Permit (30) CITY OF TIGARD MECHANICAL PERMIT
° I COMMUNITY DEVELOPMENT Permit#: MEC2017-00175
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/09/2017
Parcel: 2S106DC07000
Jurisdiction: Tigard
Site address: 13702 SW SABRINA AVE
Project: Polygon at West River Terrace,Lot 70 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 70
Project Description: Installation of NC. Unit placement to meet manufacturer's 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 03/09/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/09/2017 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 03/09/2017 $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.
ik
Issued By: / - Permittee Signature: O/ foe. l e ft/�C,,u
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 AnnlicatioilL(. ? ,, 111 "1 i it 1 1 tl\1 \
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,City of Tigard n/..., Dateor, ... 1' /2 A -' liciTMI N'Vti C_20/ -,0 )/7
13125 SW Hall Blvd..Tigard,OR 97223 LIAR 8 2u1( Plan iteview
Phone: 503.718,2439 Fax: 503.598.1960 Dategyz 00,er Per5iV 74.20/6-003.02-5-
inspection Line: 503.639.4175 Cr('t' '.' ' "..--'"'''' Date Radvier= 11111 Etalt!MI
interact: www.tigard-or.gov r...; r - -.. , ,- ' . Notified/Method:
:',:*-F.,';'''''7,1 '-'t''°''..-t-Ca'4.4'.. 'f ''''''; .'-''''';4're.-.''r''f'''''' '''' ''''''''' 1 feltehanlpena-- "itfeesarch ased on'the value of the
0
New construction 0 Addition/alteration/replacement performed.indicate the value(rounded to the nearest&thy)of all
0 Demolition 0 Other mechanical materials,equipment.labor,ovedicad,and moth.
Value:3
,, - , , ..,,,,,4..•,..
;'4!74#4,4AP'jrifS : 17,'liS;:4t5S:rj1)1r,P,*111!Ci:re.k4'ci,f,gf:,..1:11'C.;.;i leili"C''..k .?1?''' '.•• ••'''''141141.1''4, ,i Ile.:.. .}'',.1 A.A 4.'.1 4..i.7".;.11'17,CA';j 1%'',t';'"''''". '4 MO',
1-and 24iin:Ay dwelling 0 CommerciaLlindustrial 0 Accessory building Po special informatior:use dieeklIst
Muldwfumily 0 Master builder 0 Other Description 4 Qty. ( Ea. I Total
-,,..,',..!...,,,,.1.-.. -,..1...'..,,,,,..,,,•,. ,.'7. ,417.- -;',-Lv,ir-i.'-',.,--;.it4":"'(-1.`,it.,'• :.''', r. ,t''',74-1':cei.4az;:.,,,,,T,......,64; latatingit00011P
'''''...:i.41-7-1,41 ;%::::!.:I.fiS.,;3;73'...-1:::-..e- r.:511iZZ....1.g.11,14,4S1.4-.,,:`,.:Lk..c... ...zaal.. ..:Citl'•2111, ..2:`,-c.-.,:di'M,.:1,41.1(.. Air conditioning 1 46,75
Job site addms:/ -702. SW brim Ave., Furnace 100,000 STU tductssyents) 46.75
City/State/ZIP:Tigard,OR 97224 ,Furnace 100.000+BTU idnetif,erao .... 54.91
beat pump 61.06 ,
Suite/bldg./apt.no.: I Pilled name:Pbliiitiq 044-iftie%t p-tver-rtrr ' Duct work 23.32
Cross stroctrdirections at job site: Hp:Ironic hot water system 23.32
Residential holler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duel,suspended.mc. 46.75
Fluevent for any of above 23.32
Other 23.32
Subdivisiorr Pelti/on at lAkAt fe4\kr-R,rifixte,_ Lot 00:71 - .
Other fuel applie nets:
Tax map/parcel no,: Water heater 2332
•L''..•-:?1.7'....:...-' . a ;? A!.iITtilal...0'1If:1-;' 1 .'l 't*':tti11"2,.. B.39
Fl vont ft;,,„ider he..r.,gas 1
14-dd iilc 7-,.e9:-/ 19/iZarr:4-Cel r* ritanlace 2332
ini(P*8°32 ,C( 1'. - Los_ligliter(gas) 23.32
Mcrt
Wood/pellet stove 33.39 ,
• Wood fireplace/insert 23.32
Chimneyilinerilluertnun 23.32
Othót 2332
2'.:*.;:;.•':':::;':',.i'''''11.-:;',,!:;;?'`,...':::`77;il'i'AV,''s:',''S......Tg'i.:).'.S:',;:;,:,:q. ..,A-1,..ii.,F.±k-:L-5.'%:ri_Z i-?;`,4,';'4--1:1;,.'-',"2.,,‘4. Enyinnnu„tai„h„st„4 ventoxii„:
Name:Polygon WLH,LLC Range hood/other kitchen
1 equipment 33.39
Address:109 East 13's Street ClOthes dryer exhaust 33.39
CityfStatealF:Vancouver,WA 98660 Single-duct exhaust(bathrooms,
toilet compartments,utility toomS) 23.32
Phone.(360)695-7700Fax:( ) Attkierawlspace fans 2332
---t .1:,s1';11r,f'”:,;f1 l'r..i..'i•. . ,' Other 2332
........n.lkil.p.-
Business triune:Polygon IVL/1,1..LC
S14.16 for first four:54.413 for each addidonal.,
Contact name:Angela Grajewski Furnace,etc.
Oasheat pump
Address:109 East 13th Street
• Wall/saisneadedhunt heater '
City/State/ZIP:Vancouver,WA 98660 , , Water heater
Phout,(360)695-7700 Fax::(360)693-4442 Fireplace
• Range
E-mailt Angela.Grajewskigpolygonhomes.cum \ Barbecue
.....__.....„.„.,..„„,..,.
,"„ .. ,•:, ,, „
:-_--,,7 doom dlyer(gas)
'... L.A..,:.:17,4.,-.V.''.ZA"'S.4.. '.2.'1..—'1.j.;.:...i.."...:24ZZrZ/..).i......,L.L.,..:'.....JA.'Z...1'.2.P.,.,.te,'L..:
Business maw Apex Alr LLC Other
g.r.,....L . -. .cZTe,r•jf.`.1 •(- . . r:','
Address!111004 NE 72,4 AveSubtotal
City/State/ZIP:Vancouver,WA 98686 rviinimuria Permit lee( OM)
Plan review(2.5%of permit fee)
Phone:(3603424I09 I Fax:(360)3263769 State surcharge(12%of pennit fee)
CCB lie,:203034 TOTAL PERMIT FEE
Authorized s!gnatuev
....r.,t4
This permit application tatpirtalr Ifs permit is Rat obtained within ISO
days ante it Ws been*muted as earaPlete•
''' Fee methodology set by Tri-County Bonding Industry Service Bread
Print name: irk, I Date: 4.141.14-
0.944,00,41.A.w_pexiitApp_040 0 dee 44414107Tillia2COM1WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13702 SW SABRINAAVE, SHERWOOD, OR, March 23, 2017 at 11 :28:20
97140 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00175
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor