Permit (56) CITY OF TIGARD MECHANICAL PERMIT
. ' COMMUNITY DEVELOPMENT Permit#: MEC2017-00458
TEGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/22/2017
Parcel: 2S106DC13200
Jurisdiction: Tigard
Site address: 17066 SW JEAN LOUISE RD
Project: Polygon at West River Terrace, Lot 132 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 132
Project Description: Installation of A/C unit. Placement of A/C unit must comply with manufactures installation requirements.
Contractor: ANDERSEN HEATING, INC. Owner: ADLV LAND HOLDINGS LLC
16285 SW 85TH AVE STE 410 7600 EAST DOUBLETREE RANCH RD, STE
TIGARD, OR 97224 SCOTTSDALE,AZ 85258
PHONE: 503-992-6664 PHONE:
FAX: 503-536-6615
FEES
Specifics: Description Date Amount
Air Conditioning 06/22/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 06/22/2017 $10.80
Class of Work: NEW Type of Const: Minimum Fee Adjustment-Mechanical 06/22/2017 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: crc
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
,
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Mtechanical Permit ApplicaplEc FOR OF HCL t;CF O LA'
City ofTigardEivE• ,>a sr / J ��,ft rorad(>r° - .2O/?-tom YS`�
IN . s! }3125.:SWIsil•BW4„Tigard;012.97223 Plaa;tteview OfherPermif:
Phone: 503.'718 234 Fax 503.598 l9(0 JUN 2 2 17 l> y: �G GY�3G� .
3•I c A I.i .taspcciion"Line 503 639.4175 Date g�y/By;• lwic 05s� age 2 for
:.1nierACC www.ti$ard,or:$oY i°a :,!<'atiCiedlNleiliod $epte mentatlnfawaiah0n
t�C'.�tY �Ei' � ii�,i
p If"n%P''b"y' +' .,�.•.a.J3. ,r,:'yR1^'.i#y�. a •i.0,1 i 10•,:YC �.};.:y_x c.:,5co : },,,,,7 '� t x:•-: --.41.-,,fix.
+r" .. .2:7:F,y'xa g'�:Sz`:.t 'ti,R:?r; s-t_11:e�c--...u*ry 5 i3 i.tl.. ,d'grit :;l.:. ...!, `li •• �. is • .- 1-^
Meetuthicel porn*fees*arc based 6ri th value of rile wot.
®:New construction ❑Additionfait+cretion/rcplacement performeit siridicale the value(rounded_t he nearest dollar]of all
O Other: mechanical materials,equipment;labor;*.lite,pear.
piofiL
Q L3emolulon y
•
• �,C:."h.. d•�y`hfi- Y`v^'.^.•.. w•.:vw. <:;� `'^.^T'^4n:.t;Pty a^zNk 1 ' i. Vitlk `.
cam. 1,4.41,•:„. � --. r?zc' ,', *,•Q.', = r '?"- ' = " '- -`f F,� . .—'-'' ' l0ES '39AT: `'1' �n`=' ,�•5�
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Di=and 2 f0'01p:weelling 0 C.otttmeroiallindttstrla! ❑.Accessorybuilding Pie vadat infor narton use the dlsL:
®Muni=family:
❑Master builder: [).Other Description C?ty, Total
<s-`. a.• °' ClS',v ar 1t Y xib..?li'0,0 a r ;{ H. .e., €
//��// 'C1.. Aitcondinamne. . 46.73 .
Sob site•addtoss r ),Ol(f IQ S&I.tiif.,tx L 1,,.�se.... a + :Furnace 10,1)60131V(ductateects) . . . 46.75.
Gityl$tutei*:,Tigaryl,QR 97224 Fvrnacc 109.000+BTU.(ducrstvcais) 1 54.91, .
.lieat:pump r 61.06
Suite/bldg la}t.fie.:: •) Project mime:Polygon a.tWe River Ter.
Duct Kron:: § 23.33
CruaS.streei/directions.ia.jobsite: Hydronic:hot water.system 1 23.32
Residential boiler(radiator or
.. hydropic) 1•-•... 23.32 . ..
WO heaters ffeel-type.not,electric), . •
.in-tvalt:inluct:suspended.etc: 1 46.75
•
• i l[ielYent l r any of::4bOYC ... •2 23.32 •
L
5ubdivisiaa P.5an at.. :.vest tivef.terrraet: Lane O� I 2332
8
> i .... Ather'fael appliances:• _ •.
Tax'map/parcel:no.. Water-heater . 23.32
''�4!, l #'7.$N..3T< ' r7 '1 a3:? - }.t: r Gas tireplaceJipseTt 33,39.
• .z2'iP� xv' c=JFK ,h.-.«.:_S. ,...,. s+rs 7.-,tet•"' ' .'`'T�Fn- x'<„a --?'�
Fluewtnt:for watcnc�aterorgas: 1
n �w Ii a 2
fireDa ince 23:32
Add A Jc :Log tielder(gas) 2332-
,� •/n� �77 /� �-� Woodloellin stove J 3139
• F l G�JitQy ....0..._3 ..i.... Woad fit epla tisert - 23.32
Chitin/finer/flur/vent 2332
Yr- u AY;. , 4 txto x •�� S *, l � 5• A' '
Oilier; a--2•— "7: :•!-'4.7.'1'-''""';''''---'3(--- ''- . .u.: ' 8nwironneutal,exhaust and ventifatr3�
Name--ADV)[.LandHuldingsPLLCRan ehopd/oOlat.kitchen •i - ...• -
•zA
equipment_ : r 3339 :• • •... .
OIV.ss 700•-......
R1P0010.0*.Ranch ltoaif ---'i
Glothis:dr}erexliaust l 33;39
.City/Suite LHPi Seettsdele,AZ 85258 • SiiiBlq-lduct:tzhaust(bathrooms,,
toilet'Comoiutnients,utility.rooms) 23:32
Phone (602)694-4031 i ax ( ) Altie/crawlspaceInn's: i 23.32
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�KF.14:'.:.....002.01!: •2111CI: 4. I.:2332 ..
ruel. iin
UsBinessnaine Williain:i yap llcimtS,1nC .
si4..15 for fftst Ebur;54.03for titch additional.
Cssntact:iiaiite:Arieta Gri rivski ...
8 j... Fitmacc;�rtc........ ,:•.,."171..
Addi'cssi'i119 Fast 13th Street
Gas heat ttm.
.....: Wallisuspended/unit healer .... ... . . _.
Cit}/StatetZtPi Yancouven;WA.986U ... 'Water,heater
,Pliorie (360)-69.5,7700.• .Jax•'060)-6934442:42 • :Fireplace I
E mail:Angela.G.raJewsktt polygarihomes.egm • -Barbecue
as .fit:'•_ :4.:. %:. ^^-F'LA. 44:: 'E-x'',a'a 8 ,y-"n f r altdlu° �' cYsx .4 i ..
-.,.� -a,•, +al� � � .. f.�v�.M... t'Jothcsdryer.lBas) 1
Business pami Atidctsen Mechanical Inc: Other ,
..., .. .a+... k, ,x3:..
i.., ..ss Ib285SW„.. Ave.. .,.....
`ubtotal
City/SialeJZlP.Tigard,.OR:91224 Minimum permit fee $90.00)
•Plan review(25%.ofpimig.fcc)
•Plion ::(503)992=5664 Fax:(503)536-6615
State surcharge:02%ofP girmit ee)
(OB;lic. 168214 / TOTALPERM T ;>r
• This permit applkatlea expires if a:peraairit norobtpined within 180
. days after it basbeen aoceptetlss complete.
•Aotoiiltd•signattire Fu'idethbdologyseifiyTri.CountyBimtdia 4rleitry'soi»teBoard •
uu1 •
Printnarbe Angela Grajewski: .Pale:.82G, t1.
t1BsiUdii4i'erml( lEC,Pen+ pp..09Qtt3.doet
440.4637T(t lto2tCOMAYEti)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17066 SW JEAN LOUISE RD, SHERWOOD, OR,
97140
Record Type: Record ID:
Residential - Mechanical MEC2017-00458
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Mechanical final for AC ok.
Violation Summary:
Inspector Contractor