Permit (32) CITY MECCL PERMIT
COMMUNITYOFTIGARD DEVELOPMENT Permit#:HANIMEC2017A00303
TEGAR L) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/01/2017
Parcel: 2S106DB23700
Jurisdiction: Tigard
Site address: 17390 SW SABRINA AVE
Project: River Terrace Northwest Swim Center Subdivision: RIVER TERRACE NORTHWEST Lot: X
Project Description: Change hot water heater to tankless.
Contractor: APEX AIR LLC Owner: ADLV LAND HOLDINGS LLC
2210 W MAIN ST STE 107-272 BY FORSUM, MICHAEL
BATTLEGROUND,WA 98604 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 360-342-8109 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 05/01/2017 $69.06
Class of Work: OTR Type of Const: 12%State Surcharge-Mechanical 05/01/2017 $8.29
Occupancy Grp: Occupancy Load:
Stories:
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Units<10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $77.35
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports(Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 50 .232.1987 or 1.800.332.2344.
Issued By: Gam' Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicationFOR OFFICE CSE O'LI
City of Tigard REVnn , ..B
�' ea ; —
Review Permit No.: /
14 I'l 13125 SW Hall Blvd.,Tigard,OR 97223 1 y Plan //
Phone: 503.718.2439 Fax: 503.598.1960 MAY 2 017 Date/By: Other Permit:Aio `a ^AD
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris la See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISIO
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For specs al information use checklist.
❑Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
',':';'.'•:.:-.:.-1111:." Heating/cooling:
> f te t
Air conditioning ita
46.75
Job site address:17390 SW Sabrina Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name:Northwest River Ter Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision:Polygon at Northwest River Terrrace I Lot no.:Swim
Other fuel appliances:
Tax map/parcel no.: Water heater 1 23.32
t 1, . Gas fireplace/insert 33.39
Flue vent for water heater or gas
change hot water heater to tankless fireplace 23.32
Log lighter(gas) - 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.... � -:. <. '9 v .-�%-.-= `�1, Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 33.39
Addres:7600 E Doubletree Ranch Road Clothes dryer exhaust 33.39
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(602)694-4031 Fax:( ) Attic/crawlspace fans 23.32
®lF=, g g Other: 23.32
Fuel piping:
Business name:William Lyon Homes,Inc.
$14.15 for first four;$4.03 for each additional
Contact name:Angela Grajewski Furnace,etc.
Address:109 East 13th Street Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater /
Phone:(360)695-7700 I Fax::(360)693-4442 Fireplace
Range
E-mail:Angela.Grajewski@polygonhomes.com Barbecue
g t _, Clothes dryer(gas)
Business name:Apex Air LLC Other:
Address:18004 NE 72°d Ave Subtotal
City/State/ZIP:Vancouver,WA 98686 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit fee)
CCB lic.:203034 TOTAL PERMIT FEE 7?I 5---`
AZ1This permit application expires if a permit is not obtained within 180
�/�V' days after it has been accepted as complete.
Authorized signature: gi ci1/I JV * Fee methodology set by Tri-County Building Industry Service Board
Print name:Angela Grajewski Date:5/1/17 C� C/
.�
LlBuilding\Permits\MEC_PennitApp_040113.doc 440-4617T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17390 SW SABRINAAVE, BEAVERTON, OR,
97007
Record Type: Record ID:
Commercial - Mechanical MEC2017-00303
Inspection Type: Inspector:
699 Mechanical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor