Permit n CITY OF TIGARD MECHANICAL PERMIT
I ' COMMUNITY DEVELOPMENT Permit#: MEC2016-00218
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/29/2016
Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-5
Project: Willoughby Hearing Aid Center Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: Modification of ducts and grilles for new tenant
Contractor: BRAWN MECHANICAL CORP Owner: ROIC OREGON LLC
PO BOX 1746 ATTN: SCHOEBEL, RICHARD
CLACKAMAS, OR 97015 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 503-631-8040 PHONE:
FAX: 503-631-8240
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/29/2016 $130.46
Class of Work: ALT Type of Const: Plan Review 03/29/2016 $32.62
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 03/29/2016 $15.66
Stories: Info Process/Archiving-Sm$0.50(up to 03/29/2016 $0.50
11x17)
Project Valuation: $2,500.00
Fuel Air Handlers
Fuel Types: 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 $179.24
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Util otification .-nter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o direct questions to O. •y ..fling 503.232.1987 or 1.800.332.2344.
sued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required en the job site at the time of each inspection.
Mechanical Permit Application FOR 0111("1: 1 SI.01v1.1
City of Tigard RECEIVE ID eceived
Date/By: M Permit No.: Hee, ,//_ r g
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review ((OO t.ei-
• Phone: 503.718.2439 Fax: 503.598.1960 MAR 2 9 2016 Other Permit:
Inspection Line: 503.639.4175 Date/By:
1 I c. �I�l) Date Ready By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGAR' otitied/Method: Supplemental Information
BUILDING DIVISI: ,
,vvlm. ,,., ... ..,< , , 1*E O.F oAii" . 3 ti 4 e71' • ikfI,,Pf pr fft, .'. N. ,it? ! t.
Mechanical permit fees*are based on the value of the work
0 New construction Addition/alteration/replacement perfonned.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
•
Value:$ 2. --�C..'7 �'"
CAT GbRY of coi4s auCTION
❑ 1-and 2-family dwelling ,Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description j Qty. 1 Ea. 1 Total
io y c y�r Heating/cooling:
-:. a 1 ". �.��� 1��� '�A1.7.V 1</V1rA���?I1., .w � m
Air conditioning 46.75
Job site address: /5660 .„6-5.4.,,,,,6,,„... yw
Furnace 100,000 BTU(ductsivents) 46.75
City/State/ZIP: 77 410 o,Q 9a Furnace 100,000+BTU(ducts vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Q.,..1;.--. f Project name: ( ( 23.32
D G�q Duct work
Cross street/directions to job site: Q 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
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
-- ---DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
ti c,97 . Sv J7C y ,NO # ri J 'Oh(' fireplace 23.32
40/Fr 5g/'5 / /S lC� Ott/ 6x/_5T.ve 17Ta . Log lighter(gas) 23.32
��✓✓ /S Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
0 TROPERTY,OWNER• , Environmental exhaust and ventilation:
Name: IJ 1 LLO i es, 0 B �j i_EA Q� #A/61 4/6
/� CeA/TE/ Range hood/other kitchen
Address: / equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/c awlspace fans 23.32
CANT ONTACT PERSON Other: 23.32
Business name: Q /� ` t _ ,'^ �t A Fuel piping:
Y-+QrijN m�TTr-7A) 1 C*1�- uQ?�%2r7�1 0 $14.15 for first four;$4.03 for each additional
Contact name: 8c Sc �J(�T G.. Furnace,etc.
t v to X /-.--4y w/ _ Gas heat pump
Address:
co-61s-
� Wall/suspended/unit heater
City/State/ZIP: CLAC AI MA S/ 0 Y`n c1 -6 Water heater
Phone:(q-4-1 ) 9 yb -115? Fax: :603 4,3/- 0 ac(0 Fireplace
E-mail: Range
Barbecue
0:1 - -w . - `,„,:spsk y1, NNTRAC R.-: .. -,."/�' ,�"/.�. • Clothes dryer(gas)
Business name:
it K/7/1J6-�xw je„1 e W,ep,,(2„,7,U, Other .
Address: pc) gp.1( 1 .40, Subtotal
City/State/ZIP: CC A ciIAPIA. 612 13J 5 Minimum permit fee($90.00)
/� / / Plan review(25%of permit fee)
Phone:(5173) 1,31 -8o g0 Fax:( 3 C93/- 8a c/O State surcharge(12%of permit fee) , lq2,/
CCB lic.: '1.-5-"VO'1.-5-"VO902 sj2c;'/1'7 ' l TOTAL PERMIT FEE /(. '/
permexpires if a pmit nw
Authorized signature: *This Fee methodology
it setapplication by Tri-County Buildingeris Industryotobtained Service BoardithinISO
days after it has been accepted as complete.
Print name:E"jJ G/171JG Date:3 II/41
I:Building Permits MEC PermitApp 040113.doc 440-4617T(11 02 COM WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Family Fee Schedule:
'1:04,1 n: -"PTO**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_PennitApp_0401 13.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15660 SW PACIFIC HWY A-5, TIGARD, OR,
97224
Commercial - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00218
Chip Barnett
Violation Summary:
Inspector Contractor