Permit (143) 1
INCITY OF TIGARD MECHANICAL PERMIT
'> COMMUNITY DEVELOPMENT Permit#: MEC2017-00169
T[CGA,R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2017
Parcel: 2S106DC06900
Jurisdiction: Tigard
Site address: 13718 SW SABRINA AVE
Project: Polygon at West River Terrace,Lot 69 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 69
Project Description: A/C installation. Placement of NC unit must comply with manufacturer's 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 03/08/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/08/2017 $10.80
Class of Work: NEW Type of Const: Minimum Fee Adjustment-Mechanical 03/08/2017 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80 1
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions ttoo�OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:/ Permittee Signature: `
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical:Permit Applicatio ' ---' I'"--.' - - '''' ', .. . • ' 14)1( tcy ts):()NIA
• - City of Tigard 1 ,)n 17 Rixtry: 17 Lif
13125 SW Ilan'Blvd.,Tigard,OR 97223 MARL,, , N.,Review
' .. Thane: 503.718/439 Fax: 503.598.1960 Datellir Other Poona: 577911/tr,.„1-2- 3.:14(
:Inspection Line: 503.639.4175 l'r rif 0i, '1'1( A R Date Rcadytay: h.ilc Ea Ste Psoe 2 far •
I 1 Cri.'"n interact: wvomAigard-er.8av k-."1 R ' ' ' - hletifiedIdethod: Supplemental Information
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Mechanical netinillbeS4 are based/on•'the.•%title of thork
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P:411
New construction U Addition/alteration/replacement performed.indicate the value(munded to the nearestdollar)of ill
0
Demolition 0 Other: mechanical materials. tii meat.labor.overhead.and rofit.
• ,. Vatue;$
etite‘tigisTif...1-.'',f-..-.X111.y' r',70"&,-,4-7,i4.4 falktif!.'•fffi:'...-..ti:•:!. •Igit'..4,:i1A.t"..:-; , patiMillti..,74.77,721
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and 2-family dwelling 0 COMmerciallinduStrial 0 Accessory building -Fbr sieclai Infolintion iiiedser4ilii
I ;Multi-family 0 Master builder 0 Other: Description Qty; Da. Total
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N .;.:".tf:t..-i'1;11:*-. 2-4-:,-,f ttsiT-A,-5 .-At,:.4,14,4.4_!',;-4_4',L.,,_ -&", -_,,,a:t,A'''V:r*. rz'''''.4*-'•e4.1.-';- ..-- Air conditioning ( InE1111111111111
ik Job site address:/3 76..SA/ Sr I arbl A (lCL
KA-11-44,0, Furnace 100.000 13TU duets7veati) 46,75
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City/State/ZIP;Tigard,OR 97224
Furnace 100.000+BTU idoetsiventsl' 54.91
. Heat pump 61,06
Suite/bldg./apt,no.: 1 PrI3jeCt narne PC)Ilit\q catf V\it st hverTor
Cross street/directions kilo))site: /13,1:Ironic hot water system 23.32
Residential boiler(radiator or
•ltydronic) 23.32
Unit haters(Mel-type;not electric),
in-wall.in-duct,sus .clod.etc. „ _46.75
,
Flue/ant for an of above -,.3 3, .
2
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r ... Other: n _se
23.32•.P4 . VeSi- r,i4eitnra . Lotr, 9 Other fuelolinces: IMP
Tax map/parcel no.: Water heater 1 23.32
laeminsert 33.39
r":4.-i;-":,'.07,nit.• ,''.:-:1?'''''!'''''..:'%-~"'-:''.4'..:',-.24‘"-r. :;,-A-4'-'-t' -'-'11'''"..''''l-''-:"--'''-';- ---.'-'20''''i' "'..7' .'''''6P'4- Floe vent tbr Water heater isr gas RI
10;11,firlif fire lace 23.32
IV1 -*4 I lci- i ,)IP Lo• li•him : 3 M 23.32 .
Wad/ ove let st33.39 =
—&-6- , • f. 4 CC-e CiAJ 7- Wood fi •ilea/insert 23,32
Cliiinnevliintriftudvent
III 2Z-31.3322 11111
ItiPIH'l'''...';::.4:'-'1:':)•'4:':-:4'4-4't 4''''‘'''''''"-.741"4'' " It.' 4:1''''' "''''''''''''""" e'''''''''''''' '''''''''''''''I''''''''':''''':'44 Environmental exhaust and ventilation:
Name:Polygon WL11,LLC Rage hood/other kitchen
e in mem_ 33.39
Address: 109 East 13`"Street
111.111
Clothes diver exhaust 33.39
•
CiiyiStateIZIP:Vatteouver,WA 98660 Single-dut almost(bathrooms, •
toilet compartments,utility moms)
Phone:(360)695-7700 Fax:( ) Anickrawls :ce fans 23.32
*
EllikT*Mitilif]ttTlakZ23,4$114k.: 1,1'71r : ,A:77:$177:07:;',::7....,,.0".7.4' Otiler• MN 23.32 IIIIIII
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Business name:Polygon WL1L LAC
514.15 for first four:S4.63 for each additional
Contact name:Angela Grajewski Furnace,tic, .
mp
Address:109 East 13th Street — Gas heat po
I
WrillIstis i.dedlunit heater
City/State/ZIP;Vancouver,WA 98660 Water heater
Phone:(360)69S-7700 Fax::(360)693.4442 , Fireplace
Ra :c
E-mail;Angela.GrajewskiriSpolygonborneccont
Barbecue
62.M0;1410..'•&VAY.," ...c:&31..S„Ali'gri;t:••Ai;.7,411:::'.:.,,,, ,*,,,r.:::;-.-;:*,,--71:,..r',.,..:::::.'i.1-;;;;[,t,...!.-.,7:,'•,..Ifit Clothes diver(ear,. . 11111111111111111111111
Business name:Apex Air LLC Other, INS
j.':'-'4‘'''..."•.4;15*.i:Iiit,-.'^i-3,7'ir,t`44', ,.••' ;77., '..,...- ---,••.,,i4. ,
A7,77, 419.-.,#q ,, .4.,' "A'k,"•'.
Address:18004 NE 72'4 Ave
City/State/ZAP;Vancouver,WA 98686 Minirant permit fee($90.00)
Plan review(25%of Permit fee) '
Phone;(360)342.8109 Fax:(360)326-1169 State surcharge(12%of permit P.m)
CCB lid.:203034 TOTAL PERMIT FEE
This permit application aspires if it permit-is not abtained within 1$0.
days Ate it has bee*Invented as reimpiett.
Authorized signature: .., * Fee methodology sci by l'ri-Cooray niiiidi an industry Service Owed -
IPrint narneriroT. ,1 J Date: 4tot..14,,,,, ....j
t'auildingTemilAMEC_PeinitApp WU 13 cfoc 444-407T(I itIVCOSYWEEY
•
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13718 SW SABRINAAVE, SHERWOOD, OR, March 10, 2017 at 10:15:22
97140 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00169
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Mechanical final for AC only, ok.
Violation Summary:
Inspector Contractor