Permit (43) CITY OF TIGARD MECHANICAL PERMIT
III ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00181
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/04/2016
Parcel: 25111 DD00201
Jurisdiction: Tigard
Site address: 15995 SW HALL BLVD
Project: Plaid Pantry Subdivision: None Lot: None
Project Description: Install(3)refrigeration condensers on roof of building.
Contractor: ADAMS REFRIGERATED TRAILERS, INC. Owner: ROSEHILL INVESTMENTS LLC
PO BOX 2862 2001 SIXTH AVE STE 2300
TUALATIN, OR 97062 SEATTLE, WA 98121
PHONE: 503-885-0823 PHONE:
FAX: 503-692-6156
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/04/2016 $413.75
Class of Work: ALT Type of Const: VB Plan Review 04/04/2016 $103.44
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 04/04/2016 $49.65
Stories: 1 Info Process/Archiving-Sm$0.50(up to 04/04/2016 $12.50
11x17)
Project Valuation: $12,600.00
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: 3
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $579.34
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
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. "6may obtain a copy of the rules
or dir- questions • •UN • ailing 503.232.1987 or 1.800.332.2344.
I -ued By: - / / ' / 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.
Mechanical Permit Applicata }Feu \/ED Receive, FoR.1 ICE t Sl':0'l.\
City of Tigard `" `"`" Date/By:3 I7/4, Permit No/. C �O
•. 11 13125 SW Hall Blvd.,Tigard,OR 97223 / �/d /�i
Plan Re .�y`� '1 �
Phone: 503.718.2439 Fax: 503.598.1960 MAR16 2016 l: 1fV 3(2'r(t/.Other Permit:
Inspection Line: 503.639.4175 DateBy:
T I G A R D Date Ready Juris: I ® See Page 2 for
Internet: www.tigard-or.gov ,ITY (( i Notified/Metho cr.. Su lemental Information
OF TITYPE OF IMILDINGDIVISION COMMERCIAL FEE* SCHIF,DULE — 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
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$12,600.00
CATEGORY OF CONS 11tUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:15995 SW Hall Blvd. Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,Oregon 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Plaid Pantry#19 Duct work 23.32
Cross street/directions to job site:SW Durham Road 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
Other: 23.32
Subdivision: Lot no.:
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
Install 3 refrigeration condensers on roof of building. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ® TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Plaid Pantry Markets Range hood/other kitchen
equipment 33.39
Address: 10025 SW Allen Blvd Clothes dryer exhaust 33.39
City/State/ZIP:Beaverton,Oregon 97005 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)646-4246 Fax:(503)646-3071 Attic/crawlspace fans 23.32
0 APPLICANT 0 CONTACT PERSON Other: 23.32
- Fuel piping:
Business name:ADAMS Refrigerated Trailers,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:Joel Adams Furnace,etc.
Address:PO Box 2862 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Tualatin,Oregon 97062 Water heater
Phone:(503)885-0823 Fax::(503)692-6156 Fireplace
Range
E-mail:Joel@AdamslsCooler.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:ADAMS Refrigerated Trailers,Inc. Other:
MECHANICAL PERMIT FEES*
Address:PO Box 2862 Subtotal
City/State/ZIP:Tualatin,Oregon 97062 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)885-0823 Fax:(503)692-6156
State surcharge(12%of permit fee)
CCB lic.: 184031 q ; //(o TOTAL PERMIT FEE
This 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
Print name:Joel Adams Date:3/17/16
I:\Building\Permits\MEC_PermitApp_0401 t 3.doe 440-4617T(11/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15995 SW HALL BLVD, TIGARD, OR, 97224
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00181
Jeff Grove
Violation Summary:
Inspector Contractor