Permit (59) CITY OF TIGARD MECHANICAL PERMIT
Fri °.•'< COMMUNITY DEVELOPMENT Permit#: MEC2017-00455
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/22/2017
Parcel: 2S106DC13000
Jurisdiction: Tigard
Site address: 17082 SW JEAN LOUISE RD
Project: Polygon at West River Terrace,Lot 130 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 130
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: /0(40, ZeredPermittee Signature: ‹et j/�9fleke- AL1
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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Date03y: (,,, A)-- /7 '1"N6Y/,(14110/7-06 415-5-- •
lit..c:',•.i3125 SW lIall lvd.,Tigard,OR 97223
Phone::503.118.2439 Fez 503.598.1960JUN 2 2 2°17 Pia°Review
•:. , Date/33y: Other P
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! . :Inspection Line!'503.639.4175
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Sup p total Information .•
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BUILDING DIVISION-
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trattaitagigagNeg iMosgtA4Romz!ll*:too.xtPVx'xr'-ox,oggtk#,sAeW;-
. . /vlocheincel pertnit fees*aro based on 6tv valitc•of the work
0 New 0 Additionfalieration/repiaceacit performed.Indicate the value(rounded grille nearest dollar)of all
0 Dcnicif iiiini 0 011ier: mechanical materials;equipMent."labor.facritead,and profit
Valtie:'S i
-.'? MET:47400:0,WINNI.M$1050,itetd- Tee4Av-wri,"'''
....Altett,...Wi Al,tf iMil,virk.1),:r: q11,:., illt.,W,:ONAM„: „,„„AMN,, ,1141V*15.1,EgMi.:.:tetti
0:1;and 2:family:dwelling 0 Coirunercialluiduntrial 0 Accessory building For spedal InAnnation tisk checkart
el 1:41#ti-fp*I y 1 0 Master builder 0 cliber. Dcieription is-.!Ly. la. Total
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.i,'°'-' '•'.''•:::'';';',:1-:'''', Illegatitift#44,4tWASVIT:<4114$1.04-aggin:: H"11114**Iillat ,.
- Air conditioning it 46.75
661_ .SW :37eCur\ LtNAA$e cLoad
Furnace 100.000BM(ducttAvots) 1 46.75 -0•11i/:$tate/OP:Tigard,OR 97224 Furnace 300.600+BTU(deetsivenu) i 34,91
Beat pump I: 61.06
State/bldg./alit no.: I D 44 Project name:Polygon at West River Ter 1 - 1
Duct work i 23.32
Cres arieet/ditecdons to job site; liydranic hot water system 1 23.32 •
Residential boiler(radiator or i
hydronic) ,..j 23.32
Unit heaters(fuel-type,not electric), 1
in-will.in-duct,suspended,etc. i 46.73 .
• Fine/vent for any of above i 23.32
*ibipziSIOn:*MAO at West River Terrrace Lot no.:B D Other
Other hid appliances: t
1 123.32
•
ithi'iciiigiamptlip,;. .Water beater 1 2132
44g40-%•.-4.127*•:.44;;;MOWelittrIN.41atielfaXII00305; -edslit*Plu4/1"'en 1 3339
- . • - - Pine vent foe water heaver or gas 1
4tpuitifiifi :.. •lireplace I _2332
Add ..]11-1 c togliOtertgas)
WOOilinelietsiove i 2332 • .
! 33.39
Nit•51111;l9--.001q1 . ... . Wirod•tindiee/inseri • 1 23.32
hintitey/linerlflue/vent 1 23.32
. • r
Other
.:1 .44-4.1541IA/fArOlit011ettrallgeri&illit7g4f4raragir' hans"t a • venti.latio, 23.32
Nemec AD9I!1...441/01dings,13.4 . . .... . Range hood/other kitchen
' ,k_ripriient, ' 33.39
44.4.1r,44;10.0090:41etre4 Ranch Road ClothedrycinxhauSt 1 33.39
.Cily/State/ZIFt Seetbditin,AZ 85258 Sittglettlitet exhaust(bathrooms, fl
toiler nettnertnients,Utility rooms) 1 23.32
kiiiin4::(60.1)04.40i. Fax:( ) AttieJeMwispace fans I 23.32
,'i.,,i4t.1-mi4-!::4 -'§.-;:...• 7:30titmaggitlagamtilax.WANKSitili Other ; 2332
•t
lite. ',ucl piping:
I.InSitiess tian*..W.1111stitt Lyon;Hansel,
SI4.15 for first tour;$4.03 for catch additional
ecitIttiefitainO:Atilebi GitiMvski. Pliniiniketa.....- .,. I I
Addnisa:109 aStI3t1i.Streit Das heat pump 1 .,
tValitsupendedfunit heater
6040#4i.Pi'v.i.niii!i*Iiiiit 98660 :Waits beater ' 1.
flioife:OM 169.547e0, I Fax::(360)693.4442 ..Fireplace 1
Ronne I
t-iiiii:Angeht.Ora4ewskigpolygontomes.corn Barbecue --i
t
4;;.,41.tagw, - 1.;i._,Aggssfratiang; clothes:dm/(gas) f: .
149siaeiS,iaiiik*Ocici0a Mechanical,Inc- other . t
.• glarittgObilVg4';':FC';i7!.:7;..,;;'..er.),t,: :..7----.-:
40/ress00304W./Oh Ave , . ubtotal
ch)Y0144r4.04 titiled,OR 97fl4 Minlinum permit feek$90.03)
plan review(2$%of p4init fee)
P kill 6!004)9924664. • Fur(503)536-6615 -- State surebarge(12%of p it fee)
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CCB lie / TOTAL PE ' T FEE
.,
... . .. - . . ibis Feradt application expires if apermit4 DM obtoned witbin no
days after it ban been reeepteena complete.
Authorized kiti-a**.. .' • . . . . • Fee:nietlio,doloity set by In-County Buildi3 Industry Service Board
. .
Print Emilia iielit G‘Jijewski Dale:8/22116 I .
tittatiabsCifennitiiitiF4terreitAx44' 0i13.4oe 44046371*(11/07/COMAVE211 1
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
17082 SW JEAN LOUISE RD, SHERWOOD, OR, June 27, 2017 at 3:05:54 PM
97140
Record Type: Record ID:
Residential - Mechanical MEC2017-00455
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Mechanical final for AC ok.
Violation Summary:
Inspector Contractor