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Permit CITY OF TIGARD BUILDING PERMIT COMMUNITY DEVELOPMENT Permit#: BUP2011 -00257 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/04/2012 Parcel: 1 S136DB00201 Jurisdiction: Tigard Site address: 11565 SW PACIFIC HWY • Project: Fred Meyer Subdivision: 2000 -025 PARTITION PLAT Lot: 2 Project Description: Expansion and remodel Contractor: SD DEACON CORPORATION Owner: FRED MEYER INC 901 NE GLISAN ST #100 3800 SE 22ND AVE PORTLAND, OR 97232 PORTLAND, OR 97202 PHONE: 503 - 297 -8791 PHONE: 503 - 232 -8844 FAX: 503 - 297 -8997 FEES Specifics: Description Date Amount Type of Use: COM Permit Fee - Additions, Alterations, 04 /04/2012 $14,047.01 Class of Work: ADD Demolition Dwelling Units: 0 Plan Review 12/07/2011 $9,130.56 Stories: 0 Height: 0 ft Plan Review - Fire Life Safety 12/07/2011 $5,618.80 Bedrooms: 0 Bathrooms: 0 12% State Surcharge - Building 04/04 /2012 $1,685.64 Value: $3,353,330 DC Provision Review, COM TI - Ping 04/04/2012 $256.00 DC Provision Review, COM TI - LRP 04/04/2012 $38.00 Erosion Control 04 /04/2012 $832.00 Floor Areas: Erosion Plan Review CWS 04/04/2012 $270.40 Erosion Plan Review COT 04/04/2012 $270.40 Total Area: 4422 Metro Const. Excise Tax - Commercial 04/04/2012 $4,024.00 Accessory Struct: 0 Use Basement: 0 Info Process /Archiving - Lg $2.00 (over 04/04/2012 $400.00 Carport: 0 11x17) Covered Porch: 0 Info Process /Archiving - Sm $0.50 (up to 04/04/2012 $295.50 11x17) Deck: 0 Park - Commercial and Industrial 04/04/2012 $2,088.56 TDT - Transportation Development Tax 04/04/2012 $75,299.00 Garage: 0 Tig -Tual School CET - Non Residential 04 /04/2012 $2,387.88 Mezzanine: 911 Additional Plan Review 04 /04/2012 $200.00 . Total $116,843.75 Required: Required Items and Reports (Conditions) 1 Ersn Cntrl 681 -4444 Fire Sprinkler: Yes Parapet: 2 Special Inspection (see plans) Fire Alarm: Yes 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 Notificatior? 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 32.1987 or 1.800.332.2344. �■ ^ Issued By: � _ � / � Permittee igniture: /1/ U rI1 Call 503.6 :. • 75 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 proj Approved plans are required on the Job site at the time of each Inspection. Building Permit Application r`l ao/Fe4Ol3 Commercial RECEIVED FO12 OFFICE USE ONI.I Received i Permit No.: 1111 City of Tigard DEC 2 2011 Date/B : .A© �_ .4 .... P,./0 / 5? q 13125 SW Hall Blvd., Tigard, OR 97223 plan Review 1 i C Phone: 503.718.2439 Fax: 503.598.1 OF TlGAfi�D Date/B . MAO /NM l Other Permit: T I G A R D Inspection Line: 503.639.4175 �/ Date Ready /B'y: J ® See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION . Notified/Method: a S / fi Supplemental Information e- ,rv 1E4 1 I Moir o.4-- TYPE OF WORK REQUIRED DATA: 1- AND 2- FAMILY DWELLING ❑ New construction ® Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ® Addition /alteration/replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. dwelling Valuation: $ ❑ I- and 2-family g ®Co mmercial /industrial ❑ Accessory building ❑ Multi - family Number of bedrooms: ❑ Master builder ❑ Other: Number of bathrooms: JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: 11565 SW Pacific Highway New dwelling area: square feet City /State/ZIP: Tigard, OR 97223 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: Fred Meyer Store # 00375 Covered porch area: square feet Cross street /directions to job site: Deck area: square feet Intersection of SW 71 Avenue and SW Pacific Highway Other structure area: square feet REQUIRED DATA: COMMERCIAL -USE CHECKLIST Subdivision: Lot no.: 3400 Permit fees* are based on the value of the work performed. Tax map /parcel no.: 1S136AC &1S136DB Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and ofit for the work indicated on this application j ' , - - DESCRIPTION OF WORK PP , . , f Renovation of the existing Fred Meyer facility includes: updating of interior, Valuation: _. i . new south entry addition, modification of the two east facing entries; Existing building area: 138kh square feet and small addition of apparel stockroom and loading docks at the NW corner. New building area: 142k* square feet ® PROPERTY OWNER ❑ TENANT Number of stories: 1 Name: Fred Meyer Stores Inc. (Bill Mercer, Kroger PM) Type of construction: VB • Address: 3800 SE 22od Avenue Occupancy groups: City /State/ZIP: Portland, OR 97202 Existing: Mercantile Phone: (503)797 -3296 Fax: (503)797 -3539 New: same ® APPLICANT ® CONTACT PERSON BUILDING PERMIT FEES* (Please refer to fee schedule) Business name: MulvannyG2 Architecture Structural plan review fee (or deposit): . Contact name: Amy Scheckla -Cox (MG2 Contact) FLS plan review fee (if applicable): Address: 601 SW 2 Avenue, Suite 1200 Total fees due upon application: City /State/ZIP: Portland, OR 97204 Phone: (971) 998 -1443 Fax: : (971) 217 -0114 Amount received: E -mail: amy.scheckla- cox @mulvannyG2.com PHOTOVOLTAIC SOLAR PANEL SYSTEM FEES* Commercial and residential prescriptive installation of CONTRACTOR roof -top mounted Photo Voltaic Solar Panel System. Business name: T Submit two (2) sets of roof plan with connection details S �' � and fire department access, along with the 2010 Oregon Address: - n ( __ (1,Sg c-/ #� !d° Solar Installation Specialty Code checklist. City /State/ZIP: Pc) rtt cQ C)� ( 701 Permit fee (includes plan review and administrative fees): $180.00 7 l f Phone: (Sod) 01,4'7 I Fax: (513 ) gam 7 State surcharge (12 %ofpermit fee): $21.60 3 CCB lic.: L i 3 Total fee due upon application: $201.60 Authorized signature: � '7q a,_/1/ (rte This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: William Mercer (Kroger PM) I Date: 11.30.11 • Fee methodology set by Tri -County Building Industry Service Board. I:\Building \Permits\BUP -COM PermitApp.doc 02/24/2011 440- 4613T( 1 1/02 /COM/WEB) • Building Division • :1 - i,„ a Accessibility: Barrier Removal Improvement Plan TIGARD REQUIREMENT: OREGON REVISED STATUTE (ORS) 447.241. (1) Every project for renovation, alteration or modification to affected buildings and related facilities shall be made to insure that the path of travel to the altered area and the restroom, telephones and drinking fountains are readily accessible to individuals with disabilities unless such alterations are disproportionate to the overall alterations in terms of cost and scope. (2) Alterations made to the path of travel to an altered area may be deemed disproportionate to the overall alteration when the cost exceeds twenty-five per -cent (25 %). VALUATION: Total of all renovation, alteration or modification being done, excluding painting and wallpapering [1] $ N/A MULTIPLIER (25% barrier removal requirement): x .25 TOTAL BUDGET FOR BARRIER REMOVAL: [2] $ N/A ELEMENTS: In choosing which accessible elements to provide under this section, priority shall be given to those elements that will provide the greatest access. Elements shall be provided in the following order. (a) Parking $ EXISTING • (b) An accessible entrance: $ EXISTING (c) An accessible route to the altered area: $ EXISTING (d) At least one accessible restroom for each sex or a single unisex restroom: $ EXISTING (e) Accessible telephones: $ EXISTING (f) Accessible drinking fountains: and, $ EXISTING (g) When possible, additional accessible elements such as storage and alarms: $ EXISTING TOTAL (shall equal line [2] of Valuation Computation): $ N/A • I: \Building \Permits \BUP -COM PctmitApp.doc 03/03/2011 • • • v • !PI Building Division Plan Submittal Requirements • T I G A R D Commercial & Multi - Family.- New, Additions or Alterations • 1. SITE PLAN (fully dimensional, drawn to scale) labeled with: A. ® map & tax lot # Z project name ® site address El suite number • ® zoning ® applicant name ® phone number B. North arrow. C. Scale (architectural or engineering only). D. Street names. E. Setbacks. F. Parking, including disabled access. • G. Finished floor elevations. 2. EROSION CONTROL PLANS AND DETAILS. 3. BUILDING PLANS: See the "Plan Submittal Requirement Matrix" for the number of plans required based on submittal type (no redlines or tape -ons accepted). • All details listed below shall be incorporated into the plans: A. Scale (architectural or engineering only). B. Foundation plan. C. Floor plan(s). D. Cross sections. E. Reflective ceiling plan. F. Seismic bracing detail for suspended ceiling. G. Roof plan. H. Exterior elevations. I. Structural calculations, plans, details and specifications. J. Accessibility barrier removal worksheet. K. Deposit - based on valuation of project. • 4. EXTRA SET OF THE FOLLOWING: A. Two (2) copies of site plan to include vicinity map. B. One (1) copy of erosion control plan with details. • C. Fire Department Building Survey, and full set of architecture drawings. • • I: \Building \Permits \BUY -COM PermitApp.doc 03/03/2011 • of Tigard _ 42/:) E; � �A CitI IIII y f g C ° TDT — COUNTYWIDE TRANSPORTATION DEVELOPMENT TAX ?IGAR • Rate Calculation Worksheet esr wreir „ nc , er..c...nri �. ...iree�— APPLICANT ) i / e `/ei j:T , S DATE / 2 f f MAILING ADDRESS / /SG S g{ , f .- p fritt/V PREPARED BY n�� CITY / ZIP / PHONE �NqR) ? 1/.2.3 PLANS CHEC>Re249//_ etzvr !S/ 3/o 4e,03 /� 0 y,./02_ P ROJECT TITLE TAX MAP # S! 3� o / /APO 4 - YE/e t / --/ /DAT SITUS # ADDRESS // 5 5 s A/ 7>,9-e, P/C- / l41 / FORMER USE(S) . ... • USE CODE UNITS X RATE _ DESCRIPTION /NOTES / X = f%/ S %7/J2- /ORE', Z x = % - E,791,r, Sv z/!/3e F” x = TOTAL TDT, FORMER USE(S) PROPOSED USES) F' �v /4.7j/k,(C % /y/4 -- ApP,c /44 W A( V0, — 4 /36/ 2_ USE ITE # TDT DESCRIPTION /NOTES # CODE UNITS X RATE = AMOUNT / y(D 4./4x 1 r2 = 75 ��2tf/32KE r f 7c� l rr a x = / Z e S O7 2e oa4 / Co L4,.? x = a TOTAL TDT, PROPOSED USE(S) 1 O Jf , 7 q • file LESS TOTAL TDT, FORMER USE(S) — TDT INCREASE/(DECREASE) / v (INCREASE = TDT DUE) PAYMENT METHOD .. 2--19k1( CASH /CHECK CREDIT aea442, v -Q k43-41. i ( s xCt& ;lige BANCROFT AGREEMENT 5 3 3 7OV = T• 10 6 E 3 (PROMISSORY NOTE) 6, A2,14/.1 z-- a, 088.5-4 DEFER TO OCCUPANCY 7, I /OFS /CD /FORMS/TDT Rate Calculation Worksheet.indd (Rev. 4/22/09) FOR OFFICE USE ONLY — SITE ADDRESS: //S ?' 5 td , & F 5'C NA)/ This form is recognized by most building departments in the Tri- County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT I llq = Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION RECEIVED MAY 31 2012 FROM: Dustin Clauser CM( OFTIGARD COMPANY: S.D. Deacon Corps. of Oregon BUILDING DIVISION PHONE: 503 -504 -5957 By:4 RE: 11565 SW Pacific Hwy BUP201100257 (Site Address) (Permit Number) FM -375 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: Additional set(s) of plans. Revisions: 2 Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. 2 Beam calculations. Engineer's calculations. Other (explain): REMARKS: Skylight Curb Seismic Restraint Calculations FOR QFF CE USE ONLY - Routed to Pe echnician: Date: � I I f � T ( Initials: c1 Fees Due: Nes ❑ No Fee Description: Amount Due: 'c�DL 4- M P-- _V1 $ 4 10.66 $ $ el/ ,, Special P rA I y Instructions: `� Reprint Permit (per PE): ❑ Yes I ❑ No ❑ Done • Applicant Notified: Date: Initials: I:\Building\ Forms \TransmittalLetter - Revisions.doc 05/25/2012 FOR OFFICE USE ONLY — SITE ADDRESS: //g6 � •=5'4.) mC '/5 /74 This form is recognized by most building departments in the Tri-County area for transmitting information. Please complete this form when submitting information for plan review responses and revisions. This form and the information it provides helps the review process and response to your project. City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT = " Transmittal Letter T I G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov TO: DATE RECEIVED: DEPT: BUILDING DIVISION NOISIAI(I �JNIQZIIIB OM AID FROM: Dustin Clauser Z j AbW COMPANY: S.D. Deacon Corps. of Oregon U3 ua3 PHONE: 503 -504 -5957 By / RE: 11565 SW Pacific Hwy BUP201100257 (Site Address) (Permit Number) FM -375 (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: I Description: Additional set(s) of plans. Revisions: 2 Cross section(s) and details. Wall bracing and/or lateral analysis. Floor /roof framing. Basement and retaining walls. Beam calculations. Engineer's calculations. Other (explain): REMARKS: Vertical Reciprocating Conveyor Lift FOR FFICE USE ONLY Gp Routed to Permit chnician: Date: l I I Z Initials:�� Fees Due: es ❑ No Fee Description: Amount Due: Z 'RAO E.01 $ ©, CC) $ $ Special /y r/J4 Instructions: W Reprint Permit (per PE): ❑ Yes ❑ No ❑ Done A _ Applicant Notified: Date: Initials: far 3 " l:\Building\ Forms \TransmittalLetter - Revisions.doc 05/25/2012