Permit (144) ,
C ITY OF TIGARD MECHANICAL PERMIT
1 COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00528
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/12/2007
PARCEL: 2 S 115 BA -00100
SITE ADDRESS: 16200 SW PACIFIC HWY Z - ALBERTSONS ZONING: C -G
SUBDIVISION: TIGARD TOWNE SQUARE LOT: JURISDICTION: TIG
PROJECT: ALBERTSONS
Project Description: TI - interior upgrades; duct work (see other) and gas piping to pizza oven.$25,000
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: COM UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: M VENTS W/O APPL: VENT SYSTEMS:
STORIES: 1 BOILERS /COMPRESSORS HOODS: 1
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 3
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
IBJ SCHRODER BANK + TRUST CO Description Date Amount
BY ALBERTSONS INC #565
ATTN: CORPORATE ACCTG DEPT [MECPLN] Plan Rev 10112/20C $108.50
BOISE, ID 83726 [MECH] Permit Fee 10/12/20( $434.00
[TAX] 8% State Surcha 10/12/20C $34.72
Phone: Total
$577.22
Contractor:
COMFORT FLOW HEATING
1951 DON ST SUITE D
SPRINGFIELD, OR 97477 REQUIRED ITEMS AND REPORTS
Contact #: PRl 541- 726 -0100
Reg #: LIC 460
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued �J i'i�! / / . f /` l
s Permittee Signature: G C� -
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
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 Applicati E
City of Tigar °` W . ) 1012 OFFICE USE ONLY
R eceived Permit No.:
II
I • 2007 patc/By: °I �O i Si- ' ac s -ccu'
13125 SW Hall Blvd., Tigard, OR 97 C F P 0 4 Plan Review ► . . ��
Phone: 503.639.4171 Fax: 503.598.1960 Wtclar , i ' f ' J OtherPermit
T (G A R D Inspection Line: 503.639.4175 CITY ®F TIGARD Date • DIVISION ?Ty: IA See Page 2 for
Internet: www.tigard -0r.gov BUILDING Notified/Method: - Supplemental Information
TYPE OF wORK V1 V / CO R '. HEM* SCl1PAUI�E - USE CSECKLLST
El New construction ig Addition/alteration/replacement
Mechanical pemut fees' are based on the value of the work
El Demolition ❑ Other. performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor overhead, and profit.
1 CATEGORY OF CONSTRUCT_ ION ._. W Value: $ ��� WC) El 1- and 2- family dwelling (� jCommercial /industrial ❑ Accessory building
IDT STEMS FEES!
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMAI1ON AND Heating/cooling
Job site address: 14 Wo ` ry Air conditioning ho i n g pump 14-0) � C � �� 1nl� (requires site plan showing placement) + 14.00
City/State/ZIP: -1' 1�^ . 0 I Furnace 100,000 BTU ( ducts/vents) 14.00
F 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: I Project name: A1Vri •4 S 6 Gas heat pump 14.00 _
Cross street/directions to job site: Duct work S 14.00 - t!}Z;ptl
0 141 tr J • • ► Hydronic hot water system 14.00
\ J '- id G III •
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision:
I Lot no.:
Other. 10.00
Tax map /parcel no.: , Other fuel appliances
1___ _ DDES H p O ff• Ribik Water heater 10.00
/NTf -Q -f og. I I �n 7 -' 1JA f S - I thavk L ivIrveV%i Flue ven for water heater or gas 10.00
1 fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
{ Chimney/liner/flue/vent 10.00
lt'ROPl�tTY OWIOZA I !� T+N'! Other. 10.00
Name: M 1 lert 1 (u r Va 1 w,] Environmental exhaust and ventilation
Address: () [ �� B 1v d . Range hood/other kitchen
equipmtatt , 10.00 40-ea-
City/State/ZIP: ii3O t ID a5 10(a Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( 1 W, . a-11 I Fax: (US)3 ' S - &b `t 2. toilet compartments, utility moms) 6.80
ig AllOcANT 0 COPTrACr - PER9oN Attic/crawlspace fans 10.00
Other. 10.00
Business name: 1"a -1- 4 A' o c Z s - , I nc- • Fuel piping
Contact name: Ftni Z I 1 r to p s - $5.40 for first four; $1.00 for each additional
Address: 3 6 ob i k 4e Of -. -d- 220 Fumaot etc.
