Permit (141) e,
IIIICITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2017 00168
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/08/2017
T[< .ti g Parcel: 2S 106DC06400
Jurisdiction: Tigard
Site address: 17289 SW JEAN LOUISE RD
Project: Polygon at West River Terrace,Lot 64 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 64
Project Description: A/C installation. Placement of A/C unit must comply with manufacturer's installation instructions.
Contractor: WILLIAM LYON HOMES INC Owner: ADLV LAND HOLDINGS LLC
109 E 13TH STREET 7600 EAST DOUBLETREE RANCH RD, STE
VANCOUVER,WA 98660 SCOTTSDALE,AZ 85258
PHONE: 360-695-7700 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 $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
a •
Issued By: "7,-zeer,..L.oe..., ‘ --Z
Permittee Signature:
3'2P----- „.,...ge:;;,!, , ,..,).-,,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit AnplicaVisk
-City of Tigardge- 7 ,-._____ pt N. e_c '
DatelRY: ) tp / •!'177-- I _illI _2:Lilfwe
1 .- . 13125 SW Hall Blvd.,Tigard_OR 97223,, , , ,s, Ptak RCNieW
' ' Phone: 5017181439 Fax: 503398.1960 '.:. - ``) '' ' Dateity: Other Permitnc7-, (ilt -.411,224,
,1,1) Inspection 1..ine: 503.639.4175 , , Dalt Readylay; heir 01 See Page 2 tor
'Internet: www.tigard-or.gov .. ; Notate:Moho& . ....._!tipplratental Information
1,.rs,...2,,,a,-;•,,,,4,..i.---;.-s.t..A-:z-T.,=7,,,IA,'---4.,,,4,--i-,s, ',%17,,j7r,....-.j,-,..- -.„,...27...,,„2,,,,,,--_,„,-;,,,,,,T;,:-.v,.,„,*_.-4,14,i,fi,,,. ,t,::e.'.4',:t'''.1 A'"(5 paz:-,,,,,,,e,z,f,t 1.)r d:::':-4111..-f- latre,&14,si
- Mectutnicat permit fees*are based on ihe value of the work
I2j New construction ID Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition 0 Other: Illcehauleal materials.equipment.labor,overhead,and profit.
Value;$
I. and 2-family dwelling 0 Commercial/industrial 0 Accessory building •earvicial Information use dreditist
Multi-family Q Master builder 0 Other: Description I Qty. I F.a. I Total
ngit"11ing.4 -.......,
Air cow itioning
( I 46.75
Joh site address: /72/( SW Jean
LI)4,1 S-e Female 100.000 BTU(ductsA ems) *1---- " 46,75
City/State/ZIP:Tigard,OR 97224 Furnace 100.000t BTU(docisivents) ..... .") 54.91
Heat pump \--, 61.06
Suite/bldg./apt.no,: I Pr*"ainc Poitil on od- yve.sel-riic{re tr Duct work 23.32
Cross street/directions to job site: Ifydronie hot water system 23.32
Residential boiler(ntdiator or '
hyd / 2332
ronic)
• ,
Unit heaters(fuel-type,not electric), ,
in-wall.in-duet,suspended,etc. , 46.75
Flue/vent for any of above '1 23.32
Other:- 23.32 ,
Subdivision:-FiiiIT—IDA 64- ittjel f— re,,iver rayotcp__ 1,..01 n0,01-I
Other fuel applistneec --,
Tax map/parcel no,: / Water heater ( 23.32
, , '-!7.-fill;-7-tf,.7177;34:1...ra.17,n4157:,11:N.77----171-31.X:fft1W-41:V1- Gas firePhice6nseri 3339
i
Flue vent for waler healer or gas
4, /el 6,_ (,/,/,.. y
irreolooe '. , 23.32 ,
Leg lighter(gas) 23.32
Wood/relict stove 1 33.39
/6)'97 P/24/1 272-II-C7"/te ee #v/ , Wood fireplace/insert 1. 23.32
Chimney/liner/0 uelvent ' 23.32
, 23.32
7.,,,- f;,-..,1',,i,I.'c'-;:i :,r:ff,"\ , tR-1::::::::
21 ...L..-..r...,. :."4-‘1.,a':,..::ati.„1":-17,:4,-.itr.ti- .. .7-FlultriE:A...., ......, ,,,:'.44,,,I4=7Z1-.7-t!,,4,674.74,A4.1tx Eavinimutnigi exhaust and vtatositioni,
Name:Polygon Will,',LC Range hoodfother kitchen
eouipment -,, 33.39
Address;109 East 136 Street Clothes dryer exhaust 1 ., 33.39
City/Stale/L1P:VanCouver,WA 98660 Single4uct exhaust(bathrooms, Lip
toilet compartment utility moms) 23,32
Phone:(360)695-7700 Fax:( ) Anicierawlspace ittns , 23.32 ,
R7,3--..72f17,F''-''lf?,'.77.i:":15'';'ft.,1-1Z7s-1.A.4ff:IFF347,Fki.3.:54.:1=f7*;:Eff(c-rtEj-.101.;:et:37SzTeliniii-1.7.77 _Ater: —' 2332
rga **1
Business mane:Polygon W1,11,I.LC iroci pipu1
$14.15 ger first four:$4.03 for each additional
Contact name:Aupla Grajewski Furnace,etc.
, Gas heal pump i
Address:109 East 13th Street
A. Walifsmendedtunit heater
City/StatealP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 ' Firejdace I'll
Range I)
E-mail;Angeht.Grajewski*.polygoubommeorn / 7 Barbecue
( .
• .'-'-'1'ri:"1.41''''-'Fi'-f:',:':*7'-.:;"--„7:t.'..'.',":::._':'':";-7!?:'.rn,'::";''';" :..f:';':'r,:'I':'t:-rt:7:3.5, '';'ff'-'.-f--,T:.f.33T::'---Z,--7,;tt:Z:'qt7';7f, :.'-' Clothes dryer(gas)
Other: il
Business name:Apex Air Lte " '-'•"-'. -', i`t,i9 L't--ri 1'''.E,'F'‘ t;c..il-r -i `-'','-:,-2 '.---/'''E': ,:(...1
Address:J$ )4 NE ir°Ave Subtotal
— , I
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee(590.00) 7(
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)324-1769' state surcharge(12%of permit tee) Fe
CCB ik,:.203034 TOTAI,PERMIT PEE , ,QJ ve.
This permit application expires Wei-permit is not obtained within 1110
days atter it hat been accepted as complete.
Authorized signature:,_ , * Fee methodology so by Ti-County Betiding torktuty Service Beard -
Prim name: tek, ,.../ Date: 4.pi.te,..,„
.0.4.0.1-ifop,,404EritrinkApp_0401 13 doe 4444417T(I 1012KNY4AVFA) •
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17289 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type: Record ID:
Residential - Mechanical MEC2017-00168
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
FA I L
Comments:
Provide access for inspections. R109.1
House locked, 9:53 am
Investigative fee applied for no access for multiple inspections.
Violation Summary:
Inspector Contractor