Permit 'PI CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Pe
COMMUNITY MEC2022-00473
Date Issued: 6/21/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S1156A00100
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY M
Project: Trader Joe's Subdivision: None Lot: None
Project Description: Mechanical work related to shell modifications and Trader Joe's Tenant Improvement.
Contractor: PSR WEST COAST BUILDERS Owner: TECOLOTE RESOURCES INC
3458 MT DIABLO BLVD KELLY'S LEGACY LLC ET AL
LAFAYETTE, CA 94549 BY HESLIN HOLDINGS INC
23421 SOUTH POINTE DR STE 270
LAGUNA HILLS, CA 92653
PHONE: 925-299-0518 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/21/2022 $6,404.71
Class of Work: ALT Type of Const: VB Plan Review 06/21/2022 $1,601.18
Occupancy Grp: M Occupancy Load: 12%State Surcharge-Mechanical 06/21/2022 $768.57
Stories: 1 Info Process/Archiving-Lg$2.00(over 06/21/2022 $14.00
11x17)
Project Valuation: $230,000.00
Info Process/Archiving-Sm$0.50(up to 06/21/2022 $6.00
11x17)
Fuel Air Handlers
Fuel Types: Natural Gas 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: 100
Appliances
Vent Fans: 2 Vent Systems: Total $8,794.46
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. ose rules are et forth i AR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
r
Issued By: Permittee Signature: Sre" ks,- �
'/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RECEIVE
Mechanical Permit Application 1UN 9 2022 '-"'z"l ' "' ('s'`("' '
City of Tigard Ra«'vea Y I I'2 J,7i 1 Perms No �C�� I
,'� Tigard, _-Y OF 1i(ARl Date/By
13125 SW Hall Blvd., OR 97223 Plan Restew
a Phone: 503.718.2439 Fax: 503.598.1960 Other Permit
Inspection Line: 503.639.4175 DING DIVISION Datc/By y-Z7�.�/
T 1 G A It 1> Date Ready By lore H See Page 2 for
Internet: www.tigard-or.gov Nonf t �) Supplemental Information
4".4
TYPE OF WORK O RCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
Q New construction 0 Addition alteration'replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$ 230,000
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ❑X Commercialindustrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address:16200 SW Pacific Highway Furnace 100,000 BTU(ducts vents) 46.75
City/State-ZIP: Tigard,OR 97224 Furnace 100,000+BTU(ducts vents) 54.91
Heat pump 61.06
Suite bldg.'apt.no.: I Project name:Trader Joe's Duct work 23.32
Cross street'directions to job site:Pacific Highway& Durham Rd. 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
Subdivision:
I Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.. 2S1 15BA00100 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace insert 33.39
Flue vent for water heater or gas
l
/,l t� ¢.r�jr-.,q.c_ (�e.)t�k _ e�¢]'&� ,,Z.-
fireplace 23.32
77 /f / •� Log lighter(gas) 23.32
.S 1_L• � '\ ��-�77�'� � Wood pellet stove 33.39
/ fir_Q c )t> � �14 ash . .��/,?�r 1 Wood fireplace insert 23.32
Chimney liner flue vent 23.32
Other: 23.32
IDPROPERTY OWNER 1 0 TENANT Environmental exhaust and ventilation:
Name:Heslin Holdings, Inc. Range hood other kitchen
equipment 33.39
Address:23421 South Pointe Dr Suite 270 Clothes dryer exhaust 33.39
City/State ZIP:Laguna Hills, CA 92653 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(949)297-4460 I Fax (949)297-4460 Attic crawlspace fans 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:Schmidt Architects, PC
S14.15 for first four;S4.03 for each additional
Contact name:Frank Schmidt Furnace,etc.
Address:16101 SW 72nd Ave. Suite 135 Gas heat pump
Wall/suspended/unit heater
City/State ZIP:Portland, OR 97224 Water heater
Phone:(503)220-851 7 Fax::( ) - — Fireplace
franK schmia c.eom tarchitects Range
E-mail: �`"' p Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: Other:
PSR West Coast Builders. Inc. MECHANICAL PERMIT FEES*
Address:3458 Mt Diablo Blvd. Subtotal
CityIState'ZIP:Lafayette, CA 92868 Minimum permit fee(S90.00)
Plan review(25°o of permit fee)
Phone:(925)876-3461 Fax:( ) State surcharge(I 2°0 of permit fee)
CCB lie.: 197278 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
7 days after it has been accepted as complete.
Authorized signature yy� • Fee methodology set by Trt-County Building Industry Service Board
Print name: . ��7 Date: �,, 1 r —
I Building Permits MEC PernitApp.040111 dos 440 4617T(11 02 COMMTBI
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
l:'Building\Perniits'MEC_PenrdtApp_040I I 3.doc 2
City of Tigard
111 A COMMUNITY DEVELOPMENT DEPARTMENT
Q
Tlcnlzn Building Permit Review — Commercial - No Land Use
m, _ TAT
Building Permit #: M EC-Z022`00 4-7 3
Site Address: 1("Zoo SJ r o i P"c Suite/Bldg#: V\
Project Name: i
Tr�- des
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review(� ` I (,, �( ' 1,� I (�
Proposal: Y YID' i , , W o r r o.--CC(l. $o S r`Q�( ( Yvt Ooi 1 Cl c a d N S
el-- ices �"E� k- ,m pro VeAlifV2Aitc
Existing Business Activity: N I Pc
Proposed Business Activity: Gm CS-t I �_
E Verify site address/suite# exists and active in permit system.
❑ River Terrace Neighborhood: ❑ Yes g7 No
Er Zoning: G...-](.,
E`7'Permitted Use: ffrces ❑ No ❑ Spec Space
[ C,onfirm no land use required.
E Business License:
Exists: ❑ Yes ❑ No,applicant was provided a business license application
Notes: t r&f &— W GLI 1
Approved byPlanning: �n
PP �• 1 `` �i0✓11 .5 Date: (/'13 I Z
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: ( ( 1 f 21
Site Plans: # 2,
Building Plans: # Z
Building Permit#: Enter building permit#above.
Workflow Routing: 04.Planning ❑ Permit Coordinator ci4 Building
Workflow Sign-off: cig Si: -off for Planning(include notes from planning review)
Route Application Documents: 21111 :uilding: original permit application,site plans,building plans,engineer and
earn calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: %jitAxik., 5:,r, Date: Lp 113
I:\Building\Forms\BldgPennitRvw_COM_NoLandUse_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 Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
❑ SDC Fees Entered: Wash Co Trans Dev Tax: ❑ Yes ❑ N/A
Tigard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to Issue Permit
Approved by Permit Coordinator: Date:
I:\Building\Forms\B1dgPermitRvw_COM_NoLandUse_111819.docx