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111 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2021-00313
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/15/2021
Parcel: 2S103DD00700
Jurisdiction: Tigard
Site address: 13769 SW PACIFIC HWY
Project: Dutch Bros Coffee Subdivision: None Lot: None
Project Description: Mechanical equipment for new Dutch Bros Coffee building. Rooftop unit and associated ductwork per plans.
Contractor: LUNA DESIGN &CONSTRUCTION LLC Owner: GROUND 99 LLC
1709 NE CONIFER BLVD 610 SW ALDER ST STE 1221
CORVALLIS, OR 97330 PORTLAND, OR 97205
PHONE: 503-702-1851 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 06/14/2021 $855.71
Class of Work: ALT Type of Const: VB Plan Review 06/14/2021 $213.93
Occupancy Grp: B Occupancy Load: 12%State Surcharge-Mechanical 06/14/2021 $102.69
Stories: 1 Info Process/Archiving-Lg$2.00(over 06/14/2021 $8.00
11x17)
Project Valuation: $30,000.00
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: 2 Vent Systems: Total $1,180.33
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ���_� •-,
Ca I 3.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received /� d 79Z/ .02, Permit 2/
_ . 13125 SW Hall Blvd.,Tigard,OR 9722R E C E i V E D DateBy: // jai
tihM �/� �i 3
Plan Review
Phone: 503.718.2439 Date/By: "g 24 ,5 Other Permit:
r i Ci A R D Inspection Line: 503.639.4175 Date Read B 7T Juris: WI See Page 2 for
Internet: www.tigard-or.gov NAY 41O21 Notifi ethod: Supplemental Information
TYPE OF WORI4+ COMMERCIAL FEE*SCHEDULE-USE CHECKLIST-
III New construction 0 Addition/alteratb� Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$ $30,000
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
0 1-and 2-family dwelling I Commercial/industrial El Accessory building
For special information use checklist.
❑ Multi-family El Master builder ❑ Other:
Description Qty. Ea. Total
efO� SITE INFORMATION AND LOCATION Heating/cooling:
Job site address:i 3765 SW Pacific Hwyconditioning
_-_ -- �31 -- - Air46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Tigard, OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: 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
Subdivision: Lot no.: Other: 23.32
Tax map/parcel no.: Other fuel appliances:
---- -- Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Mechanical equipment for new Dutch Bros. Coffee building. Flue vent for water heater or gas
fireplace 23.32
Rooftop unit and associated ductwork per plans. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER ❑ TENANT Other: 23.32
Name: Ground 99 LLC Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 13640 Birdshill Rd equipment 33.39
ClothCity/State/ZIP: Portland, OR 97219 Single-ductes ctexhaust(r 33.39
exhaust(bathrooms, •
Phone:( ) Fax:( ) toilet compartments,utility rooms) 23.32
Attic/crawlspace fans 23.32
❑ APPLICANT 1111 CONTACT PERSON Other: 23.32
Business name: Studio 3 Architecture, Inc. Fuel piping:
Contact name: Matt Johnson $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address: 275 Court St NE Gas heat pump
City/State/ZIP: Salem, OR 97301 Wall/suspended/unit heater
Water heater
Phone:( 503 390-6500 Fax::( ) Fireplace
E-mail: matt@studio3archtitecture.com Range
-- ---------------- Barbecue
CONTRACTOR
Clothes dryer(gas)
Business name: Luna Design and Construction Other:
Address: 1 709 NE Conifer Blvd MECHANICAL PERMIT FEES*
Subtotal $855.71
City/State/ZIP: Corvallis, OR 97330 Minimum permit fee($90.00)
Phone:( 541) 224-8257 Fax:( ) Planreview(25%ofpermitfee) $213.93
State surcharge(12%of permit fee) $102.69
CCB iic.: 200358 ����,Z TOTAL PERMIT FEE $1,172.33
f . This permit application expires if a permit is not obtained within 180
.`,`, Authorized signature: Ati days after it has been accepted as complete.
* Fee methodology set by Tri-County Building Industry Service Board
Print name: Matt Johnson Date: 5/4/2021
) \\(ding\Permits\MEC_PermitApp_082520.doc 440-4617T(I 1/02/COM/WEB)
w
City of Tigard
IIICOMMUNITY DEVELOPMENT DEPARTMENT
i
TIGARD Building Permit Review — Commercial - No Land Use
Building Permit #: M e 2 2J-00 31 3
Site Address: 13769 SW Pacific Highway Suite/Bldg#:
Project Name: Dutch Brothers Coffee
(Name of commercial business occupying the space. If vacant,enter Spec Space.)
Plannir. Review
Proposal: Roof top mechanical
Existing Business Activity: eating and drinking establishment
Proposed Business Activity: eating and drinking establishment
® Verify site address/suite# exists and active in permit system.
® River Terrace Neighborhood: ❑ Yes n No
® Zoning: C-G
I Permitted Use: DE Yes ❑ No E Spec Space
® Confirm no land use required.
Xl Business License:
Exists: 1'C7 Yes ❑ No,applicant was provided a business license application
Notes:
Approved by Planning: ATM GetN_"-_" Date: 5/10/2021
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
8uildirj Per-lit Subolitral '/ /
Original Submittal Date: , 5//,-/r/�Z1
Site Plans: #
Building Plans: # 2
Building Permit#: [Enter building permit# above.
Workflow Routing: LPlanning ❑ Permit Coordinator Ili—Building
Workflow Sign-off: P'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:
A, I
��o/zBy Permit Technician: i j/�/ ! Date: 024
I:1Building\Forms\BldgPermitRvw_COM_NoLandUse_l l 1819.docx
Coordinator.Reviet�
❑ Conditio . " et"prior to issuance of building permit
❑ Approved,NO •ased: D .
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Appli -
Revision Notice 3: Date Sent to ; .. 'cant:
❑ SDC Fees Entered: W.- o Trans Dev Tax: ❑ Yes ❑ N
igard Trans SDC: ❑ Yes ❑ N/A
Parks SDC: ❑ Yes ❑ N/A
❑ OK to -. s e Permit
. .roved by Permit Coordinator: Date:
I:\Building\Forms\BldgPermitRvw_COM NoLandUse_111819.docx
Branden Taggart
From: Branden Taggart
Sent: Thursday, February 4, 2021 6:13 PM
To: 'matt@studio3architecture.com'
Subject: Dutch Bros. Coffee Permit Applications - 13769 SW Pacific Hwy
Attachments: Permit Applications.pdf; ELC_PermitApp_ELR_ERE_061715.pdf; MEC_PermitApp_
082520.pdf; PLMF_PermitApp.pdf; PLMU_PermitApp.pdf
Hi Matt,
After review of the Dutch Brothers permit applications, we will need you to revise the applications for the following
reasons:
• Mechanical Permit: Please revise the application to include the mechanical scope of work in the "Description of
Work" section.
• Electrical Permit: Plan review is only required if one of the plan review criteria is met from the Plan Review
section on the application. Please review the Plan Review section and revise the application to include the
applicable items in the fee schedule. If plan review is not required,the permit can be created online by the
electrical contractor through our website: https://aca.accela.com/TIGARD/Welcome.aspx. If the contractor has
not worked in Tigard previously,we will need to add their licenses to our database before a permit can be
created online.
---- , • Plumbing Permit(s): Site Utilities and Building Fixtures Plumbing Permit Applications combined the same scope
of work on both applications. We will need you to revise the applications and separate the scope of work for
each Plumbing Permit Application. Also, please enter the correct scope of work in the "Description of Work"
section.
Please let me know if you have questions.
Thank you,
Branden Taggart
IIIn City of Tigard
is . Senior Permit Technician
Community Development
MARI)
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandentc tigard-or,gov
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