Permit (86) CITY OF TIGARD MECHANICAL PERMIT
IN
a. ' COMMUNITY DEVELOPMENT Permit#: MEC2017-00929
Date Issued: 11/22/2017
T E�C tkkt 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DC00100
Jurisdiction: Tigard
Site address: 17096 SW ROCKY RAMBLE LN
Project: Polygon at West River Terrace,Lot 1 Subdivision:POLYGON AT WEST RIVER TERRACE Lot: 1
Project Description: Adding NC unit. Placement of A/C unit must comply with manufactures requirements.
Contractor: PRO HEATING AND COOLING INC. Owner: WILLIAM LYON HOMES INC
2095 NW ALOCLEK DR, SUITE 1103 109 E 13TH ST
HILLSBORO, OR 97124 VANCOUVER,WA 98660
PHONE: 503-443-5692 PHONE
FAX:
FEES
Description Date Amount
Specifics:
Air Conditioning 11/22/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 11/22/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/22/2017 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: l//4
�" Permittee Signature: s, � � /`L'� ��
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RECEIVEP
Mechanical Permit Applicata FOR OFFICE USE ONLY
. City of Tigard !� Received �y�5)...?e�
_ n 13125 SW Hall Blvd.,Tigard,OR 97223 N O V 2 0 2017 Date/By: <! 17 frt- Permit No../i�� 'n/ vol /
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review /v1 � V
Date/By: Jun 5 Permit: 5720/7— /)lj
TIGARD Inspection Line: 503.639.4175 CITY OFTIGAR1t9 ge2 !/[�
Internet: www.tigard-or.gov CITY F !Ut tl it Date Ready/By: 7uris: I ®See Page 2 for��� ��� �I®_NNotified/Method: Supplemental Information
--:TYPE,OF'WORD I.? COMMERCIAL FEE*,SGkll.DDLE'—USE(,H1:,CIMIST--
®New construction Mechanical permit fees*are based on the value of the work
❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
-. -CATEGORY OF_,CONSTRIJCTION Value:$
❑ 1-and 2-familydwelling RIESII?_ENTIAi4.EQPW4Nx/SYSTEMS FEES*
g 0 Commercial/industrial ❑Accessory building For special information use checklist.
®Multi-family 0 Master builder
❑Other: Description Qty. Ea. Total
JOB"SITE INFORMATION AND_LOCATION _ Heating/cooling:
Job site address: 17096 SW Rocky Ramble Lane Air conditioning 1 46.75 46.75
Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.:5.1 Project name:Polygon at West River Ter Heat 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-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision:Polygon at West River Terrace Lot no.:1 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION•OF WORK Gas fireplace/insert 33.39
MST2016 00601 Flue vent for water heater or gas
fireplace 23.32
Adding A/C Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
PROPERTY OWNER Other: 2332
❑„TENANT
Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
Address:7600 E Doubletree Ranch Road equipment 33.39
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
®'APPLICANT' ,.ti. .. ,. C NTiCr PERSON Other:
2332
Business name:William Lyon Homes,Inc. Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Nichole Thorpe Furnace,etc.
Address:703 Broadway St Suite 510 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
E-mail:Nichole.Thor P a @P Yg of onhomes.com Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Pro Heating and Cooling,INC Other:
Address:2095 NW Aloclek DR Suite#1103 MECHAI CA1 PERMIT FEES*
Subtotal
City/State/ZIP:Hillsboro OR 97124 Minimum permit fee($90.00)
Phone:(503)443-5692 Fax:(503)941-5075 Plan review(25%of permit fee)
State surcharge(12%of permit fee)
CCB lac.:209001 TOTAL PERMIT FEE
/ This permit application expires if a permit is not obtained within 180
1 days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Nichole Thorpe I Date:11/20/2017
I:\BuildingTermitAMEC_PermitApp_040113.doc 440-06171(11/02/COM/WEB)