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Permit
CITY OF TIGARD MECHANICAL PERMIT o e 31. COMMUNITY DEVELOPMENTwoo! "'� Permit#: MEC2018-00532 -f a GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 � Date Issued: 09/10/2018 D Iry\� Parcel: 1 S 135DA02400 Jurisdiction: Tigard Site address: 11045 SW HALL BLVD Project: Brookside Memory Care Subdivision: METZGER ACRE TRACTS Lot: 7 Project Description: Mechanical for a new 16,327 square feet,32-bed residential care facility. 10/25/18:REPRINTED to correct address from 11035 to 11045. Contractor: V&A BUILDER LLC Owner: BROOKSIDE RCF LLC 16508 SE OATFIELD RD 5987 SE ROBHIL DR MILWAUKIE, OR 97267 MILWAUKIE, OR 97222 PHONE: 503-502-5924 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 09/10/2018 $1,312.91 Class of Work: NEW Type of Const: Plan Review 09/10/2018 $328.23 Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/10/2018 $157.55 Stories: Info Process/Archiving-Lg$2.00(over 09/10/2018 $4.00 11x17) Project Valuation: $48,000.00 Fuel Air Handlers Fuel Types: Electricity Units< 10000 cfm: Gas Pressure: Units> 10000 cfm: Furnaces Boilers&Compressors Furnaces<100K BTU: 2 0-3 HP: Furnaces>=100K BTU: 3-15 HP: Floor Fumaces: 15-30 HP: Unit Heaters: 30-50 HP: Vents w/o Appliances: 50 or Greater HP: Air Conditioning: Heat Pump: 12 Appliances Vent Fans: Vent Systems: Total $1,802.69 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: Cf\ ��i�, 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 MECHANICAL PERMIT 111, COMMUNITY DEVELOPMENT Permit#: MEC2018-00532 T[G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2018 Parcel: 15 135DA02400 Jurisdiction: Tigard Site address: 11035 SW HALL BLVD Project: Brookside Memory Care Subdivision: METZGER ACRE TRACTS Lot: 7 Project Description: Mechanical for a new 16,327 square feet,32-bed residential care facility. Contractor: V&A BUILDER LLC Owner: BROOKSIDE RCF LLC 16508 SE OATFIELD RD 5987 SE ROBHIL DR MILWAUKIE, OR 97267 MILWAUKIE, OR 97222 PHONE: 503-502-5924 PHONE: FAX: FEES Specifics: Description Date Amount Type of Use: COM Permit Fee 09/10/2018 $1,312.91 Class of Work: NEW Type of Const: Plan Review 09/10/2018 $328.23 Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 09/10/2018 $157.55 Stories: Info Process/Archiving-Lg$2.00(over 09/10/2018 $4.00 11x17) Project Valuation: $48,000.00 Fuel Air Handlers Fuel Types: Electricity Units<10000 cfm: Gas Pressure: Units>10000 cfm: Furnaces Boilers&Compressors Furnaces<100K BTU: 2 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: 12 Appliances Vent Fans: Vent Systems: Total $1,802.69 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: — 0. Permittee Signature: �.'al 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 Application F o►z ()HALL i SI. 0\1.1 Received City of Tigard ate/By: `7 j I q f PermitNo.: '�__,y,f-, 13125 SW Hall Blvd.,Tigard,OR 97223 fiw , , JJ J 'S/ , (�� ' ° � lanReview Phone: 503.718.2439 Fax: 503.598.1960 lw j Other Permit:f 7....l boa DateBY: LelI IJV T i G n iz D Inspection Line: 503.639.4175 Date Ready/By: Juris: See Page 2 for Internet: www.tigard-or.gov � 1 0 ZO10 Notified/Method:f, ` nric1.47.6.0 Supplemental Information I�-i(4� I UI 4ON "'X 1✓S�J✓Mechanical permit fees*are based on the value of the work ®New construction 0 Addltion/alteratioVO iriehi performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit. Value:$$48 00 ❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building For special information use checklist. ❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total ;< Heating/cooling:� > 1 LO( 1tk Air conditioning 46.75 Job site address:11035 SW HALL BLVD. Furnace 100,000 BTU(ducts/vents) 46.75 City/State/ZIP:Tigard Or.97223 Furnace 100,000+BTU(ducts/vents) 2 54.91 109.82 Heat pump 61.06 Suite/bldg./apt.no.: I Project name:Brookside Memory Care 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: l Lot no.: Other: 23.32 Other fuel appliances: Tax map/parcel no.: Water heater 3 23.32 69.96 �� 'N Gas fireplace/insert 2 33.39 66.78 °• ` - .,° ` ° ° ' ,'. Flue vent for water heater or gas Install 2 furnaces 120K btu with 5 ton AC fireplace 23.32 install 2 PSI Gas line Log lighter(gas) 23.32 Wood/pellet stove 33.39 Install 9 foot commercial Type"I"hood with exhaust fan and MUA Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 Other: 23.32 ,,,, 14.- LhE < ,,,,.,,,.':. ., •,2• " Environmental exhaust and ventilation: Name:Benjamin Damian Range hood/other kitchen equipment 4 33.39 133.56 Address: Clothes dryer exhaust 3 33.39 100.17 City/State/ZIP: Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 44 23.32 1026.0 Phone:(503)998-4872 Fax:( ) Attic/crawlspace fans 23.32 a C:OI' A ' Other: 23.32 Business name:V&A Builder LLC Fuel piping: $14.15 for first four;$4.03 for each additional Contact name:Vasile Handolescu Furnace,etc. 2 14.15 28.30 Address:16508 SE Oatfield Rd. Gas heat pump Wall/suspended/unit heater 1 4.03 4.03 City/State/ZIP:Milwaukie Or.97267 Water heater 3 4.03 12.09 Phone:(503)502-5924 Fax::(503)653-3970 Fireplace 2 14.15 28.30 Range 2 4.03 8.06 E-mail:v.a_builderllc@yahoo.com Barbecue 1 4.03 4.03 �� � Clothes dryer(gas) 3 4.03 12.09 Business name:V&A Builder LLC Other:Gas convection 2 4.03 8.06_ Address:16508 SE Oatfietd Rd. Subtotal 1608.3 City/State/ZIP:Milwaukie Or.97267 Minimum permit fee($90.00) Plan review(25%of permit fee) Phone:(503)502-5924 Fax:(503)653-3970 State surcharge(12%of permit fee) CCB lic.:169582 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: * Fee methodology set by Tri-County Building Industry Service Board Print name:Vasile Han escu Date:7/10/2018 I:\Building\Pevnits\MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB) FOR OFFICE USE ONLY—SITE ADDRESS: 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 11011s Transmittal Letter 1 A RI) 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov TO: /O7V. DATE RECEIVED: DEPT: BUILDING DIVISION FROM: �As , L 6- kt-1 lao C ( _ .. AL.7 3 0 0I COMPANY: 3W 1 Lip LL C.- PHONE: 5°1 5© a--- 9grArM RE: I(OZ5---- 3 CU '/k Bt-u_06 0000171;r)(5- 2_ (Site Address) (Permit Number) _8leooes,W /Yc/ma y C � (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 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: IIZ�ii f'S p -f ---r--e 4 L S �7 ®I rz.C 04-- ,S FOR OFFICE USE ONLY Routed to Permit Technician: Date: q-S 1 Initials: Fees Due: ❑ Yes N No Fee Description: Amount Due: Special Instructions: Reprint Permit(per PE): ❑ Yes Xj No ❑ Done Applicant Notified: /V) Date: 1/u ft 5c. Initials: /°-7: avxyv sl it ( i4•{ ✓s,c) ua -Rn1dv`ij'' I:\BuildinForms\Transnlettci s_ 36 FOR OFFICE USE ONLY—SITE ADDRESS: 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 41 1111111 _ Transmittal Letter i ,c,A R n 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov I TO: /0 . DATE RECEIVED: DEPT: BUILDING DIVISION RECAVED fAUG 9 2018 FROM: VAS Le' pi-MDOLtc-s .( CITY OP .1 AAD COMPANY: kic A s cif (Lc&---(2._ LL, C. BUILDING DIVISION PHONE: Cc ° I cb Z 5,..2_ /..2_ 4 B# RE: f I 0 3i SW WAY—L- 8 L.V,a /41"(720/t3-aZ (Site Address) (Permit Number) b A0f<__s ('‘.&-- 1"te.I4'I'orz) CA-2e (Project name or subdivision name and lot number) ATTACHED ARE THE FOLLOWING ITEMS: Copies: Description: Copies: Description: 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): j REMARKS: &-� E 4;,-.1) "V1+C e-e/� l L �4 04-) oA, .s� c 4 e.(" r M 'i/,(---/cP c`c 4--C__ yn Lel*to itit r"L?1 - i FOR OFFICE USE ONLY Routed to Permit Technician: Date: 1;Ci 6 ` I Initials: -", Fees Due: NYes 1=1 No Fee Description: / Amount Du . $ )). Special Instructions: Reprint Permit(per PE): ❑ Yes ❑No ❑ Done Applicant Notified: lid Date: 'rho l r Initials:4=7, Of .rra/ t -61/1 (e..44,04' ti.l, z.e_.) .....,) I:\Building\Forms\Transmitta tter-Revisions_061316. c City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11045 SW HALL BLVD, TIGARD, OR, 97223 June 18, 2019 at 9:00:00 AM Record Type: Record ID: Commercial - Mechanical MEC2018-00532 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS - NoCofO Comments: Type one hood under separate permit will inspect at later date Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11045 SW HALL BLVD, TIGARD, OR, 97223 June 18, 2019 at 9:00:00 AM Record Type: Record ID: Commercial - Mechanical MEC2018-00532 Inspection Type: Inspector: 699 Mechanical final Chip Barnett Result: PASS - NoCofO Comments: Type one hood under separate permit will inspect at later date Violation Summary: Inspector Contractor