Permit (143) CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2019-00659
Date Issued: 09/23/2019
-Fm r1(t 1-:) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY D
Project: Rite Aid Subdivision: 1994-028 PARTITION PLAT Lot: 2
Project Description: Replacement of 5-ton RTU.
Contractor: MCDONALD MILLER FACILITY SOLUTIONS Owner: SN PROPERTIES PARTNERSHIP
12801 NE AIRPORT WAY 1121 SW SALMON ST
PORTLAND, OR 97230 PORTLAND, OR 97205
PHONE: 971-244-0901 PHONE:
FAX: 971-244-0902
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 09/19/2019 $395.97
Class of Work: ALT Type of Const: Plan Review 09/19/2019 $98.99
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/19/2019 $47.52
Stories: Info Process/Archiving-Sm$0.50(up to 09/19/2019 $12.50
11x17)
Project Valuation: $11,847.00 Misc Administration Fee 09/20/2019 $5.00
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 $559.98
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
fXTtt-Wift"
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 s-t forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OU 6 by calling 503.232.1; or 1.8 1.332. .
Issued By: or
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 Application FOR OFFICE USE ONLY
City of Tigard Received !� l� ;"" �0/
Iiii . 13125 SW Hall Blvd.,Tigard,OR 97223 ._ y
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By 9- J n Other Permit:
TI G A R D Inspection Line: 503.639.4175 -^ j��
Internet: www.tigard-or.gov Date Ready/By: G 6 (/ Juris: ® See Page 2 for
dig Notified/Meth� Supplemental Information
L,` „ ,r `/f%fir r�,1/111J �i r�r:l yfin r �'.!'r �!!r/l,!"rif/r 1i1 ,/k'i+f�ltAhd///i% I�/�r� �P»i&�,a`.
' . � i & .,1 % !'' 4.,ct ,,, :4711.1)1:':`,Z §' ' :1 t6 _... ,:t.9; cfry.t 'yt
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 ❑Other: mechanical materials, .
equipment,labo�overhead,and profit
r ;Akaff',„*"74,.:44,w,‘,1,44',,,tii* `r� 4 II ,4y `f Valuel4 ENT EE
,F,'i' , l„,-,,r AIS, dc.:7,,1,/, i# 17e., ,, r,, .,.,,.^( /,/il,yi,:: r /;, ///% iAH ^� r
1 � �r +fs.+ - �„.,, A
❑ 1-and 2-familydwelling Commercial/industrial � �������� �� � �'S`,��� ��� �
g 0 Accessory building - For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
,jj'%0/, .0. ,u�,'�//'!!o r r/ '`r/ rte.., /Jr /�,%! /` �„ ,r'/j,' Heating/cooling:
/ -� SITTr'uvF11.. AT10 ATi011f
It
Air conditioning 46.75
Job site address. �G� Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: l Ul t)3-g.9--ti Furnace 100,000+BTU(ducts/vents) 54.91
j ,, Heat pump 61.06
Suite/bldg./apt.no.: J/ Pr Iect name: p 1 f"C_ �( <✓Ci Duct work
23.32
Cross street/directions to job site: f VV _'p1,,,/('C1. 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
r 'i.!!i!//lrr/al/ /fl!//J f /
., Fi! %roi K`f/! DESCR1PTIO1�fi ., wOBT% r�rr r , , ,: %%/`` Gas fireplace/insert 33.39
f�7 Flue vent for water heater or gas
/19 l fit aI l/I• S--Ivo
_lo l�,'nA r'.,.. Sre lace 23.32
j,1-1,_
1 Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chinmey/liner/flue/vent 23.32
77i4, JiPI�P ,, x„....,,, ,,044",,004.i yb?:N / /f F,,f f r r fi pl r1 Other:
23.324", , f ri/' r91, ,, /,f�/f:`/;is', '" ' � yr„ '''':
Environmental exhaust and ventilation:
Name: �1 I/ 11,6vv- .Range hood/other kitchen
equipment 33.39
Address: &/1 �.4Clothes dryer exhaust 33.39
City/State/ZIP: CA Alt,0-vtit (-- /' '..'0
// Single-duct exhaust(bathrooms,
ll.✓�/ toilet compartments,utility rooms) 23.32
Phone:( ) 1 Fax ( ) Attic/crawlspace fans 23.32
/� /!,l l��/lililFll/ !����r !`/ !t !�f ,�lr! ! JJ; f!!/ r / r / !
'f l��irt``i!`/r d%!'., trr'J;;,1'.,,r r j';%lfi% �//tt'fO/'," /% , ff " ' Other: 23.32
0 C ec _t/1�/ l p r Fuel piping:
Business name: I,�� C1 ✓l f 'C/D'
$14.15 for first four;$4.03 for each additional
Contact name: ( erfli(i& (5-4-0�4/1/1 Furnace,etc.
Gas heat pump
Address: /' / i� 0 if 1:41� Wall/suspended/unit heater
City/State/ZIP: ;�`1p
�tl/ v` '7•9 -) Water heater
PGonei - - - _ - `FuepTace - --
—Z: J� Fax::(� � ��-��7�� .
c
E-mail: A ,ctiviiiAt_ Range
ior i� //,'l frr": lt [elf f r f� �� f Barbecue
, �f�%l ,mf o o. r, S, °1? e/trv//% r �/,f/f% o' Clothes dryer( as)
Other:name: L1 _(1/1.6/GaY_ r
00/71*: 5*:7„'12t1 11/;j460
",Address: // l Y/V 2 � i
Subtotal
City/State/ZIP: 'l
- 14/ -1,' 'f Minimum permit fee($90.00) _
/ r 7P Plan review(25%of permit fee)
Phone:( ) Fax: ) / State surcharge(12%of permit fee) _
CCB lic.: /5 C./3615
615 G ( / j PERMITTOTAL FEE
!!!vim l 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: IJ 'r ( -
O.,- Date:
I:\Building)Permits\MEC PemtitA 1-i 113...
_ ._ 440-4617T(11/02/COM/WEB)
City of Tigard
a COMMUNITY DEVELOPMENT DEPARTMENT
1111 1
T1cARD Building Permit Review — Commercial - No Land Use
Building Permit #:
Site Address: %(�c2t9C) 5-64.9 //a Suite/Bldg#:
Project Name: A 4„,e,-_,,/ R
(Name of commercial business occu ying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: R4,--P. —4n, Tv
Existing Business Activity:
Proposed Business Activity:
,Verify site address/suite# exists and active in permit system.
,,River Terrace Neighborhood: ❑ Yes 1No
,1_ Zoning:
2Permitted Use: ❑'Yes ❑ No ❑ Spec Space
Confirm no land use required.
❑ Business License:
Exists: ❑ Yes ❑ No,applicant notified to obtain business license
Notes:
Approved by Planning: Date: F
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: et
Site Plans:
Building Plans: #
Building Permit#: ❑ Enter building permit#above.
Workflow Routing: ❑ Planning ❑ Permit Coordinator ❑ Building
Workflow Sign-off: ❑ Sign-off for Planning(include notes from planning review)
Route Application Documents: ❑ Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable, etc.
Notes:
4"..
By Permit Technician: Date: l'l�l/y-
I:\Building\Forms\BldgPennitRvw_COM_NoLandUse_060116.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: R :'te:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans I• Tax: ❑ Yes ❑ N/A
Tigard Trans I C: ❑ Yes ❑ N/A
Parks S ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit C s rdinator: Date:
I:\Building\Forms\BldgPermitRvw_COM_NoLandUse 070915.docx