Permit 111 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#. MEC2017-00882
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/08/2017
Parcel: 2S106DB00600
Site address: 13555 SW CALABASH TER Jurisdiction: Tigard
Project: River Terrace Northwest,Lot 6 Subdivision: RIVER TERRACE NORTHWEST Lot: 6
Project Description: Installation of A/C. Unit placement must meet manufacturer's requirements.
Contractor: ANDERSEN HEATING, INC.
16285 SW 85TH AVE STE 410 Owner: WILLIAM LYON HOMES INC
TIGARD, OR 97224 109E 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
Class of Work: OTR $10.80
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: 4
Permittee Signature: ,e/V. �-j'��G� 6 7C,1/4.1
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 Applic k a ,.,r' I()i i (II t I( I l SI ()NI 1
City of Tigard
ipi, Received tnate/B //J / Permi2NG L ,�/7- //O -
.. 13125 SW Hall Blvd.,Tigard,OR 972231;U� 1 2017
: Plan Review
Phone: 503.718.2439 Fax 503.598.1960 ABY OtherPermit
T I v R 1, on Line: 503.6394175 ��� �ti� a ,-. ¢ t .
DWeRedyByJung >a Sec Page Z for
Internet www.tigard-0Lgov ^)�t a ,§ ,:.',
t N hod; Supplemental Information
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®New construction 0 Addition/alteration/replacement Mechanical permit it Fees are based on to thevalue arothe woar
performed.Indicate the value(rounded to nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit
Value:
❑1-and 2-family dwelling 0 Commercial/mdustrial 0 Accessory building For gxdat byornradon use dredtlist
®Multi-family 0 Master builder 0 Other: Description I Qty. i Ea. I Total
Hnfl cooling:
Job site address: A Air conditioaiag i 1 46.75
I � w 1 SY 1 Teyrce. Furnace 100,000 BTU(ducts/vents) T 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(doaslvms) 54.91
Heat pump 61.06
SuitelbldgJapt no.: I Project name:River Terrace Northwest Ductwork 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or i
hydronic) 2332
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 2332 1
Subdivision:River Terrace Northwest I Lot no.:� Other 2332
Other fuel appliances:
Tax map/parcel no.: Watcr heater 2332
-4-Gas fireplaeefinsert _ 3339 i
Flue vent for water heater or gas I
new home construction fireplace 23.32
,/.A6 g/C--- Log lighter(gas) 23.32
�' Wood/pellet stove 3339
Wood fireplace/msert 23.32
C neylliner/flue/vent 2332
()then 12332
Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen i
eg_u'prnent 33.39
Address:7600 E Doubletree Ranch Road Clothes dryer exhaust
i 3339
City/State/ZIP:Scottsdale,AZ 85258 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32 :
Phone:(602)694-4031 Fax: Anic/crawisoace fans 91 12
Other
2332
Business name:William Lyon Homes,Inc. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Angela Grajewski Furnace,etc. _
Address:109 East 13th Street Cres heat pump
Wall/suspended/mit heater
City/State/ZIP:Vancouver,WA 98660 Water heakr
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace 2 ••
E-mail:Angela.Grajewski®polygonhomeacom Barbecue
Clothes dryer(gas)
Business name:Andersen Mechanical,Inc. Odie
Address:16285 SW 85a Ave Subtotal9ef.G -)
1 City/State/ZIP:Tigard,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit See)
Phone:(503)992-6664 Fax (503)536-6615 State surcharge(12%of permit fee) rl? , v
CCB He.:168214 TOTAL PERMIT FEE /pp .f%6
This permit application eipirrs ifs permit is not obtained within 180
days
fter it has been accepted as complete.
Authorized signature: yo4;
• Fee methodology aset by Tel-county Building Industry Service Board
../g1
Print name:Angela Grajewsld Date:8/22/16 e. 7. ,
1:113wltrmg\Pm nittU EC PermitApp 040113.doc 410-4617T(11fi2/COMfWEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13555 SW CALABASH TER, SHERWOOD, November 9, 2017 at
OR, 97140 11 :09:21 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-00882
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor