Permit CITY OF TIGARD MECHANICAL PERMIT
INIs . COMMUNITY DEVELOPMENT Permit#: MEC2022-01081
Date Issued: 6/7/2023
T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113AD01700
Jurisdiction: Tigard
Site address: 16920 SW 72ND AVE
Project: Grocery Outlet Subdivision: ROSEWOOD ACRE TRACTS Lot: 26-34,P
Project Description: TI for new grocery store:install(3)RTUs.
Contractor: SUMMIT PROPERTIES AND DEVELOPMENT CO INC Owner: BRIDGEPORT LAND LLC
6445 CITATION DR SUITE G 3939 NW ST HELENS RD
CLARKSTON, MI 48346 PORTLAND, OR 97210
PHONE: 248-625-4711 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/07/2023 $4,798.71
Class of Work: ALT Type of Const: Plan Review 06/07/2023 $1,199.68
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 06/07/2023 $575.85
Stories: Info Process/Archiving-Lg$2.00(over 06/07/2023 $14.00
Project Valuation: $175,000.00 11x17)
Info Process/Archiving-Sm$0.50(up to 06/07/2023 $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:
Appliances
Vent Fans: Vent Systems: Total $6,594.24
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 100
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
Issued By: g_2...... ..1...„„.......„Ze„ al Permittee Signature: aZ `-.e.-C
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4
b Mechanical Permit Application Fol4 olFlcl: I'sh:o',I.v-
City of Tigard HiCEIVED Received r
13125 SW Hall Blvd.,Tigard,OR 97223 Date/By: �', I r allPemri g.C>G�:2--o f G�1
® Phone: 503.718.2439 Fax: 503.598.196 Plan Review Other
T 1 G A R D Inspection Line: 503.639.4175 '`O 0 2022 Date Read/I ��' suds �m. v���
Internet. www.tigard-or.gov y y: a la See Page 2 for
CITY OF TIGARD Notified/Method: tc1:. L let, D. Supplemental Information
TYPE 0}-141UING DIVISION C OMWE L SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ 75,, 00G
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building For special information use checklist.
0 Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 3 46.75
Job site address:16920 SW 72nd Ave Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP: Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 2 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Grocery Outlet Duct work .3 23.32
Cross street/directions to job site:SWC SW Durham Rd&SW 72nd Ave 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: 1 Lot no.:
Other: 23.32
Other fuel appliances: _
Tax map/parcel no.:2S113AD01700 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Grocery store tenant improvement in an existing building. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ® TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Shana Seeno Range hood/other kitchen
Address:
5650 Hollis Street equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP:Emeryville,CA 94608 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( 253 )777 7658 Fax:( ) Attic/crawlspace fans 23.32
ft APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: GF(GreenbergFarrow) Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name: Florence Abrenica for GF Furnace,etc.
Address: 92 East Main Street,Suite 410 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Somerville, NJ 08876 Water heater
Phone:( 732) 784.3231 Fax::( ) Fireplace
E-mail:fabrenica@greenbergfarrow.com Range
Barbecue
Q
CONTRACTOR Clothes dryer(gas)
Business name: TBD L y " 7 10 p-c-4\rC- Other:
) ) r_ MECHANICAL PERMIT FEES*
Address: /G'f t 7 ifk,.,„p, /'G'. Ll S di /Lit0 Subtotal
City/State/ZIP: , j CeAtuti l aj q T6 E) L Minimum permit fee($90.00)
��/ (J i Plan review(25%of permit fee)
Phone:17`a :� ii Fax:( ) State surcharge(12%of permit fee)
CCB he-: 1 o,ot t cr 19.1*O1�idtA TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: «c""°"9Fa"° Fri * Fee methodology set by Tri-County Building Industry Service Board
Print name: Florence Abrenica for GF Date: 11/8/2022
1:\Building\Permits\MEC_PermitApp_040113_doc 440-4617T(I 1/02/COM/WEB)
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:\Building\Permits\MEC_PermitApp_040113.doc 2
City of Tigard
mec (il M �a RECEIVED
NOV 1 0 2022
III
COMMUNITY DEVELOPMENT DEPARTMENT
T 1 G R Building Permit Review — Commercial - NiOFm i- :se
A D
Building Permit #: M e—C ?-O .Z.- 01 b
Site Address: ((p q 2! SA) 72..1,9( Ave Suite/Bldg#:
Project Name: erociAryOoftei(
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Planning Review pp�
Proposal: Tl N(?G vl ca/1 �. 'ncavp[aa r T'!dlP
AC
Existing Business Activity: SNieA " OneN' d( pew/
Proposed Business Activity:
Ef Verify site address/suite# exists and active in permit system.
rEi River Terrace Neighborhood: ❑ Yes .No
fr-Zoning: C
Permitted Use: zEr Yes ❑ No ❑ Spec Space
.12"Confirm no land use required.
