Permit (64) 71 r,, CITY OF TIGARD MECHANICAL PERMIT
l COMMUNITY DEVELOPMENT
Permit#: MEC2016-00680
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2016
Parcel: 2S 106DC 11800
Jurisdiction: Tigard
Site address: 17302 SW JEAN LOUISE RD
Project: Polygon at West River Terrace,Lot 118 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 118
Project Description: Installation of A/C unit. Placement must meet manufacturers installation requirements.
Contractor: APEX AIR LLC Owner: ADLV LAND HOLDINGS LLC
2210 W MAIN ST STE 107-272 7600 EAST DOUBLETREE RANCH RD, STE
BATTLEGROUND,WA 98604 SCOTTSDALE,AZ 85258
PHONE: 360-342-8109 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 09/26/2016 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/26/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/26/2016 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
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 OUNNC�b�y calling 503.232.1987 or 1.800.332.2344.
Issued By: /f l / 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 on the job site at the time of each inspection.
m
rt-ri ri 1-111 VI
Mechanical Permit Anplicat 11 O to, ,,,,,till .){ I 1 ,1 i i\t
SI City of Tigard
13I25 SW Hail Blvd.,Tigard,OR 97223 � ; /-24// ill"' »14(' /`�EC ?/([,v..ti`4?�P
Phone: 503.71g:2439 Fax: 503.590,1960 SEP 2 6 2016 eview
Inspection Line: 503.639.4175
Dee Internet: www.tigard-or.gov CITY(C*' 1'1(3. ,
Supplemental leformation
ia ,� '. : ! a .,;iia 6*+ ' .
Mechattirat pertnit i are based wo the woe ofdte word a y
Lt N a construction 0 Addition/alteration/replacement
Q Demolition i ce.Indicate the value(rounded to the nearest dollar)of all
t�ti rnechantcal materials,+ `spent,la x r overhead and ftt
Value S
m�, ' ,, • • r$3 � I- ---r., .r,
❑ 1 and 2-family dwelling 0 Commercialfindustrial 0 Accessory building '
FM'a ce r r n, rt r trc tt 6
0 Multi-family 0 Master builder 0 Other: Description
1 lam, 1 Total
_ .fie `;� t"S ‘ ::,e':,- o-#,• <. .gym �. FB Hea�o�'fi
CN
Job-site s: 17302 SLA c ea' I,cL e �f���,) Fur ace i00 00 1 46.75 �.
1`�V (5►� Furnace Itl(l.t BTU{al�cas�entsl 1F+.75 `-
City/State/ZIP:Tigard,OR 97224 Furry ICltt.0 +Ij`l U(d rct vents} 54. 1 Q
Suite/bldg./apt.no:: Project name: ,� (Nat-rQ
PO�11.g WW 1 G t :hoar m .ft6
33 3.3"2
Cross street/directions to job site: I lydronic hot water system 23.32
Residential boiler(radiator or
h)dronict 23.32
Unit heaters tfuekype,not electric),
in-wall,in-ducts suspended,etc 46.75
Fluelvent for any of above 23,32
Subdivision: �,l— Ides ,/1 � ,O,
Other
I o tqq o. A Wes f WYV T�.r A.cp tot nu:I(e 2332
'Fax m aplpareel no.:
Dow fpri appllaa€cs
Water heater 23.32
�� �' ��, �"��� � � . , , � � `` Gas iiielildcviiiisal 33;39
, /, J 1 l Flue vent(orwaterheaterar OS
fireplace 23.32
Log lighter(east 23.32
Wood/pello stove 33.39
Wood fireplacelinscrt 23.32
h 23,32
x � t{ rbi .� �_ .. � LN23.32
in�rftlue;t€errt
Name: Environmental exhaust and ventilation:
Polygon 4i'LU,1 Range hood/otherkitchen
Address' 109East 13#e Street equipment 33.39 `
Clothes dr)erexhaust 33.39
City/State/ZIP:Vancouver,WA 9 Single-duct exhaust(bathrooms,
Phone;13611 95-771Fq Fax: toilet com rtrnents,utility=moms) 23 32
�,, � � Attic,'erasv)spa fans 23.32
.�. ,. •• � ' ...: ,�t � 4
Other 23.32
Business name:Polygon W1.0,1,1,C Fuel plain:
SttiS fur first than 54.03 for twit additional
Conti name:Angela>rr tjewskt Furnace,etc.
Address: 109 East 13th Street has heat Pump
Wall/suspendedfun t
City tate/ZIP Vancouver,WA heater
90660
Water heater
Phone.(360)69S-7700I Fax::(360)693- 2 I i
-t tttail:Air clat. t�tjRanee
ewskl5tpuligunho rsxont
Biobeeile
. .� ,A. ,<�; Clothes dncr its)
13s ss name: Air L1 C Other.
us»t
Address:18004NE72"Ave ;
Subtotal
City/State/ZIP:Vancouver,WA Minimum permit fee($90.00)
than review(25%of permit fee)
Phone:(36013424109 Fax:(360)326-1769
State surcharge(12%or permit fee)
FEE
CCI3 lie.:203034 TOTAL PERMIT
This permit applicationespir ifepermitis.atabtainedssitni,tit
Authorized signature: days atter it baa bora accepted as eo nplet r
Fee rouse setTri-C otam}'Beddii India mice.Beard
Prim nate: t/s. ./ Date: 4.1'1 €L• jr
i Bw$4aag't +sit%v..'4i[,L':";Petr$ra.i +0104$3.q 44$$$$$$$T$$i 9 ca4L'a• mtanp /II (.,--. f// 7
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
17302 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00680
David Young
Violation Summary:
Inspector Contractor