Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2021-00203
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 5/13/2021
TIc;AIt. - 9 Parcel: 1S136DB00201
Jurisdiction: Tigard
Site address: 11565 SW PACIFIC HWY
Project: Fred Meyer Subdivision: None Lot: None
Project Description: Expand the(E)grocery pick up area inside the F.M.store.(E)walk-in cooler expanded&reach-in freezer
relocated.Emp area only.New floral area built beside C.S desk.(2)add'I parking stalls will be converted to(2)
grocery pick-up spaces.
Contractor: PROTEMP ASSOCIATES INC Owner: FRED MEYER STORES INC
9788 SE 17TH AVE STORE#375
PORTLAND, OR 97222 1014 VINE ST
PROPERTY TAX 7TH FLOOR
CINCINNATI,OH 45202
PHONE: 503-233-6911 PHONE:
FAX: 503-238-9767
FEES
Specifics: Description Date Amount
Type of Use: SF Permit Fee 05/07/2021 $277.46
Class of Work: ALT Type of Const: VB Plan Review 05/07/2021 $69.37
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 05/07/2021 $33.30
Stories: Info Process/Archiving-Lg$2.00(over 05/07/2021 $4.00
11x17)
Project Valuation: $7,500.00 Info Process/Archiving-Sm$0.50(up to 05/07/2021 $17.50
11x17)
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 $401.63
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc: walk in
Duct Work: 20 freezer
Fire/Smoke Dampers:
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance. or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: HollyVa-vvDe,Wee Permittee Signature: Owr4ppl%GGit"W-rt
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
. s`
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tig
ard d Received
g Date/By: 7 / 1)1 BIT' Permit No.: �a�2 )i_ pc.:3
114 • 13125 SW Hall Blvd.,Tigard,OR 97223 �� it 1 \ OOO t [.(�grEl
Phone: 503.718.2439 Fax: 503.598.196 V E UPlan Review �"
,. ,.Li Date/By: 4-id-a j Other Permit: &V 1.4I
Inspection Line: 503.639.4175 y ,
I I U \K D Date Read By: ® See Page 2 for
/
Internet: Metho www.tigard-or.gov MAR 2 5 2021 otified/ G // _tuns ... Supplemental Information
TYPE OF WORK CITY OF TIGARD C MM RCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
1-3 Newconstruction ElQl ���1V�,1G1�Addi[ion/alteratio performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: Lit)S � Cyr k 4-C- c,S ' mechanical materials,equipment,labor,overhead,and profit.
Value:$ 7,500.00
CATEGORY OF CONSTRUCTION ith lir i. r RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 11565 SW Pacific Highway Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name:Fred Meyer Grocery Pick Up Expansion Heat pump 61.06 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
Other: 23.32
Subdivision: I Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Enlarging existing walk-in cooler, adding new transfer fan, fireplace 23.32
for walk-in cooler. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER I l2 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Fred Meyer-Karena Zevely Range hood/other kitchen
equipment 33.39
Address: 3800 SW 22nd Ave. Clothes dryer exhaust 33.39
City/State/ZIP: Portland,OR 97219 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503 )797.3511 Fax:( ) Attic/crawlspace fans 23.32
N APPLICANT Li CONTACT PERSON Other: 23.32
Fuel piping:
Business name: Western Construction Services —
$14.15 for first four,$4.03 for each additional _
Contact name: Pam Deegan Furnace,etc.
Address: 2300 E. 3rd Loop, Ste. 110 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Vancouver,WA 98661 Water heater
Phone:(360 ) 953.8517 Fax: :(360 )694.7818 Fireplace
E-mail: pam@westernconstruction.com Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: IBD Other:
r 0 le YY-1 MECHANICAL PERMIT FEES*
Address: q'--`$g c� con-. Z- Subtotal
City/State/ZIP:?vr1-1CI,n' U. ct-1-Z2,Z Minimum permit fee($90.00)
Phone:(gj3) 7:2 •Z Na \\ Fax:( ) Plan review(25%of permit fee)
Q�� State surcharge(12%of permit fee)
CCB lic.: eery TOTAL PERMIT FEE
'this permit application expires if a permit is not obtained within 180
4 days after it has been accepted as complete.
Authorized signature: /1,a , _ D �_ • Fee methodology set by'rri-County Building Industry Service B�
Print name: Pamela A. Deegan Date: 03.24.21
City of Tigard
114 COMMUNITY DEVELOPMENT DEPARTMENT
T l c n 1. Building Permit Review — Commercial - No Land Use
Building Permit #: /►1 27J9,/,,-)v,9-0.3
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: Enlarging existing walk-in cooler, adding new transfer fan, and new condenser for walk-in cooler
Existing Business Activity: Sales-oriented retail
Proposed Business Activity: Sales-oriented retail
IS -rify site address/suite# exists and active in permit s stem.
ie,'ver Terrace Neighborhood: ❑ Yes LJ No
��' Zoning: C-G
0 Permitted Use: LIYes U No U Spec Space
0 Confirm no land use required.
0 Business License:
Exists: 0 Yes 0 No,applicant was provided a business license application
Notes:
Approved by Planning: _1 ,/,,,;, Date: 4/2/21
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved 0 Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Building Permit Submittal
Original Submittal Date: ,3/ 'J}l - 4v o 4,3 fl 411,4 -r;
Site Plans: # r
Building Plans: ;.1_. ..____
Building Permit#: n/ter buildingermit# above. nn ^^��
Workflow Routing: a �'ing Permit Coordinatortuding
Workflow Sign-off: ff for Planning(include notes from planning review)
Route Application Documents: wilding: original permit application,site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: ��� Date: `(ti— -t
I:1Building\Forms\Bl dgPenn itRvw_COM_NoLand Use_111819.docx
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to e pplicant:
Revision Notice 2: Date Sent . Applicant:
Revision Notice 3: Date Se. to Applicant:
❑ SDC Fees Entered: Was Co Trans Dev Tax: ❑ Yes ❑ N/A
T • rd Trans SDC: ❑ Yes ❑ N/A
arks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permi oordinator: Date:
I:1Building\Forms\B IdgPermitRvw_COM_NoLandUse_111819.docx