Permit CITY OF TIGARD MECHANICAL PERMIT
ti
• IS COMMUNITY DEVELOPMENT Permit#: MEC2016-00412
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/14/2016
Parcel: 2S106DB23700
Jurisdiction: Tigard
Site address: 17390 SW SABRINA AVE
Project: River Terrace Northwest Swim Center Subdivision: RIVER TERRACE NORTHWEST Lot: X
Project Description: Mechanical for swim center.
Contractor: APEX AIR LLC Owner: ADLV LAND HOLDINGS LLC
2210 W MAIN ST STE 107-272 BY FORSUM, MICHAEL
BATTLEGROUND,WA 98604 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 360-342-8109 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 07/14/2016 $652.51
Class of Work: NEW Type of Const: Plan Review 07/14/2016 $163.13
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 07/14/2016 $78.30
Stories: Info Process/Archiving-Sm$0.50(up to 07/14/2016 $2.00
11x17)
Project Valuation: $22,000.00
Fuel Air Handlers
Fuel Types: 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:
Appliances
Vent Fans: 2 Vent Systems: Total $895.94
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 2
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: 7 (9P/66../61--770
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit APPliCatREC EIVED
FOR OFFICE 1 SE O\L\
City of Tigard n' Received / p / ..• Permit No. �j
I�!
Date/By: CO l /0 4. ? /767: /6 --�0 99.CJ
;P - ■ 13125 SW Hall Blvd.,Tigard,OR 97223 ► 2016 i
Plan Re• •
Phone: 503.718 2439 Fax: 503.598.1960 Date/BY .° ( h I I. other Perm a/a, 0( —4,03,5'.6
T I G A R D Inspection Lina 50 L639.4175 'IIDate Rea Juris: ® See Page 2 for
Internet: www ti and-or. ov
g gBUILDING olvIc"ON
Notified/Method:-2 ty/f or.. Supplemental Information
. - GR., .'-. .s r,__..., _. .,
� ° Mechanical permit fees*are based on the value of the work
®New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
1-,. Value:$ D 0
0 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder ❑Other: Description Qty. Ea. Total
i', Ito k ' Heating/cooling:
itioning 46.75 1
Job site address:"1739000 SW Sabrina Ave Furnaced100,0 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: l Project name:Northwest River Terrace Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
Swim Center 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:Northwest River Terrrace I Lot no.:TR X
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
1 ,'''''44.'' '''':1i i e e k Gas fireplace/insert 33.39
CC,�� �+ ccFlue vent for water heater or gas
C t1 t C Cd E9(A\p rn� - -COY SUO\ fireplace 23.32
ry ��r Log lighter(gas) 23.32
lX Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
i � i-.4;14,%,;&ki Other:
v. < igra . 1 _ . ,� „_ �., , _
..... Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
a a ' t s,t Other: 23.32
Fuel piping:
Business name:William Lyon Homes,Inc. $14.15 for first four;$4.03 for each additional
Contact name:Angela Grajewski Furnace,etc. 1
Address:109 East 13th Street Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
- i e ' as, Clothes dryer(gas)
Business name:Apex Air LLC Other:
tee., t a
Address:18004 NE 72°d Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Ajj)i.
days after it has been accepted as complete.
Authorized signature: (/ * Fee methodology set by Tri-County Building Industry Service Board
Print name: A ,Gra\g u� ��
Date: 4 7 ( t,
I:\Building\Permits\M EC_PermitApp_04011 c 440 ITT( /02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17390 SW SABRINAAVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Commercial - Mechanical MEC2016-00412
Inspection Type: Inspector:
699 Mechanical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor