Permit CITY OF TIGARD MECHANICAL PERMIT
4 2 COMMUNITY DEVELOPMENT Permit#: MEC2016-00301
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/26/2016
Parcel: 1S135BC00201
Jurisdiction: Tigard
Site address: 10765 SW GREENBURG RD
Project: 7-11 Subdivision: None Lot: None
Project Description: Replacement of(3)heat pump package units
Contractor: SOURCE REFRIGERATION Owner: GREENBURG ROAD CENTER LLC
5506 SE INTERNATIONAL WAY 22020 17TH AVE SE#200
MILWAUKIE, OR 97222 BOTHELL,WA 98021
PHONE: 800-677-2688 PHONE:
FAX: 503-652-0449
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/26/2016 $812.53
Class of Work: ALT Type of Const: VB Plan Review 05/26/2016 $203.13
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 05/26/2016 $97.50
Stories: 1 Info Process/Archiving-Sm$0.50(up to 05/26/2016 $10.00
11x17)
Project Valuation: $28,263.00
Fuel Air Handlers
Fuel Types: Natural Gas 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 $1,123.16
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B O� Permittee Signature:
Cal 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicat' -` r1 FOR OFFICE lSE ONI.I
City of Tigardttli1-4 Received 1 J7 Permit No.:�,/£,e�/�.CO �,
Date/By: �� ` /Jr� 1 l
1312514 ull nSW Hall B.2 39d., Fax: R 97223 Plan R}v w F
Phone: 503.718.2439 Fax: 503.598.1960 q C Date/B /f MVPOther Permit:
T I t i,A K D Inspection Line: 503.639.4175 tit N I 0 L Z U Date Rea' tures H See Page 2 for
Internet: www.tigard-or.gov ; y Notified/Method: j �J� Supplemental Information
DIDIVISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ �/I'J�� . 00
RESIDENTIAL EQUIPMENT/S"YSTEMS FEES*
❑ I-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:10765 SW GREENBURG ROAD 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#25562-HVAC Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
f Residential boiler(radiator or
SW C T'rV C,!'�51 '' (5J'J G -0/1 IPA 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.:
II Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
, A Flue vent for water heater or gas
pu,sh �— P1, k , 3 I4-L°f - f vim sp ym-cv74-6 e fireplace 23.32
Log lighter(gas) 23.32
`�1 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:7-ELEVEN#25562 Range hood/other kitchen
equipment 33.39
Address: 10765 SW GREENBURG ROAD Clothes dryer exhaust 33.39
City/State/ZIP:TIGARD,OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)639-4059 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)209-4634 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)
Plan review(25%of permit fee)
Phone:(503)209-4634 Fax:( )
State surcharge(12%of permit fee)
CCB lic.: 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 Tri-County Building Industry Service Board
Print name: ?AV) 2,cq e l/ Date: 1 2Q)(k
C Building.Permits MEC_PermitApp_0401 I3.doc 440-46171(1 102,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
10765 SW GREENBURG RD, TIGARD, OR,
97223
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00301
Jeff Grove
Duct detection test done on two units
Violation Summary:
Inspector Contractor