Permit ,t CITY OF TIGARD BUILDING PERMIT
COMMUNITY DEVELOPMENT Permit#: BUP2020-00176
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/1/2020
Parcel: 1S136DB00201
Jurisdiction: Tigard
Site address: 11565 SW PACIFIC HWY
Project: Fred Meyer Subdivision: None Lot: None
Project Description: Footing and framework to support condenser.
Contractor: POLAR REFRIGERATION INC Owner: FRED MEYER STORES INC
8819 NE 117TH AVE STORE#375
VANCOUVER, WA 98682 1014 VINE ST
PROPERTY TAX 7TH FLOOR
CINCINNATI,OH 45202
PHONE: 360-852-3939 PHONE:
FAX:
Specifics: FEES
Description Date Amount
Type of Use: COM
Class of Work: ALT Type of Const: IIA Permit Fee-Additions,Alterations, 09/01/2020 $608.23
Demolition
Occupancy Grp: M Occupancy Load: 0
12%State Surcharge-Building 09/01/2020 $72.99
Dwelling Units: 0 Plan Review 09/01/2020 $395.35
Stories: 0 Height: 0 ft Info Process/Archiving-Lg$2.00(over 09/01/2020 $2.00
Bedrooms: 0 Bathrooms: 0 11x17)
Value: $38,668 Info Process/Archiving-Sm$0.50(up to 09/01/2020 $17.50
11x17) •
Floor Areas:
Total Area: 0
Accessory Struct: 0
Basement: 0
Carport: 0
Covered Porch: 0
Deck: 0
Garage: 0
Mezzanine: 0
Total $1,096.07
Required: Required Items and Reports(Conditions)
Fire Sprinkler: Parapet:
Fire Alarm: Protected Corridors:
Smoke Detectors: Manual Pull Stations:
Accessible Parking: 0
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law, All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: J Permlttee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical PermitApplicatliRECEIVED Foa()flu 1': l 51:t)N>u1
City of Tigard Received'
DateRy: 7 3/ 20 / Pciotitr" 13t.iF'?.Q 2.0 -0 J7(„
i al 13125 SW Hall Blvd.,Tigard,OR 97223 J U L 2 7 2020 Plan Re sue
Phone: 503.718.2439 Fax: 503.59$.1960 Datetl3y. 46 - r O ii Other Permit:
I.1 ti.y is r, Inspection Line: 503.639.4175 CITY OF TI GAR D Date Ready/By: Tails: See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISION Notified' 4 rho :3127 ze 4) ' Supplemental Information
�� TYPE PF "oRK' eg r �;:. ® * s€ 1 -- t�s c I Is isT
r
❑New construction Q/Additzon/alteration`rcpla�eroent , 1 kfec�i�permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
7 Demolition 0 Other: mechanical materials,equipment,labor,overh d rofit Value $
i $,., ,
- 0 L-and 2-family dwelling Commercial/industrial 0 Accessory building For li
❑Multi-family 0 Master builderspecial information use Qty.hetyi(tsr
0Other; Description
r Ea. Total
' Heating/cooling:
Job site address: I 1 - _ F _ t/ t., r conditioning iN0,i0g 46.75
��� ��+c� "fi c t7�' f Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP: 7 ,<,,,--ct Or q -7 3' Furnace 100,000+BTU(duets/vent_a) 54.91
Suitetbldg./apt.no.: Projeetname: / /1.{�� / 1 Ductwor 61.06
23.32
Cross street/directions to job site: H eV' f�r Ductwo rkk 9 q f '1F„3 -2/3 fiydronic hot water system 23.32
Residential boiler(radiator or
hydronic)
23.32
Unit heaters(fuel-type,not electric),
in-wall,induct,suspended,eta: 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax naap/parcel no.: Water heater
23.32
;, , f IYESi i£,PTIf9`,,OF ' .R Gas treplace/insert 33.39
t.R Ct7� —` - -- Flue vent for water heater or gas
a a t trZe.,- ( $JLi"l Cl e n„Ce.,'` fireplace 23.32
f l!JGt Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fine lace/insert 23.32
Chimney/liner/flue/vent,
23.32
.,, �'RiitiLffii . �, ;,i1 Other.
k 4- - i
23.32
,am : Fr e.tq ,vt� . Range by od/otheli MI exhaust and ventilation:
/�' �.t Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: °f"-#- I owl J xr^ q- rc7�6, Single-duet exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( )
AdicierawIspace fans 23.32
' ,, i Other: 2332
j Fuel u log:
Business name: 0 {jai.- -'1' o>'1 [ p
Contact name: '.rl .J ,� _ SI a 15 for first four,$
443far each additional
Y t 111 rrr"�" ( Furnace,-etc.
Gas heat pump
City/State/ZIP: f/1 4/� �^ Watcrt-pended/unitheater
4k'elp�<ei VV "V _ 156 t sr Water heater
Phone:(13il) ct,"if . `g'5, G Fax:p:( ) Fireplace
fr E-mail: �.-1 e }' (tom./- `-- F , t' ,0,-) Dar e
eue
s z YFil v d a't` e. $ Seta .*a n E.m "�
�y . � .� j � .��'r/ cloth,,,dryer(g�
1 Business name: iP-t.) Gf. / _ rs2r"a ' .'� Other
l Address: J 't" ',",+)4ECtL4_i1C 43.Pr",RNOT VEER" ( —�
Y. Subtotal
City.Statt/Zff: Minimuni permit fee(S90.00) ._
Phone:( ) Fax.( ) Plan review(25V0 of permit fee) ---1
;`CS lie.: % ''''.7 d'�
1 State surcharge{.. of permit fee)
TOTAL PERMIT FEE
This permit application es;;rzs if a permit,
is not obtained within 180
Authorized Signature: days atter it has teen accepted as complete.
,..6.,
f " 3iee methodology sex b't .$ _ r-r f { K y i:ri-County Building Industry Service Board
1 ?rsnY name: �P C )�9tL: /1J
.,,euitding',amitsWEC_Peimtapp_040113.doc v 440.4677I'/l ilmt(t1RnAw[:CO,
Mechanical Permit Application - City of Tigard
Page 2 -Supplemental Information
Commercial&Multi-Family Fee Schedule:
'otal VaIna 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.
1aBuilding\Perm0sWIEC FemutApp 040113.dac 2
City of Tigard
.11Ni COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD Building Permit Review — Commercial - No Land Use
mom
n,.
Building Permit #: , _ --
Site Address: 11565 SW Pacific Hwy Suite/Bldg#:
Project Name: Fred Meyer
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review
Proposal: Replace ground level condenser; will not be visible from any public street/sidewalk
Existing Business Activity: Sales-oriented retail
Proposed Business Activity: Sales-oriented retail •
QVerify site address/suite#exists and active in permit s stem.
❑° River Terrace Neighborhood: ❑ Yes No
QZoning: C-G
ElPermitted Use: H Yes U No U Spec Space
❑o Confirm no land use required.
❑o Business License:
Exists: ❑r Yes ❑ No, applicant was provided a business license application
Notes:
•
Approved by Planning: —t Date: 7/29/20
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: 7/.P.-7/d-6
Site Plans: #
Building Plans: #
Building Permit#: a-Enter buildingR Kermit# above.
Workflow Routing. ErPlanning an Build Permit Coordinator ing
Workflow Sign-off: e Sign-off for Plan
ning(include notes from planning review)
Route Application Documents: ding: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: �/-1 ' d Date: 7/-r/Z-e,
L\Building\Forms\BI dgPermitRvw_COM_NoLandUse_111819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building per. .
❑ Approved,NOT Released: Date:
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 Dev :x: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
1:\Buil ding\Forms\BIdgPemiitRvw_COM_NoLandUse_1 1 1819.docx •
1