Permit (30) CITY OF TIGARD MECHANICAL PERMIT
`' ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00256
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/02/2016
f c; la 1) 9 Parcel: 2S102AA00600
Jurisdiction: Tigard
Site address: 12045 SW HALL BLVD
Project: 7-Eleven Subdivision: TIGARD HIGHWAY TRACTS Lot: 12
Project Description: (2)new frozen refrigeration cases and compressors.
Contractor: SOURCE REFRIGERATION Owner: ALPROP LLC
5506 SE INTERNATIONAL WAY 6149 SW SHATTUCK RD
MILWAUKIE, OR 97222 PORTLAND, OR 97221
PHONE: - 77-2688
PHONE:
800 6
FAX: 503-652-0449
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 04/28/2016 $260.60
Class of Work: ALT Typeof Const: Plan Review 04/28/2016 $65.15
VB
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 04/28/2016 $31.27
Stories: 1 Info Process/Archiving-Sm$0.50(up to 04/28/2016 $5.00
11x17)
Project Valuation: $6,890.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units>10000 cfm:
Furnaces Boilers&Compressors
Furnaces<100K BTU: 0-3 HP:
Fumaces>= 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:y Total $362.02
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Refridgerate
Duct Work: d cases and
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 direc estio o OUNC by calling 503.232.1987 or 1.800.332.2344.)�
Issue By: rrp1. n / f Permittee Signature: f� , /
_14.4
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 Application 1, FOR O F F I C I. I SE ON 1.1
Received
City of Tigard Date/By: (3 /(p Permit No.. ^o`, ,�x`I s`
111 . " 13125 SW Hall Blvd.,Tigard,OR '14 JV777►►► Plan Revie plan , O`V Y/—(�IXIc 4p
Phone: 503.718.2439 Fax: 503.59 '+ GG Date/By: 41/,`, 1 iY1 4 Other Permit:
1 I t.,A u I 1 Inspection Line: 503.639.4175 • 4S'1,01 Date Ready/By: loris: ® See Page 2 for
Internet: www.tigard-or.gov PQ� \. V ?‘0\) Notified/Method:(. 51//_ ✓ _;-T�` Supplemental Information
TYPE OF W Y�' �� ,0 COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
j� Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alterati� ent performed.Indicate the value(rounded to the nearest dollar)of all
o Demolition 0 Other: ��y mechanical materials,equipment,labor,overhead,and profit.
Value:$$6,890.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
o Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION
Air conditioning 46.75
Job site address: 12045 SW HALL BLVD 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:7-ELEVEN#23999 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
SV•f c -( Rv—`f o S W 14 U *()j L,U 0- 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
I Flue vent for water heater or gas
QI\A '\---.‘e.fe Aa_ Z 0 2-Q > -<r v'tGj-ex'`.(3--i'--€i j fireplace 23.32
Log lighter(gas) 23.32
� � `CSCC�, 1S Sc�� Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:7-ELEVEN Range hood/other kitchen
equipment 33.39
Address: 12045 SW HALL BLVD Clothes dryer exhaust 33.39
City/State/ZIP:TIGARD,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)620-8338 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name:SOURCE REFRIGERATION&HVAC Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:BEN BOYER Furnace,etc.
Address:5506 SE INTERNATIONAL WAY Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: MILWAUKIE,OR 97222 Water heater
Phone:(503)2094634 Fax::( ) Fireplace .
Range
E-mail:BBOYER@SOURCEREFRIGERATION.COM Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:SOURCE REFRIGERATION&HVAC Other:
MECHANICAL PERMIT FEES*
Address:5506 SE INTERNATIONAL WAY Subtotal
City/State/ZIP:MILWAUKIE,OR 97222 Minimum pennit fee($90.00)
Phone:(503)209-4634 Fax:( ) Plan review(25%of pennit fee)
State surcharge(12%of permit fee)
CCB lie.: 149200 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'Fri-County Building Industry Service Board
Print name: t23.efA, (.- (\fQ� Date: i ft-( 1 t o
C Building Permits MFC_PermitApp 040113.doc 440-4617T(I 1 02 COM WEB)