 DEB DONE No Hold DEB 8/16/00 MECC750 Misc. Inspection 8/18/00 TLP PASS No Hold TLP 8/18/00 refrigeration lines under slab 400# test MECA075 (F) Reprint Permit 8/21/00 ZZZ DONE No Hold ZZZ 8/21/00 Page 1 of 1 CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 / / BUP Requested l - 9 9 AM PM BLD Location ($ 2 0 J S C Suite MEC 1- 4 0 - G 0 3 / Contact Person j Ph 2S7 66 5 PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing � Firewall .— ,�—t'r 6C(6- Pal 0�t s y /75 1i-v Fire Sprinkler T , / 5 Fire Alarm Susp'd Ceiling n `� Roof � t e I /�� �1J / rc /' E Misc: Final PASS PART FAIL _ �{ PLUMBING � S r e3 . 5YS � Post & Beam / /` Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL ctINECRXMAL, Post & Beam Rough In Gas Line Smoke Dampers tb PART FAIL ""= Service Rough In UG /Slab Low Voltage Fire Alarm Final PASS PART FAIL SITE I/ in Backfil r Gad g Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk Other ( Date 7 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.