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Permit
CITY OF TIGARD MECHANICAL PERMIT Il a COMMUNITY DEVELOPMENT Permit#: MEC2015-00326 Date Issued: 06/02/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136CD02200 Jurisdiction: Tigard Site address: 7850 SW DARTMOUTH ST Project: Costco Subdivision: PALMER ACRES Lot: 3 Project Description: Replacing existing nitrogen tire inflation system,replacing the nitrogen storage tank,and modifying N2 system piping. Contractor: ARCTIC SHEET METAL Owner: COSTCO WHOLESALE CORPORATION 2310 NE COLUMBIA BLVD. PROPERTY TAX DEPT 111 PORTLAND, OR 97211 999 LAKE DR ISSAQUAH,WA 98027 PHONE: 503-288-5844 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 06/02/2015 $121.25 Class of Work: ALT Type of Const: Plan Review 06/02/2015 $30.31 Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 06/02/2015 $14.55 Stories: Info Process/Archiving-Sm$0.50(up to 06/02/2015 $10.00 11x17) Project Valuation: $2,185.00 Fuel Air Handlers Fuel Types: 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 $176.11 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Nitrogen Duct Work: Tank 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 1. 4. ' Alp Issued By: Permittee Signature: j P�' Call 50 . 39.4175 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. ErBuilding Division Over-The-Counter (OTC) Mechanical Permit TIGARI' Check List Project Description: IAA Est Ti APPLICATION SPECIFIC INFORMATION GENERAL INFORMATION *Class of Work: Occupancy Group: LAA Type of Construction: *Type of Use: _Oregon Specialty Code: Number of Stories: FUEL FURNACES Type: Furnace< 100K BTU Furnaces>= 100K BTU Gas Pressure: Roof Top Unit(RTU) Tons Floor Furnaces Unit Heaters Vents without Appliances Air Conditioning Heat Pump AIR HANDLERS HOODS Units <= 10000 cfm Type I Hood Type 2 Hood Units > 10000 cfm Grease Duct 1 Hour Shaft Fire Wrap APPLIANCES Boiler(BTUs) Vent Fans Gas Line Solid Fuel Fireplace/ Clothes Dryers Gas Outlets Woodstove Duct Work Gas Fireplace Fire/Smoke Dampers Other Mechanical Units—Describe: Total Project Valuation: $ ? FEES DUE $ 2 ,2_5- Mechanical Permit Fee $ Plan Review $ 12%State Surcharge $ Info Proc/Arch,Lg(over 11x17$2.00) $ in cc, Info Proc/Arch,Sm(up to 11x17$0.50) $ Misc.Admin Fee $ Hourly Rate Fee $ Hourly Rate State Surcharge $ Other $ Other Building Staff: Date/Time: $ (7,,( TOTAL FEES DUE *OPTIONS: TYPE OF USE: COM=commercial;CMS=commercial manufactured structure. CLASS OF WORK: ACS=accessory;ADD=addition;ALT=alteration;FND=foundation;DEM=demo; FND=foundation;FPS=fire protection system;NEW=new;OTR=other(use for fences,decks,retaining walls,signs,awnings or canopies); REP=repair. 1:1Building\Forms\OTC-MEC.docx 01/13/2011 Mechanical Permit Applic i, I \N FOR OFFICE USE:ONLY City of Tigard �J Da e�Y lfJ G Permit No.: ,,ca t 0,1 • 13125 SW Hall Blvd.,Tigard,OR 97223 11111 fi Phone: 503.718.2439 Fax: 503.598.1 015 Plan Review L ( ether permit: 1 a 2 Date/By: a ��//i©�' T I G A R U Inspection Line: 503.639.4175 V,` B T. I` Date Ready/By: / ® See Page 2 for Internet: www.tigard-or.gov „` I`�h" Notified/Method:6 « Supplemental Information TYPE tV�Ci>iAO11`��r WWWW a . ,aL COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 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. Value:$2185 CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES* ❑ 1-and 2-family dwelling CO Commercial/industrial ❑Accessory building For special information use checklist. ❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling: Air conditioning 46.75 Job site address:7850 SW Dartmouth Ave 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.: Project name:N2 Tire Infl.Replacement Duct work 23.32 Cross street/directions to job site:SW Pacific Hwy. Hydronic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric), in-wall,in-duct,suspended,etc. 46.75 Flue/vent for 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 Remove and replace exsisting Nitrogen Tire Inflation system with new/like unit. fireplace 23.32 Remove and replace nitrogen storage tank with new/Larger storage tank. Log lighter(gas) 23.32 Wood/pellet stove 33.39 Modify N2 system piping to customer specifications. Wood fireplace/insert 23.32 Anchor bolt all units to re-enforced cement floor. Chimney/liner/flue/vent 23.32 12 PROPERTY OWNER ® TENANT Other: 23.32 Environmental exhaust and ventilation: Name:Costco Range hood/other kitchen equipment 33.39 Address:7855 SW Dartmouth Ave Clothes dryer exhaust 33.39 City/State/ZIP:Tigard/OR/97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)639-0811 Fax:(503)639-3849 Attic/crawlspace fans 23.32 ® APPLICANT ❑ CONTACT PERSON Other: _ 23.32 _ Fuel piping: Business name:Arctic Sheet Metal _ $14.15 for first four;$4.03 for each'additional Contact name:Neil Olstad Furnace,etc. Address:2310 NE Columbia Blvd Gas heat pump Wall/suspended/unit heater City/State/ZIP:Portland/OR/97211 Water heater Phone:(503)341-4530 Fax::(503)280-5825 Fireplace Range E-mail:nolstad @arcticsheetmetal.com Barbecue _ CONTRACTOR Clothes dryer(gas) Business name:Arctic Sheet Metal Other: MECHANICAL PERMIT FEES* Address:2310 NE Columbia Blvd Subtotal 00 $90 permit fee permee( . ) City/State/ZIP:Portland/OR/97211 Minimum _ Plan review(25%of permit fee) Phone:(503)288-5844 Fax:(503)288-5849 State surcharge(12%of permit fee) CCB lic.:17095 TOTAL PERMIT FEE l�• ,� CThis permit application expires if a permit is not obtained within 180 / days after it has been accepted as complete. Authorized signature: _ _;� /`� . • Fee methodology set by Tri-County Building Industry Service Board la Print name:Neil Olstad Date:5- 8-2015 1:\Building\Permits\MEC_PermitApp_040113.doc 440-4617T(I 1/02/COM/WEB)