Permit (240) CITY OF TIGARD
COMMUNITY DEVELOPMENT MECHANICAL PERMIT
Permit#:
MEC2016-00866
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/29/2016
T[Ca} 9 Parcel: 1 S126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Target Subdivision: None Lot: None
Project Description: Remove and replace existing mini-split with new.
Contractor: SOURCE REFRIGERATION Owner: DAYTON HUDSON CORPORATION
5506 SE INTERNATIONAL WAY BY TARGET CORP T-0345
MILWAUKIE, OR 97222 PROPERTY TAX DEPT/TPN-0950
PO BOX 9456
MINNEAPOLIS, MN 55440
PHONE: 800-677-2688 PHONE:
FAX: 503-652-0449
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 12/29/2016 $333.66
Class of Work: ALT Type of Const: IIB Plan Review 12/29/2016 $83.42
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 12/29/2016 $40.04
Stories: Info Process/Archiving-Sm$0.50(up to 12/29/2016 $4.50
11x17)
Project Valuation: $9,421.63
Fuel Air Handlers
Fuel Types: Electricity 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 $461.62
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: Split system
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 By: Permittee Signature: r
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 FOR OFFICE LSE()NEN
City of Tigard RECEIVED
ReceivedDate/By: /02 c z i6, Irr Permit No.71i -00,:p6
71 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 2 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175DEC 9 U Date Ready/By: loris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
WU&DING DIVISION
TYPE QF WO COMMERCIAL n '"SciiEDULE — USE CHECI{LIST
_`'"` 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.
I
, O ,, , �. RESIDENTIAL EQUIPMENT SYSTEMS
FEES*
❑ 1-and 2-family dwelling 1'Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
s F46,, . t 'V Air conditioning 46.75
Job site address: b Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: \cv.j. 0'Q °\l 22--3 Furnace 100,000+BTU(ducts/vents) 54.91
1 Heat pump 61.06
Suite/bldg./apt.no.: 1 Q(} Project name: `Ta 34c- Duct work 23.32
Cross street/directions to job site: 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
Oth
Subdivision: Lot no.: er' 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
' Gas fir lace/insert 33.39
1)ESCRIPT)( OFW eP
.a ({ Flue vent for water heater or gas
('`QP(a-cc_ ‘42--XSi5A- tel % fireplace 23.32
rt �
� Log lighter(gas) 23.32
SP,I\- kA VAc W'`"' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
f ..,...v.,,,...„,-., Other: 23.32
igr I?R31*ER OWNER 7.v , Environmental exhaust and ventilation:
Name: T 0. elt- Range hood/other kitchen
equipment 33.39
Address: ct ocisk �te_,,,, t s\k 61v Qi. Clothes dryer exhaust 33.39
City/State/ZIP: `T ?, Single-duct exhaust(bathrooms,
J toilet compartments,utility rooms) 23.32
Phone:(5O3) GIA-1-4 _ 0,77j Fax:( ,},) Attic/crawlspace fans 23.32
0 AP?IC < y }CONTA e'1 Other: 23.32
Business name: 56 . �q.� Fuel piping:
�� 11' }t $14.15 for first four;$4.03 for each additional
Contact name: e..Sh. - 4.11 Furnace,etc.
S5 Sc___ ' ��f cj W Gas heat pump
Address: kg
Wall/suspended/unit heater
City/State/ZIP: At;(L es 7-1
0.-P-, zav_ Water heater
Phone:( 53)c--7,)_, "3'77y2 Fax::( ) Fireplace
i Range
E-mail: I .--e- e, 5 e t i s tivv..__ Barbecue
CONTRACTOR' Clothes dryer(gas)
.
Business name: t_ : Other:
MECHANICAL PERMIT FEES*
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lie.: \m 1oo TOTAL PERMIT FEE
2- y/6/, 6,eZ.
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: r/ / * Fee methodology set by Tri-County Building Industry Service Board
Print name: ,evtv`. Q/,4/,( Date: /pi- —027—/C,1
\ \ME
I:\BuildingPermitsC_PermitApp_040I13.doc 440-46171(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial& Multi-Family Fee Schedule:
Total Valuation: Permit Fee:
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional$100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional$100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional$100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Building\Permits\MEC_PermitApp_040113.doc 2
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
9009 SW HALL BLVD 100, TIGARD, OR, 97223
Record Type:
Commercial - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
MEC2016-00866
Inspector:
Jeff Grove
Contractor