Permit A AIL d C ITY OF TIGARD MECHANICAL PERMIT
,
DEVELOPMENT SERVICES PERMIT #: MEC2006 -10004
13125 SW Hall Blvd., Tigard, OR 97223 503-6394171 DATE ISSUED: 2/28/2006
PARCEL: 1 S136DC -04500
SITE ADDRESS: 07501 SW DARTMOUTH ST 100 WINCO ZONING: C -G
SUBDIVISION: PP1995 -013 LOT: JURISDICTION: TIG
Project Description: Change out deli seafood case. Valuation, $2000.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= ,10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
WAREMART INC Description Date Amount
BY BURKE + NICKEL
3336 E 32ND ST #217 [MECH] Permit Fee 3/31/200E $62.50
TULSA, OK 74135 [TAX] 8% State Surcha 3/31/200€ $5.00
Phone: Total $67.50
Contractor:
SOURCE REFRIGERATION & HVAC IN
5506 SE INTERNATIONAL WAY
MILWAUKIE, OR 97222 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 652 -0884
Reg #: LIC 149200
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 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: - 2 �j Permittee Signature: 7 Q .e y
Call 503 - 6394175 by 7:00 a.m. for inspections that business day.
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 Per 1 si 1 ' FOR OFFICE USE ONLY
n� ri �
REEew Q D Permit No / t d e6.1 131SW Hall Blvd. Tigard OR Fa U 2006 u P l� 1 �'r`
Phone: 503.639.4171 Fax: 503.598.1960 erfildlNl ' I l Da teBy: Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD i S I I Date Ready/By: Mal 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified /Method: Supplemental Information
BUILDING DIVISION
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Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
q�� :,:���, :;.'::. ,]} 9 ;� Value
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, e CA E CO e .,,n.,,,, . -, t. v,-.- ,?Nzz, -, ti°. "., .. --1� : -i;.. $ ,F Y+'
. -_ z -. ,. ,,,,, ,,,,,,, ,,, , :.. EQUIP SI'TElVIS FEES „ &�
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❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
? i s -yt;', y4a, ^,t'�n,EEe•�' .,�, ,crL,- N .Stti�ts "L't., •. - ..�:s- ; :�°;�,'�
If S �E > „ IIVFORMATIUN- AND3. OCA�TIO G u. ” Heating/cooling
Air conditioning or heat pump
Job site address: 7500 Dartmouth Rd (requires site plan showing placement) 14.00
City /State /ZIP: Tigard, Oregon 97223 Furnace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. no.: Project name: Winco #23 Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.: Other: 10.00
Tax map /parcel no.: , fuel appliances
,,$., .,a;s��x.�:.:c,�e• .::' _•.a7 <sa. ;� - ;; ,,�,,•,, -. Water heater 10.00
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, ila ;.WpI2K.. ,,:.; ;,° ,
S ,C O . ,,,,, '.;: ',m: <;;,k4'.: ,, l ` Gas fireplace
g� .: �%; ,,�.� >;;��� arixa -, > u,.:,.. . ,�'. >:� .., . , 10.00
like for like change out , deli seafood Flue vent for water heater or gas
fireplace 10.00
no new piping, no new systems
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
x' " -,,,, a ,�,.. .......«,... _ ;.;, :.0 a,,<rr s,, :. x >:�uscvW��,,....;c: a � g „ : ,�•' @ "> ,ay;• �£r ,, € y iner /flue /vent
10.00
t, ; E, ;may;,;; EN NT. ,,,:
'; , ®;ri"PROPERTY ,QW : '' "% `�
'� ,�:a, ' aim:: -. .,.� Other:
Name: Winco #23 Environmental exhaust and ventilation
Range hood /other kitchen
Address: 7500 Dartmouth Rd equipment 10.00
City /State /ZIP: Tigard, Oregon 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
>,•, : .,, : ;;; �:. >' s r t i Attic /crawlspace fans 10.00
.wit =:�.� ...r ,.,�..p % �. �` ''�?s�� O�TA G�T` PERS , `NE; : - .:E,i. �R > , .'<:F , ': "
i " ;. <. ^; "Eil ';`.; :'AI'Pl&i AI!I '> -': ' �...v' ® = N, '.^�,a,3,, ; :u t,E. t'x.:; 10.00
;' a �,,.> .,; >. �.. Other:
Business name: Source Refrigeration Fuel piping
Contact name: Bryce Dootson $5.40 for first four; $1.00 for each additional
Fumace, etc.
Address: 5506 SE International Way Gas heat pump
City /State /ZIP: Milwaukie, Oregon 97222 Wall /suspended/unit heater .
Phone: (503) 849 -9279 Fax: : (503) 652 -0449 Water heater
Fireplace
E -mail: bdootson @SourceRefrigeration.com Range
a i N r:',.w e� ':sue a ;7,, , . .., ?„ ``• ., ., x @E1 °'x':z:
;,�',,r= ,,�< �a� :: �'��,i; °- > >`�=.,�r B arbecue
Clothes dryer (gas)
Business name: Source Refrigeration Other:
Address: 5506 SE International Way ' ' " IYIECHA�NICA PER144IT jEES s ' ''
City /State /ZIP: Milwaukie, Oregon 97222 Subtotal
Minimum permit fee ($72.50)
Phone: (503) 652 -0754 Fax: (503) 652 -0449 Plan review (25% of permit fee)
CCB lic.: 149200 State surcharge (8% of permit fee)
i / I TOTAL PERMIT FEE
J i This permit application expires if a permit is not obtained within 180
Authorized signature: ; 1% ■
/ days after it has been accepted as complete.
Print name: Philip Cardwell Date: 2 -28 -06
* Fee methodology set by Tri- County Building Industry Service Board
i:\ Buildin g\Permits \MEC- PermitApp.doc 12/03 440 -4617T (I I /02/COM /WEB)
CITY OF TIGARD i/uEc
BUILDING DIVISION PERMIT #: ZOO. & -1�,�
0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Ai ��� �
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ':.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 7.5 ( six) p o - U i p4 s C CLASS OF WORK:
SUBDIVISION: ' LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: (Li (Mco
OWNER: PHONE #:
•
CONTRACTOR: '500 �e� F jam , , PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
CA C .7- -- e V F Eb E V P--E
I
_ IIIMILIf V•. 0121
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2
PA SS H PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS
[ I FA CALL FOR INSPECTION ❑ ADDITIONAL EES ASSESSED
Inspect�� •
c ... 1
YR A Date: I a 0 ( Phone #: (503) 718 - 2-4z
I.