Permit (177) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENTIII
Permit#: MEC2016-00787
Date Issued: 11/17/2016
TIG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DB06100
Jurisdiction: Tigard
Site address: 15192 SW 154TH AVE
Project: Polygon at Bull Mountain,Lot 59 Subdivision: POLYGON AT BULL MOUNTAIN Lot: 59
Project Description: Installation of A/C. Unit must meet manufacturer's placement requirements.
Contractor: APEX AIR LLC Owner: NGUYEN, HUNG THANH
2210 W MAIN ST STE 107-272 BUI,TRINH THUY
BATTLEGROUND,WA 98604 15192 SW 154TH AVE
TIGARD, OR 97224
PHONE: 360-342-8109 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 11/17/2016 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 11/17/2016 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 11/17/2016 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ZeCt27 ,,/,..e.-- Permittee Signature: 94/ 'Z, l e 9-770A/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Perniit Applic, 'GEIVED FOR on IC F_I SE i")\IA
City of Tigard
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131SWHal „Tard, 3197223sEP 0 2016 DeNV,
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Plastic 501718.2439 Fax: 503.59111960Other PiairaMSTdek,<-410 z2 5-0
Ilimai4y: .
1.1"tt I) ln$Pe°tim 3°3'639'4175 CITY OF TIGARD DawRdB, bet* la&g.Pate 2 tor
Inerntet: www.tigard-er.nov
BUILDING DIVISION N'-'464-41"1.elhad: ...qapplementat Information
TYPE OF WORK. COMMERCIAL FEE SCHEDULE- ISE CHM<B-LiST
Mechanical pemth(c are based on the value of the work
.>al NCW COTIStrUCtiOli 0 Additionialterationireplacemem performed,Indicate the mine(rounded to the nearest dollar)of ali
El Demolition 1:1 Other mechanical rtraterials. - it-iment.Jabot,meth:end.and 3rotil
Volum S
CATEGORY OF CONSTRUCFION • • _ • --
RtSIDENTLAL EQUIPMENT/SYSTEmS FEES
0 i-and I-family dwelling 0 CoinmerciaVintinstrial 0 Aayssoly building For spedatinfrrmation use MerAtis4
Multi-family 0 Master builder 0 Other: I Dtwr intion ON. E4. Total
' 4 JOB SITE INFORMATION AND LOCATION . In- ...._...4
. Air-conditioning 1 . .75
Job ado address: 15192_ b\i\J is -ill', il-vf, '..- . . 11,111 '1"
CityiStatefZIP:Tigard,OR 97224 furnace 169.000+gni r3ictsh-ctaxi" 54_9 i
Heat pump 6 1.01i I
suite/W(12Am.no.: Project name:3'01nm at Roll Mustin
thict svork, 23.12 I
Cross strectidirectk=o to job site: ionic hot water stens 2332
Residential boiler(radiator or
hydronic) , , 2332
..........
Unit heaters t1bel-type...not ritectrie), '
in-wall imsittet„,suspended etc. 46 75
Flue/vent for ape of above .2332
Other: 2332
Subdivision.:Polygon at Ball Nivantain Lot no iP -
Other fad opplinator-.
i t.
Tux:mapipareei no,: Water heater
. - DE804101018 OF 1-YORK Gss thePlacelimert 3339 I
' Flue vent far water hearer or-Las
Corrtr tharlc ure.Taco 2332
, .....
A I Log lighter tans). 23.32
/ 0 - . - Woodipelict stove , 3339 1
Wood firmlaceiinsert 2332
• Chimam,
lmerfilue _
21,3_7
Other e2132OPERTOWER TEAT r-P
Faviroarnentol triroust and ventilation: -
Name:Puiygon Wiitli LLC i ' Ranee hood;other kitchen1
--- ..
et mem I 3334. i
Address:409 Kis/le stftot
mif.,,,,,diver exhaust 33 39 i
rity/SlateZEP:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
_ . - 1 toilet,eumpantocuts utility rooms) 23 32 I
Phone:(38098-7700 Fax:( I Atire'crawlspace fans 2132 i
—,
.0 CONTACT PERSON Giber I 2132
. . .
Fad piping:
Business name:Polygon W1,11,LLC
• . 51435 for fitxt four;$4.113 for each additional
Contact name:Angela Grojessaki Funtate,..ete,
Address::100 East 13th Street Cas heat pump I
Well/ads.endedittnit beater
City/StatelZIP:Vaarauler,WA 98660 %straiten:ter I
Ilhone:(360}695-7100 Fax::(360)693-4442 - FirePlix*
Ranee 111.1111111111_
B-ntaii:Aageia-Grajewski4olyganhaines-rain
Barb
• , . - CONTRACTOR Clothes dryer(gas)
BuSiness name:Apex Air LLC Other:
Ald eiS?iti-2.6=-6-- .
-. ' MECILANICAL PERMITTEFS*
Address:18004 NE 72'4 Avg- Subiatol
City/StatufZIP:Vancouver,WA 98686 Minimum permit cze($90.00) 9e,trzt
Flan'review(25%of 4Xurnit fee) I
Phone:(36013424109 Far:(36())326-1769 4$ ,/,...A
Stair surcharge(12%Operand fee) re lot V
i ..
CCB lie,:203034 TO TALTERMIT FEE i
-- Thi$i iwralit application twins go revolt to not obtained within litti
days atted-tt.ttea hem accepted as complete.
Authorized signatune: ,, '-- ' — ' Fee inediedeltro set by Tri-CuoutyPialding itiamtry Service Beard
IPrint 11,0rAF.' I coN, .../ Dote: 4.pi.,,g,.., ----I C
L'42(1YktiCar:i IVO ,i-1f e 4-7-771--vc- 171 .- /
f1,,,1;9-,.. ,'i e7— itt ?-774;
. Inspection Detail Portlet: Edit Mode Page 1 of 1
Record ID:MST2015-00250
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Case# Inspection Type * Address
MST2015-00250 699 Mechanical final 15192 SW 154TH AVE,TIGARD,OR 97224
Request Date
Requestor's Phone Requestor
[08/12/2016 '
Request Comment
Scheduled Date * Scheduled Time
06/15/2016 E v v AM v
Inspection Date Status * Department *Current Department Inspector *Current User
08/15/2016 _a PASS v Building v David Young V
Result Comment Standard Comments
Date:8/15/2016
Note:no AC installed at time of final inspection.
Permit and inspection required at time of installation.
check spelling
CAP Type * Internal use only * Inspection Time
Building/Res/Master Permit/NA 15RES-00000-01711 10 v : 59 v AM v
Submit Date Submit Time
08/15/2016 *"'-'1 10 v : 59 v AM v
https://ay.accela.com/portlets/inspection/inspectionDetailCapSpecific.do?mode=view&fr... 10/21/2016