j
Gas heat pump
City/ State/ZIP: Bo`s (1) 8--1 00 Wall/suspended/unit heater
Phone: 'LO$ - 3ti5 2t{2 I Fax: : ( S ) 145- 3151 Water heater
Fireplace
E -mail: relrI4WSCP tet.i- -11- . COI, Range
t .dam..„ .b...�
(70N1TtACTOR. f(5': .. '_t - L Barbecue
Business name: Clothes dryer (gas)
rti FOR T ILO W 4& ' Other P i7 o 9 G1/4.) ! .t(O W'
Address: �•.• ." . •- R
l q5 / j)o 00 s true i Ffi FEES*:
City/State/ZIP: 5 P2 a 4 �� 77' 1 7 Subtotal
`i Minimum permit fee ($72.50)
Phone: w ill) 7 �.(p •' p J 00 I Fax: ( ) -
Plan review (25% of permit fee) t
CCB lic.: ,40 ;Olt '
State surcharge (8% of permit fee) �� I I TM- { r FS, TOTAL PERMIT FEE y 77�-
Authorized signature: / 1: , _; _r n — - - This permit application emir m If a permit Is not obtained within 180
q T�GW �1 days after it has been accepted as complete.
Print name: F `1 P• 6 Date: et 1 S I 0/ I • Fee methodology set by Tri- County Building Industry Service Board
I :1Building‘PermitsV�a3 C-PermitApp.doc 04406 440.4617r(I1/02/COM/WEB)
CITY OF TIGARD •
BUILDING DIVISION ,� PERMIT #: MEC2007- 00528
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/12/2007
Phone: (503) 639 -4171 A 'l
Inspection Requests (24 Hrs.): (503) 639 -4175 `:_..
INSPECTION WORKSHEET FOR DATE: 3112/2008 TIME: 7:00AM PAGE: 3
SITE ADDRESS: 16200 SW PACIFIC HWY Z - ALBERTSONS CLASS OF WORK:
SUBDIVISION: TIGARD i'OWNF_ SQUARE LOT #: TYPE OF USE:
PROJECT NAME: AWERTSONS
DESCRIPTION: TI - interior upgrades; duct work (see other) A; ; i r le izz • , e t i : I
OWNER: IBJ SCHRODER BANK + TRUST CO, vv PHONE #:
CONTRACTOR: COMFORT FLOW HEATING PHONE #: 541
Inspection Request Scheduled For: Date: 3/12/2008 1 f'" Pour Time:
Code # Inspection Description Confirm # Contact # Mess e
6% Mechanical final 066583-01 503-710-2713 Y
Corrections /Comments /Instructions: .4--Z, v r �oL 4 IV Q.:...k, i........_ . ...�
&-jb kJc _
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, /
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I V ' ' " - t Date: 3 ik L (6 #: - 718- ��
p D Phone . (503)
CITY OF TIGARD •
BUILDING DIVISION r PERMIT #: ME02007- 005528
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/12/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 A!!
INSPECTION WORKSHEET FOR DATE: 11/13/2007 TIME: 7 :01AM PAGE: 111
SITE ADDRESS: 16200 SW PACIFIC HWY Z - ALBERTSONS CLASS OF WORK:
SUBDIVISION: TIGARD TOWNE SQUARE LOT #: TYPE OF USE:
PROJECT NAME: ALBERTSONS
DESCRIPTION: TI - interior upgrades; duct work (see other) and gas piping to pizza oven.` 25,000 .
OWNER: IBJ SCHRODER BANK + TRUST CO, PHONE #:
CONTRACTOR: COMFORT FLOW HEATING PHONE #: 641 - 726.0100
.
.
Inspection Request Scheduled For: j am Date. 11/13/2007 Pour Time: lc
Code # Inspection Descri. ion ',NlL. , ?6Confirfl/# Contact # Me age
615 Mechanical rough -in / u 52-01 603.710.2713 Y
Corrections /Comments /InstructiFns: � LQ
-N
Cor-i ■1. 0 UN Ou.J.L-k_ -
--- _
9 _,u,,,r-& -\ gv-- ccs e-ile .
fi
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: VU V 1J Date: `` 11) / °-) Phone #: (503) 718- - 2-Y" l
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