Permit R EVISE D
CITY OF TIGARD 1 MEC HANICAL PERMIT
1111
C COMMUNITY DEVELOPMENT Permit #: MEC2011 -00563
T t G AR. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/11/2012
Parcel: 1S136DB00201
Jurisdiction: Tigard
Site address: 11565 SW PACIFIC HWY
Project: Fred Meyer Subdivision: 2000 -025 PARTITION PLAT Lot: 2
Project Description: Mechanical work associated with expansion and remodel 6/20/12, reprint to add (4) Type I hoods
Contractor: SD DEACON CORP OF OREGON Owner: FRED MEYER INC
901 NE GLISAN ST SUITE 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 06/11/2012 $21,725.95
Class of Work: ADD Type of Const: VB Plan Review 06/11/2012 $5,431.49
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 06/11/2012 $2,607.11
Stories: 1 Additional Plan Review 06/11/2012 $90.00
Project Valuation: $322,378.00
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: 5 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 1
Heat Pump:
Appliances
Vent Fans: 15 Vent Systems: Total $29,854.55
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 30 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
or direct
C
^
orista
OUNC b ailing 503.232.1987 or 1.800.332.2344. a. Issued B \ Permittee Signatur� \ 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.
CITY OF TIGARD OFFICE COPY MECHANICAL PERMIT
Permit #: MEC2011 -00563
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/11/2012
Parcel: 1 S136DB00201
Jurisdiction: Tigard
Site address: 11565 SW PACIFIC HWY
Project: Fred Meyer Subdivision: 2000 -025 PARTITION PLAT Lot: 2
Project Description: Mechanical work associated with expansion and remodel
Contractor: SD DEACON CORP OF OREGON Owner: FRED MEYER INC
901 NE GLISAN ST SUITE 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 06/11/2012 9 /A277 $5"
Class of Work: ADD Type of Const: VB Plan Review 06/11/2012 J1, $5,434-.-49
Occupancy Grp: M Occupancy Load: 12% State Surcharge - Mechanical 06/11/2012 if ora.33 $7,�TT
6-1
Stories: 1 Additional Plan Review 06/11/2012 �
ro i c $90'Q
Project Valuation: $322,378.00
Fuel Air Handlers ,4 Z 4 7 E2 72t CZ
Fuel Types: Natural Gas Units < 10000 cfm: /=d,L. 4E7�Gc
Gas Pressure: Units > 10000 cfm: J/h et en/ .
Furnaces Boilers & Compressors •
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 5 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 1
Heat Pump: q/
Appliances
Vent Fans: 15 Vent Systems: Total
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: 30 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
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / "N. A - Permittee Signature: OA/ /0L, / e.ey- -/ /UA/
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.
Mechanical Permit Aptilication RE') cEg r �-1 � FOR O USE
FFICE ONL Y
s W +-e� Received
City of Tigard Date/B : (;/7 4 10. permitl,o.
//
n 13125 SW Hall Blvd. Tigard, OR 97223 Plan Res Review
Phone: 503.718.2439 Fax: 503.598.1960, JUN 07 2012 Date/By:
Other Permit,
TIGARD Inspection Line: 503.639.4175 Date Ready/By: tats I Id See Page 2for
Internet: www.tigard- or.gov pp CITY OFTIGARD Notified/Method: r l / � �I I Supplementallnfonnation
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE' SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction la Add ti on/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit ,
value: 3a. 312
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
❑ 1- and2- family dwelling ® Commercial /industrial ❑ Accessory building For special ir{fort:w oausechecklst
❑ Multi- family ❑ Master builder ❑ Other. Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling
Air conditioning
Job site address: 11565 SW Pacific Highway (requires site plan showing placement) 46.75
City/State/ZlP: Tigard, OR, 97223 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+. BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: I Project name: FM #375 Tigard Heat pump •
(requires ate plan showingplacement) 61.06
Cross street/directions to job site: .SW 71' Ave Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electiic),
Add New Unit Heaters, Add New Fan Coil Units and Condensing Units. in -wall, in -duct, suspended, etc 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other: _ 23.32 _
Tax map/parcel no.: 11S136DB, Tax Lot 201 Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Demo and Replace eleven Rooftop Units; Add three Rooftop Units, Demo fifteen Flue vent for water heater or gas
Enitaust fans, Replace and Add New Exhaust fans. Demo and Replace Kitchen hoods, fireplace 23.32
Log lighter (gas) 23.32
Add New Unit Heaters, Add New, Fan Coil Units and Condensing Units. 'Wood /pellet stove , 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER I ❑ TENANT Chimney /lined lue/velt 23:32
Other: 23.32 _
Name: Fred Meyer Stores Environmental exhaust and-ventilation:
Address: 3800 SE 22nd Ave Range hoodlotherkitchet
equipment, . 33.39
City/State/ZIP: Portland, OR, 97202 Clothes dryer exhaust •33.39
Single -duct exhaust (bathrooms,
Phone: (503)232 -8844 Fax:.(503)797 -3509 toilet compartments, utility rooms) 23.32
' ❑ APPLICANT - ® CONTACT PERSON Attidcrawlspace fans 23:32
•
Business name: Mulvauty,G2 Architecture Other: 23.32
Fuel plptnz
Contact name: Amy Sdteclda -Cox $14.15 for first four; $4.03 for each a_ dditional
Address: 601 SW Second Ave Furnace, do.
