Permit C ITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00054
pi DEVELOPMENT
SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/26/2006
PARCEL: 1S136CD-02200
SITE ADDRESS: 07850 SW DARTMOUTH ST ZONING: C -G
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Produce cooler expansion. (3) deli cases, (6) evap. coolers Refrigerant lines. Value: $47,800
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
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: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
COSTCO WHOLESALE CORPORATION Description Date Amount
ATTN: EXCISE TAX DEPT 111 [MECH] Permit Fee 1/26/200€ $741.80
999
WA 98027 [TAX] 8% State Surchart 1/26/200€ $59.34
Total $801.14
Phone:
Contractor:
KEY MECHANICAL CO
8545 SE MCLOUGHLIN BLVD REQUIRED ITEMS AND REPORTS
MILWAUKIE, OR 97222
Contact #: PRI 503 231 - 0731
FAX 503 236 - 5848
Reg #: LIC 93479
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: /� Permittee Signature: / W ar.
Call 503 - 639 -4175 by 7:00 a.m. for inspections that bus ess day.
This permit card shall be kept in a conspicuous place on the job site until •0 pletion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A licatio FOR ° OFFICE USE 'ONLY • Clty of Tigard V E I V ® Received Permit No / I
13125 SW Hall Blvd., Tigard, OR 97223 Date/By _ V '� �� 0'00 Plan Review Other Permit.
J
Phone: 503 639.4171 Fax: 503.598.1960 /� �{ 6 2006 / /ymtN 1 Date /By
Inspection Line. 503.639.4175 H {V 6 2006 _ x � .� i• �.' I Date Ready/By. El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method ` Supplemental Information
CITY OF TIGARD
ljEDa ilYc °"
COMMERCIAL FEE* SCHEDULE = 'USE
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor verhead, and rofit.
—
- _ CATEGORY OF CONSTRUCTION
Value: $
RESIDENTIAL EQUIPMENT / S STEMS FEES *'
❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
C CU j� � /'O ti,..f (
Job site address: J1 i7 1 l Air conditioning or heat pump (requires site plan showing placement) 14.00
City /State /ZIP: `7 /94 d ` c 7-R Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg./apt. no.: Project name. Furnace 100,000+ BTU (ducts /vents) 17.90
��� Gas heat pump 14.00
Cross street /directions to job site: $J(43)' r 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
Subdivision Lot no..
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
; DESCRIPTION OF •WORK Water heater 10.00
Akibcice �� �� fo
Gas fireplace 10.00
�8�` �,[ Flue vent for water heater or gas
�0 , � / /� /
fireplace 10 00
3 (1.P.l� ` ( / /, 0,f/d p-,c-e �.PIY l O*JI -P V-' Log lighter (gas) 10 00
47 Q,/ r, Gt " 04,�y, i /IAA-4' r Wood /pellet stove 10.00
d Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
PROPERTY 'OWNER ❑TENANT Other: 10.00
Name- cr — CO Environmental exhaust and ventilation
Range hood/other kitchen
Address: �� �jQ� /� equipment 10.00
City /State /ZIP: � Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
.. APPLICANT '"CONTACT " .PERSON Attic /crawlspace fans 10.00
_✓ Other: 10 00
Business name: r iktECI., 4N/ <AL
Fuel piping
Contact name: . G/ $5.40 for first four; $1.00 for each additional
� I
Address: ,( .� y `% ' Q Furnace, etc.
Gas heat pump
City /State /ZIP.. 14t / / ili/ ' ' 7 Wall /suspended/unit heater
"
Phone 3) qc3 / . 6 -7 f Fax: :(513) , 4. " R Water heater
Fireplace
E -mail. Range
CONTRACTOR Barbecue
Business name: 4�y //ic/1 0(<4 �� Clothes dryer (gas)
Other:
Address: ,,id7Q./a 14r MECHANICAL PERMIT FEES*
City /State /ZIP: ^ Subtotal
Minimum permit fee ($72.50) 7
Phone: ( ) Fax ( ) Plan review (25% of permit fee)
CCB lic.: 73 V77 State surcharge (8% of permit fee) Se
/ TOTAL PERMIT FEE i ii
Authorized signat - / This permit application expires if a permit is not obtaine within 8d
� days after it has been accepted as complete.
Print name,V�Jtr• �`f MP Date: -. . ICS * Fee methodology set by Tn- County Building Industry Service Board
L
r\ Bwldmg\Permits\MEC- PermitAppp03 440.4617T(II /02/COM/WEB)
/06 5. a- / 74.l
•
Mechanical Permit Application - City of Tigard
Page 2- Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10 ;000 :00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or ;^�00
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and r‘ ;
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof
Note: All new commercial buildings require 2 sets of plans.
•
i:\Building\Permits\MEC- PermitApp doc 12/03 2
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BUILDING DIVISION PERMIT #: ���C�O(�5'ODOSA
13125 SW Hall Blvd., Tigard, [)R 97223 DATE ISSUED: 1/��(���
Phone: (503) 639-4171
|nop��ion�Requests (24Hm.):(6O3)63O'4176 ~ .�� «���
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INSPECTION WORKSHEET FOR DATE: 512312006 TIME: 7:03AIYI PAGE: 93
SITE ADDRESS: O7B6OSW DARTMOUTH �T CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: COSTCO
DESCRIPTION: Produce uoo|mvexpansion. (3) deli cases, (6) (Nap. coolers. Refrigerant lines. Value: V7.800
OWNER: COSTCO WHOLESALE CgRPORAD0N, PHONE #:
CONTRACTOR: KEY MECHANICAL CO PHONE #: 603-731'0731
Inspection Request Scheduled For: Date: 51202006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 030871'01 603-518'1222 N
Corrections/Comments/Instructions:
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' CITY OF TIGARD -
BUILDING DIVISION PERMIT #: tv1FC.: ( 013.00O5i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1126/2 0 €�
Phone: (503) 639 -4171 u� fi
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4125/2006 , TIME: 7:00AM PAGE: 24
SITE ADDRESS: 07850 SW DARTMOUTH ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: COSTCO
DESCRIPTION: Produce cooler oxpan'i ion. (3) deli cases, (6) orap. coolers. Refrigerant lines. V2lue: $47,800
OWNER: Ct ETC() WHOLESALE CORPORATION, PHONE #:
CONTRACTOR: KEY MECHANICAL CO PHONE #: 50323'H) ;31
Inspection Request Scheduled For: Date: 4/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mot:hanical roach -ip S' 02(3661 -01 501 - 519 -2319 N
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Corrections /Commen /Instructions:
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7.4 PASS PARTIAL APPROVAL n CANCEL NO ACCESS
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FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: 4; Cs I✓ Date: 7 2—s /c& Phone #: (503) 718- 2 -V 24