Permit (179) uill CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016 00790
Date Issued: 11/17/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S108DB06500
Jurisdiction: Tigard
Site address: 15396 SW THAMES LN
Project: Polygon at Bull Mountain,Lot 63 Subdivision: POLYGON AT BULL MOUNTAIN Lot: 63
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 $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: A )1C----- Permittee Signature: ',ti f ' —,:'‘7 /t4 -7-7e"..01
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Annlica CEIVE � f l R Ui ( i i Si: ()NI
City of Tigard Received
77
INc / %40 i P ;i te7.Re) --ee70
1312$SW Hall Blvd Tigard,OR 97221 SEP 2 0 2016
Deal VtS7. O/ OOO9O
Phone- $£t3 718.2439 Fax. 503.59111960 Damn,. € t haat
i lEl,itl) Inspectimline: 5133,639A175 CITY OF 7IGARD D.122,-,,i,',,,, tom, TB ePage•2tor
Internet. www.tigarrr-or.go, BUILDING DIVISION, 4` t: nr ,>„ (latermation
'IIP or won-, CSC wiAlEttCIAL tFEE&>SCH tC1LE- VSE CUECKLtS`t-
txatt tttt tirttt Mechanical(*mut fees*are based on the'.clue of the v.ork
New0: ddition/alteration.r placement
performed_Indicate the value(rounded to the nearest dollar)ot"all
n Demolition 0 Other, mer..banical materials,vauipmem labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT!SkSTEMS FEES*
❑1-and 24atmtily dwelling 0 Cotranercialiindustth l 0 Accessory building For spade!Information urrehec'Atisc
Multi-runty 0 Master builder 0 Other: Description LC?ty'. - tom, Total
JOB SITE INFORMATION AND LOCATIONntin tet+utiu
] (� r Airrnditirrrtin ��
Job site address: I 331( SW 1lno. 5 t� 4 T ttrttacc 1 tit t,e.c _ ., f ) I 4635
City/State/ZIP:Tigard,OR 97224 Furnace 100.000+13W idtietwwuttsl 53,91
Heat pomp t
Stine/bldg./apt.no., Project name:Polygon at Bali Nfountain
Duct work
23.32
Cross street lircction to job site; tlydronie hot watersyttem 23,32
Residential boiler(radiator or
hydroa e)
Unit heaters(fuel-type,not eiectrk).
in-wall,in-duet,suspended, 46,75
Flues cat for ens of above 1 23,32
Subdivision:Polygon at Buil Mountain Lost no.; do Other23 n
Other fuel applhine :
Tax ntap/'parcel no.: Water healer 23.32
DESCRIPTION OF WORK> `r 194e59=1 ,: 13 39
(rey�.�y n� p
l i f iA t h (� s 23.32
Ad
oodi, Ilet stove ainiassiimunin
1 33.39
a?ttd,lareildetinsrrt 2132
C:ltimnllincrttlttersrent 2132
'", PROPERTY OWNER 0 TENANT Cltfi 23.3'2
Ent it onmental exhaust and ventilation:
Name;Polygon WLBI,LLC Ranee hood'ather kitchen I
ei, meta _ 31 39
Address:109 East i3 Street
Clothes diver exhaust L 33,39
City State.1ZLP:Vancouver,W98660 Sin e-duct exhaust(bathrooms,
toilet cry 4, "moots,unlit atoms) '1 2:3.32
1 Aniecraufspace fans 23.3`2. i
APPLICANT ■ CONTACT PERSON Other: 23.32
Business name-Polygon WIJ-1,LIA'
Fuel piping:
31-1.15 for first font;S4.03 for each additional
Contact name:Angela Grajewski Furnace,etc. !
Address;109 East 13th Street Gas brat pump
Wallisu•.-;,.<dedaurnt heater
11111111111111111111111.1111111111111111111=CilyIStatetZIP: water heater
!shone;.(360)693-7700 Fax;;(360)6934142 I"ir be
Mange
E-mail: ntg to C rut}t sdti -ptril att6ctrues er3rrt
Barbizon
CONTRACTOR Clothes dryer aas1
13ttsauese name:Apex Air[ /Lid 1' Other
r ... �! ! 4 .. MECHANICAL PERMIT PEES"
Address:10004 NE n'4-Ave
Subtotal
City/State 71P:Vancouver,WA 98686 Minimum permit fee(390.00 i /29 .0,
Mao ret i (25%ofpermit fee)
Phone:(364)3424109 Fax:(360)326-1769 '
State surcharge()g of permit fes) 1 /Q•8C)
CUB lie.:203034 TOTAL PERMIT FEE QG! ,f)
This permit application aspires ft'a permit is not et'taineat within Igo
Authorized signature-
days after it taxa bootaccepted ase#trapletr.
, * tee tee ltedolou set by Tri-C'taaartty Building%dusty Service Board
Print flamer-n/7 Date: 4.// j't,..
--Z. 47A-7-//(0
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/ie3 ,c/e.- /..7.--. 77/f67 ®/ /
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. • Inspection Detail Portlet: Edit Mode Page 1 of 1
Record ID:MST2016-00040
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Case# Inspection Type * Address
MST2016-00040 699 Mechanical final 15396 SW THAMES LN,TIGARD,OR 97224
Request Date
Requestor's Phone Requestor
,09/20/2016 '
Request Comment
Scheduled Date * Scheduled Time
09/21/2016 —3: v : L v AM v
Inspection Date Status * Department *Current Department Inspector *Current User
09/21/2016 FAIL v Building v:1 David Young
Result Comment Standard Comments
Date:9/21/2016
Seal all penetrations in mechanical room.
Note: no AC installed at this time, permit and inspections required at time of installation.
check spelling
CAP Type * Internal use only * Inspection Time
Building/Res/Master Permit/NA 16RES-00000-00282 10 V : 34 v AM v'
Submit Date Submit Time
09/21/2016 10 v : 34 v AM v
https://ay.accela.com/portlets/inspection/inspectionDetailCapSpecific.do?mode=view&fr... 10/21/2016