Gas heat pump
City/State/ZIP: Portland Or, 97202 Wall /suspended/unit heater
Phone: (971) 998 -1443 I Fax:: (503) 223 -8331 . Water heater
Fireplace
E- mail: ,anysdhedda -cox@ tulvannyg2.com Range . .
CONTRACTOR - 'Barbecue
Business name:- SD Deacon Clothes dryer (gas)
Other:
•Address: 901 NE Glisan Street, Suite 100 MECHANICAL PERMIT FEES'
City/State/ZZIP::.Portlatd, OR 97232-, Subtotal
Min imumpermit fee ($90.00)
Phone: (503) 297 -3791 I Fax: (503) 297 -8997 Plan review (25% of permit fee)
CCB lic.: ro lea a, eP . State surcharge (12%.o£ permit fee)
�/ TOTAL PERMIT FEE
Authonzedsi natur i��� " This permit application (spires 'lap omit is not obtained within ISO
g days after It hasbeui accepted as complote.
I -Print name: William Mercer I Date: 6/5/12 I • Fee methodology set by Tri- County Building industry Service Board
LIBuCdnglPennuslMEC- Pe rmitAppdoc 09)09/10 440- 4617r,(1.1N21COM/WEB)
FOR OFFICE USE ONLY — SITE ADDRESS: //6 SA) R9 e /`l C jcJJ
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 R n. 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
ED
MAY 31 2012
FROM: Dustin Clauser CITY OFTIGARD
COMPANY: S.D. Deacon Corps. of Oregon BUILDING DIVISION
PHONE: 503 -504 -5957 B 411
RE: 11565 SW Pacific Hwy MEC201100563
(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: RTU Curb Seismic Restraint Calculations
FOR OFFICE USE ONLY
Routed to Permit hnician: Date: 6 3 1 ( ( P2._- Initials:
Fees Due: es ❑ No Fee Description: Amount Due:
1 A r 0 $ .00
$
$
$
Special
Instructions:
Reprint Permit (per PE): ❑ Yes ❑ No ' ❑ Done
Applicant Notified: Date: Initials:
•
1:\ Building\Forms \TransmittalLetter- Revisions.doc 05/25/2012
- ii PO— ge /ri
Mechanical Permit Applicat' FOR OFFICE USE ONLY �'/
Received City of Tigard DECEIVED Date/By:. / & // / Pe rmit No.: MEc
^ / /�O �j
-
II
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 4 (/KJ ��
✓
Phone: 503.718.2439 Fax: 503.598.1960D E C 2 2011 Date/By: 411.# I 3\2. ,1`J er Permin? -74 a0 // OM /3
Inspection Line: 503.639.4175 Date Read /B t� ris:
TIGARD Ready /By. la See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: SW Supplemental Information
i IJ
• • 11 ; _ a _ _ • t.. " W flL && _ K
TYPE OF r IRK COMMERCIAL FEE* 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ 754,638
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 11565 SW Pacific Highway (requires site plan showing placement) 46.75
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: FM #375 Tigard / 504 - A nr - E� Heat pump
� — (requires site plan showing placement) 61.06
Cross street/directions to job site: SW 71" Ave T.r Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
Add New Unit Heaters, Add New Fan Coil Units and Condensing Units. in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: 1S136DB, Tax Lot 201 Other fuel appliances: •
DESCRIPTION OF WORK Water heater 23.32
Demo and Replace eleven Rooftop Units, Add three new Rooftop Units, Demo fifteen Gas fireplace 33.39
Flue vent for water heater or gas
Exhaust fans, Replace and Add New Exhaust fans. Demo and Replace Kitchen hoods, fireplace 23.32
Log lighter (gas) 23.32 .
Add New Unit Heaters, Add New Fan Coil Units and Condensing Units. Wood/pellet stove 33.39
Wood fireplace /insert 23.32
® PROPERTY OWNER I ❑ TENANT Chimney/liner /flue /vent 23.32
Other: 23.32
Name: Fred Meyer Stores Environmental exhaust and ventilation:
Address: 3800 SE 22nd Ave Range hood/other kitchen
equipment 33.39
City /State /ZIP: Portland, OR, 97202 Clothes dryer exhaust 33.39
Fax: 503 797 -3509 Single -duct exhaust (bathrooms,
Phone:
(503)232-8844 ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Mulvanny G2 Architecture Other: 23.32
Fuel piping:
Contact name: Amy Scheckla -Cox S14.15 for first four; 54.03 for each additional
Address: 601 SW Second Ave Furnace, etc.
Gas heat pump
City /State /ZIP: Portland Or, 97202 Wall /suspended/unit heater
Phone: (971) 998 -1443 Fax: : (503) 223 -8381 Water heater
Fireplace
E -mail: amy.scheckla- cox @mulvannyg2.com Range
CONTRACTOR Barbecue
Business name: i)f, N f AF / C / J� Clothes dryer (gas)
I I t/ Other:
Address: '730 (0 tJ 3 ? =` 0I- MECHANICAL PERMIT FEES*
Cit /State /ZIP: J
� p,�. nn //'' ,, Subtotal
y �� D �M. y �IJU� wg � Minimum permit fee ($90.00)
Phone: ) O -+39 Fax: ( ) 3a4. -g5--b(' Plan review (25% of permit fee)
CCB lic.: /6,5 7 State surcharge (12 %ofpermit fee)
a " TOTAL PERMIT FEE
Authorized signature: 4------- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 4.l.w• ■•• 1 1/4l • 6 - 1 AgL Date: I 1 - 3 J - `) • Fee methodology set by Tri- County Building Industry Service Board
1: \Building \Permits \MEC- PermitApp,doc 09/09/10 440 -4617T (11 /02/COM/WEB)
FOR OFFICE USE ONLY — SITE ADDRESS: 1/56 & Pict &cer
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
1 2 Transmittal Letter
FlG A -Ft n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: Mark VanDomelen DATE RECEIVED:
DEPT: BUILDING DIVISION RECEIVED
JUN 20 2012
FROM: Dustin Clauser
CITY OF TIGARD
COMPANY: S.D. Deacon Corp. of Oregon BUILDING DIVISIO
PHONE: 503 -504 -5957
RE: 11565 SW Pacific Hwy MEC2011 -00563
(Site Address) (Permit Number)
Fred Meyer #375
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: I Description: Copies: Description:
2 Additional set(s) of plans. Revisions:
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: Commerical Kitchen Hood Mechanical Review
FOR 1OFFIFE USE ONLY
-: to Pe it a 'cian: Date: 6/21 I Z Initials
ees Due: es ❑ No Fee Description:
Special
Instructions:
Reprint Permit (per PE): Yes ❑ No El Do
Applicant Notified: • .V644 __,A b. Q , Initials
I:\Building\ Forms \TransmittalLetter - Revisions.doc 05/25/2012
• •
•
. -. •
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 $5000.00 $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
$181 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 addition $100.00 or
fraction there; to and including
' — $50,000.00.
• -$50,000.01 to $loo,coo.00 $1,363:71 for the first $50,000.00 and
' . $149, for each additional $100 or
=
= fraction thereof, to and including . •
' .= $100,000.00: •
$100,000.01 and tip, $2,608.71 'for the first $100,000.00 and
•. $2.92 foreacti 'additional $100.00 or
fraction thereof. • •
, .
, .
Note: All new COmmercial,bnildings require 2 sets of plans.
• _
•
•
•
c ,
1:\BuildingWermits\MEC-PennitAmidoc 09/09/10 2
05/0312012 15:43 Grey Wolf (FA)03603262506 P.0011004
Grey Welt II4VAC INC.
7306 NE 37"' Ave, Vancouver, WA 98665
E - mail: nancyw@greywolfhvac.com
Office: 360 -635 -6117
Fax: 360- 326 -8506
rt°111 c
Fax - 76'q
To: City of Tigard Bldg. Dept. Attn: Debbie From: Nancy Wilde, Office Manager
Fa= 503 - 598-1960 Pages: 4 pages including cover
Phone: Date: 5/3/2012
Re: Permit Application CC:
•
❑ Urgent ❑ For Review ❑ Please Comment 0 Please Reply O Please Recycle
• Comments
• 05/03/2012 15:44 Grey Wolf TAX) .1603268506 D En �00 0
•
j� Gl, �J J!J
MAY -3 2012
Pymt Aut : CITY OF TIGARD
Standard Form Subcontract Agreement BUILDING DIVISION
Subcontract #: 17503
Code #: 4184- 15500.S
•
• THIS AGREEMENT, made this April 10, 2012, by and between Grey Wolf HVAC Inc., hereinafter called
"Subcontractor ", and S.D. Deacon Corp. of Oregon, hereinafter called "Contractor", who state and agree as
follows:
Subcontractor agrees to perform all work set forth herein in the construction of Fred Meyer - Tigard for Fred
Meyer Stores, Inc and Ohio Corporation hereinaftercalled "Owner", at 11565 SW Pacific Hwy, Tigard, OR
97223 in accordance with the terms and provisions of this Subcontract, the contract between Owner and
Contractor, dated March 22, 2012 including all the General and Special Conditions, Drawings and Specifications
and other Documents, including those listed on Exhibit D, forming, or by reference made a part of the General
Contract all of which shall be herein referred to as the "Contract Documents" and which are incorporated into this
• Subcontract by reference, and Subcontractor agrees to be bound to Contractor and Owner by the terms and
provisions thereof.
It is agreed that the materials to be furnished and/or work to be done by Subcontractor is generally described on
the enclosed ExhibitA and includes all work necessary or incidental thereto, hereinafter called the "Work".
It is agreed that Contractor shall pay Subcontractor the sum of One Hundred Seve Nin Thousand ht
Hundred Ninety Eisrht and 00 /100 Dollars ($179,898.001 for the full, complete and prompt performance of the
Work contemplated hereby and in full compliance with the Contract Documents as well as the attached Exhibits.
The Exhibits listed below are incorporated by this reference as though fully set forth herein.
Exhibit "A" Scope
Exhibit "B" Standard Form Subcontract Agreement Terms and Conditions (OR 0895)
Exhibit "C" Insurance Requirements •
Exhibit "D" List of Documents .
Exhibit "E" Subcontractor Safety Requirements
Exhibit "F" Indemnification Addendum
Exhibit "G" Subcontractor's Disclosure Consent
All of the documents listed are made a part of this Subcontract, and Subcontractor is responsible for their
contents whether or not it has received or reviewed a copy of each document. All documents listed are available
at Contractors office for review and copies of documents are available upon written request.
CONTRACTORS ARE REQUIRED BY LAW TO BE LICENSED AND REGULATED BY THE CONTRACTOR'S STATE LICENSE
BOARD. ANY QUESTIONS CONCERNING A CONTRACTOR MAY BE REFERRED TO THE REGISTRAR, TELEPHONE
NUMBER (503) 378 -4621.
IN WITNESS WHEREOF, the parties hereto have executed this Subcontract Agreement by their proper
officers or duly authorized agents.
S.D. Deacon Corp. of Oregon Grey Wolf•HVAC Inc.
• By: By u �w�c
Bradford . Howe, Executive Vice Pres' enk Name/Title Ukto �3
•
Address: 901 NE Glisan Street, Suite 10L Address: 7306 NE 37th Avenue
Portland, OR 97232 Vancouver, WA 98665
Phone: 503 - 297-8791 • Phone: 360 -588 -3207