Business License:
Exists: ❑ Yes ,a-No,applicant was provided a business license application
Notes: ikift R-T U S Wi f&(( 'CO iz era ped --0) ostolted he t i/I/11 ( (1
Approved by Planning: Date: 11/to (ZL
7791
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: i I. h i/ /?--.)-
Site Plans: # '7j
Building Plans: #
Building Permit#: N Enter building permit#above.
Workflow Routing: i Planning 41 Building
Workflow Sign-off: Sign-off for Planning(include notes from planning review)
Route Application Documents: ,K Building: original permit application, site plans,building plans,engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: c- Date: ( I it 7/-1-.)--
I:\Building\Fonns\BldgPennitRvw_COM NoLandUse_09072022.docx
P rmit Coordinator Review
•
❑ Conditions issuance of permit
❑ Approved,NOT Released: Date:
❑ ENG Revisions Required: Date:
Notes:
❑ SDC Exemption ❑ A or ❑ Received ❑ Does not apply
❑ Fees Entered: ash Co Trans Dev Tax: ❑ Yes ❑ N/A ❑ Deferred
Tigard Trans SDC: ❑ Yes ❑ N/A ❑ Deferred
Parks SDC: ❑ Yes ❑ N/A ❑ Deferred
LIDA Fee: ❑ Yes ❑ N/A
OK to Issue/Approved by Permit Coordinator: Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
I:\Building\Fonns\BldgPermitRvw_COM_NoLandUse 08162022.docx
Joseph Bailey
From: Florence Abrenica <fabrenica@greenbergfarrow.com>
Sent: Wednesday, November 16, 2022 9:58 AM
To: #Building Permit Technicians
Subject: RE: SDCs
Hi Karen,
I hope this answers your questions:
1. The address is correct and the GOI is replacing the DSW Shoes
2. Per Grocery Outlet,the total cost for the mechanical work will be $175,000
Do you require additional information from me?
What are the next steps?
Florence Abrenica,PE
x Development Manager
m: 732.784.3231
www.greenbergfarrow.com ( Ft[1 [ J F
Confidentiality Notice:This email may contain confidential and/or private information.If you received this email in error please delete and notify sender.
From:#Building Permit Technicians<TigardBuildingPermits@tigard-or.gov>
Sent:Tuesday, November 15, 2022 8:25 PM
To: Florence Abrenica <fabrenica@greenbergfarrow.com>
Subject: RE: SDCs
EXTERNAL SENDER—Do not click links or open attachments unless you recognize the sender
Hi Florene. We've received your plan submittal and have a couple questions.
We are wondering about the address. The address on the application is currently a very active DSW Shoe
store. Is that being replaced?
We also need the total valuation on the mechanical work rather than the itemized equipment. I can fill that in
on the application once we get it.
Talk to you soon,
Karen
Karen Abdill
City of Tigard
Building Division Services Supervisor
503-718-2718
Karen.abdillWtigard-or.gov
s
TIGARD
From: Florence Abrenica <fabrenica@greenbergfarrow.com>
Sent:Tuesday, November 8, 2022 8:18 AM
To: Karen Abdill <karen.abdill@tigard-or.gov>
1
�
,
,
�c;#8uihding Permit Technicians«Tigard8ui|dinAPennhs@tigard-or.gov>
Subject: RE:GDCs
Some people w�o often get
'' '---_-�_--' � ''—"'— `~'~^'~~.^_~'`~^''^^~' ~^^'~.a,.�
I'm getting our package ready for submittal and will submit 3 hard copy sets of plans for building, electrical, mechanical
and plumbing with application forms. What fees are required to be submitted? |will be sending under separate cover, �
as per my transmittal letter attached.Who should the check be made payable to?
Thanks,
Florence ubrenica, PE
Development Manager
m,732.78*.3231
mmmm,,gneenbergfarmnnw.mmmm |
Confidentiality Notice:This email may contain confidential and/or private information.n you received m/aomanmonnrn/eaaedeleteanunumyaenuer,
From: Karen AbdiU<kanen.abdiU@tigard-orRwv»
Sent:Thursday, October%O 3032 2:22 PM
To: Florence Abrenica <fabrenica@RreenberRfarrnvv.com>
Subject: FVV: SDCs
EXTERNAL SENDER— 0o not click links or open attachments unless you recognize the sender
Here is the wmrkohcct l was talking about. l»|cuoc don't distribute it anywhere. Just for your use.
Thanks,
Karen
KarenAbdi||
City ofTigard
Building Division Services Supervisor
508'718'2718
Karen.abdi||@tiRard'or.Rov
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record |avvm. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mailsane retained
by the City of Tigard in compliance with the Oregon Administrative Rules''City General Records Retention Schedule."
2