Permit (176) ,, CITY OF TIGARD MECHANICAL PERMIT
I111 '=` COMMUNITY DEVELOPMENT Permit#: MEC2016-00789
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2016
Parcel: 2S 108DB06400
Jurisdiction: Tigard
Site address: 15108 SW 154TH AVE
Project: Polygon at Bull Mountain,Lot 62 Subdivision: POLYGON AT BULL MOUNTAIN Lot: 62
Project Description: Installation of A/C. Unit must meet manufacturer's placement requirements.
Contractor: APEX AIR LLC Owner: POLYGON WLH LLC
2210 W MAIN ST STE 107-272 109 E 13TH ST,STE 200
BATTLEGROUND,WA 98604 VANCOUVER,WA 98660
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 $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • , Permittee Signature: (7AL
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicati
illECEIVED f f fR of fl f t sf
City of Tigard tiue0.... /j /s, /, i.,,,;04, Paean Nor:/tr_--ee. iti,_I-z26/71,:ci
, * 13125 SW Hall Blvd Tiwird OR 97223
14 Pim itevicie
SEP 2 0 2016
mom, .111t3M11.2439" Fax: ;03.59113960 Omens Other PermitCf57;204/5`...0002.5-:3
1 1,..„,it.r, Inspection Line: 503,639A 175 CITY OF TIGARD Cktt R''.4413 Turvi. RI See Page.2 tar
intemet: www.tigattl-or,gov tionfiedMethod Simplementat information
BUILDING DIVISION....
TYPE or WORK. , COMMERCIAL FEE''SCFIEDIJLE- USE CHECK-UST
Mechanical permit ftvs*are based on the value of the work
t... New construction [3 Addition/alteration/replacement perftioned,Indicate the value(rounded to the neamst dollar)of all
El Danot won E3 Other mechanical auttetiads,equipment labor,overhead,and profit
Value:$
CATEGORY OF CONSTRUCTION .
RESIDENTIAL EQLIPMENTi SISTERS FEES*
0 I-and 2--furnily dwelling 0 Coramaciatfindastria) 0 Accessory building For sordid litformodon rise cherAlia
''' Multi-Funtily 0 Master builder 0 Other Description _ 1 Qty. Ea. 4 Trial
m -----------------"•••
,---i376-i3 Jog SITE INFORMATION AND LOCATION a lagitaaliall: 1 .
Air conditioning , 46.75
Job xite address: into sw (stinn Ned .,...,.....
, , ,...: ,- . ,,,..) 1 46.35
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+11Til iduetsmants1 54,91
I teat pump 61.06
Sttiteibldgiapt.no.: Project name:Polygon at Bull Mountain
Duct Ni Oa2332
...
Cross street/directions to job site: - hot water system .23 32
_ _ :.
Residential boiler(radiator or
hydronic) 23 32
Unit heaters(Mel-typo,not electric),
in-wall,irt-duck,suspended,vie, 46,75
Flues-cat for arty of above t 23.32
• . ,
Subdivision:Polygon at Bull Mountain Inc,0,L67
_____. ,Other: .. 2332
Other litel appliances: .
Tax map/parcel no., Water healer 23.32
,
DESCRIPTION OF WORK Ona fligglooctin1 setl , 3139
Contniew than ri,L,irepwivaet:for water heater or gas
. aik .J -
t C - Log lighter(gas) 23:;/
cWW1(;!::Pelrepineintla:evion;:asefertvefit 221133j331229- - -
Other: 23.32
PROPERTY OW,NER 0 TENANT
' . Eni iranmentat exhaust and ventilation:
Name:Polygon Will,LLC Ranee hood other kitchen
I .._1.
i equipili 4.131
Address:109 East tr Street I Clothes diver exhaust 3139
City/State/IP:Vancouver,%VA 98660 Sinale-duct exhaust(Ixathriumis.
toilet compartmeras,utility rooms) Li 2a 32
Phone:(3601695-77110 Fax:i ) Attic's:raw Ispace farts 2332
APPLICANT 0 CONTACT PERSON Other: 2332
Business name-Polygon WL11,LLC Fuel piping:
81435 the first faun$4.03 for each add:if...aim'
Contact name:Angela Grajewski ' Furnace.,etc. I I '
Address:109 East 13th Street Gas heat pomp
' 9VA/susdediunit heater 1
City/StatefZIP:Vancont er,WA 98660 Water heater
Phone:(360)6954700 !
, Fax::(360)693-4142 Fireplace ,
,. Range a
12-mail:AngebtGraiewskIiiiiillygenhoines.torn Barbecue
CONTRACTOR Clothes dryer(ass)
1//71.-lusittess name:Apes Air LLC WO C-)4.09/2- 2
MECRANICALETRALff FEES* _
Address:18004 NE 72"Ave Subtotal
City/State/ZIP:Vanrourer„WA 95I16 Mininsurri permit the($ 0) e2,1rt)
Nan review(25%of permit fee)
Phone:(3601342-8169 Fax:(360)326-1769 State surcharge(12%of peonit fee)
Cal lie.:203034 TOTAL PERMIT FEE /e9p ,
This permit application espirm if a permit is not obtained.itbia ISO
days after it hat been accepted as complete.
Authorized signature: --- * Fee metitadnim-set by Tti-Cmtuty Building faslotty Service Beard
Print riatitn: 1 4", / Date: 4-II.tt..- (1,9-S&--- e-oS C.-2S
I awe v5 Pr.”.1,1,kit tiPetthapp 04010 doe 440-46-1' :1',,`;(tr.i W115, /VO . '`je,_-- 605 .1- 7717 e -,,,.---
7 -t/V°7 4-= in,L.Ciet- 77e;^."
Inspection Detail Portlet: Edit Mode Page 1 of 1
Record ID:MST2015-00253
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Case# Inspection Type * Address
MST2015-00253 699 Mechanical final 15108 SW 154TH AVE,TIGARD,OR 97224
Request Date
Requestor's Phone Requestor
109/16/2016
Request Comment
Scheduled Date * Scheduled Time
09/19/2016 r V : V AM v
Inspection Date Status * Department *Current Department Inspector *Current User
09/19/2016 ' . PASS V Building V David Young V
Result Comment It Standard Comments
Date:9/19/2016
Note:no AC installed at time of final inspection.
✓ Mechanical contractor to be changed on permit to reflect contractor that installed HVAC.
check spelling
CAP Type * Internal use only * Inspection Time
Building/Res/Master Permit/NA 15RES-00000-01717 10 V : 10 V AM V
Submit Date Submit Time
09/19/2016 1: 10 V : 10 V AM V
https://ay.accela.com/portlets/inspection/inspectionDetailCapSpecific.do?mode=view&fr... 10/21/2016
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
15108 SW 154TH AVE, TIGARD, OR, 97224
Record Type:
Residential - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
No AC installed prior to building final inspection.
Violation Summary:
Tel: 503.718.2439
Inspection Date:
Record ID:
MEC2016-00789
Inspector:
David Young
Inspector Contractor