Permit (102) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017 00881
Date Issued: 11/08/2017
T1GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S106DB00500
Jurisdiction: Tigard
Site address: 13545 SW CALABASH TER
Project: River Terrace Northwest,Lot 5 Subdivision: RIVER TERRACE NORTHWEST Lot: 5
Project Description: Installation of A/C. Unit placement must meet manufacturer's requirements.
Contractor: ANDERSEN HEATING, INC. Owner: WILLIAM LYON HOMES INC
16285 SW 85TH AVE STE 410 BY POLYGON WLH LLC
TIGARD, OR 97224 ATTN GAST, FRED
109 E 13TH ST
VANCOUVER,WA 98660
PHONE: 503-992-6664 PHONE:
FAX: 503-536-6615
FEES
Specifics: Description Date Amount
Air Conditioning 11/08/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 11/08/2017 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 11/08/2017 $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.
Issued By: 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 Applicatl Fr''-:4:-....iv,!.... ,,
City of Tigard n Reces // ''/7 t/ier /7- _ ...P/
13125 SW Hall Blvd.,Tigard,OR 97223
III- Phone: 503.7181439 Fax: 503.598.1960 �'`�,�_ 1 Dat Y Review Other Permit
T ,,e;<n �P�3n Litiet 503.639.4175 ..
Internet www.tigard-or.gery Gil [_ @ t+ r Arc,- �e ROB��' luau: H See Page 2 for
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1 "r;? 1 vofiSed/Metbod Supplemental Information
®New construction 0 Addition/alteration/replacement
Mechanical permit fees*are based on the value of the work
❑Demolitionperformed.Indicate the value(rounded to the nearest dollar)of all
0 Other: mechanical materials,equipment,labor,overhead,and profit.
valete a � '
❑I-and 2-family dwelling 0 Commercial industrial 0 Accessorybuildingck
la Multi-family $ Forapexiol WornmNaa use checklist
0 Master builder 0 Other: Description l Qty. I Ea. I Total
13 c .
`
Ha cools -,
Job site address:: , n �+t Air conditi•.1.� 146.7s
W, & )Y n 1 ��3A_ Furnace 100,000 BTU(duets/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
—
Suite/bldgJapt no.: l Project name:River Terrace Northwest Hem pump 61.06
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-duet,. . .dcd,etc. 46.75 '
Flue/vent for any of above 23.32
Subdivision:River Terrace Northwest I Lot no.:G Other 23.32
I _ 1 Other fuel appliances:
Tax map/parcel no.: Water boater 23.32
' r w Gas . .lace/rnsert 33.39 _
new/home construction/; - Flue vent for water heater or gas
23.32
''7 aeLS /c — fireplace 23.32
- Wood/pellet stove 3339 '
Wood fireplace msert 23.32
Chimney/liner/flue/vent 23.32
j Older2332
' ' "" Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road cut 133.39
Clothes. er exhaust i 33.39 _
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms, '
toilet compsxmrpa u
Phone:(602)694-4031Fax ( ) utility rooms)
23.32
Other
_ . 332.
2332.
Business name:William Lyon Homes,Inc Fuel Pitting:
S14.15 for first four;54.03 for each addl soma '
Contact name:Angela Grajewsld etc•Address:109 East 13th Street Gas heat pump
City/State/ZIP:Vancouver,WA 98660 Wall/suspended/unit heater
Water heater
Phone:(360)695-7700 Fax::(360)693-4442
E-mail:Angela.Grajewski@polygonhomes.comBarbecue
Clete
1. 111.1111.11111.
Business Business name:Andersen Mechanical,Inc. Other ---
Address:16285 SW 856 Ave
Subtotal yQ,
City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00)
Phone:(503)992-6664 Far(503)536.6615 Plan review(25%of permit fee)
State surcharge(12%of permit fee) sr/ ,�G)
CCB lic.:168214 TOTAL PERMIT FEE ell a CJ
�/` _ Thispermit application expires if a permit is not obtained within 180 •
Authorized signature: /, ]Ii/1J
4/?5:44 ,
dayss after k has been accepted as complete.
• Fee methodology set by Tri-County Building Industry Service Board
Print name:Angela Grajewski Date:8/22/16 �2
r:u aB vdEc P�anpp am13.aoe 440-4617T(11/02/COM/WEB) � `�� f i7 C'L�i'Z��L'
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13545 SW CALABASH TER, SHERWOOD, November 9, 2017 at
OR, 97140 11 :16:46 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00881
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor