Permit (115) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2017-01006
Date Issued: 12/20/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DB16400
Jurisdiction: Tigard
Site address: 13174 SW AUBERGINE TER
Project: River Terrace Northwest,Lot 164 Subdivision: RIVER TERRACE NORTHWEST Lot: 164
Project Description: Adding NC unit. Placement of NC unit must meet manufacturer's requirements.
Contractor: PRO HEATING AND COOLING INC. Owner: ADLV LAND HOLDINGS LLC
2095 NW ALOCLEK DR, SUITE 1103 BY FORSUM, MICHAEL
HILLSBORO, OR 97124 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 503-443-5692 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 12/20/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 12/20/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/20/2017 $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. .�[
i $t G�2��«,a726
Issued By: .1.21-/////4:7-4 .—
//Gi/ %!''! 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.
RECEIVEI
Mechanical Permit FOR OFFICE USE ONLY
Cl of Tigard 7 Received permit No.: 4/t(; '}„
13125rSW Hall Blvd.,Tigard,OR 97223 9 Q 1/ Date/By: t✓�
No Plan Review
Phone: 503.718.2439 Fax: 503.598.1960
Other Permit,44: S /7 �/4Inspection Line: 503.639.4175 CITYof icARDate/By.
TIGARD .,k
Date ReadyBy: Juris: Ea See Page 2 for
Internet: www.tigard-or.govDiviry hfied/Method: Supplemental Information
TYPE �l♦WQRK - Co MMERCIAL FEE*:-SLkH.DULE . USE CIIEC I1ST ..€
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION ._ - IBES*
Value $
.=TtESIDENTIAL)�QUIP11'IE]V'I'/SI'S'r�14IS F
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
®Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
— �JOB STIL INFORMATION AND`)LQCATION• .
Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address: 13174 SW Aubergine Terrace Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.:3.3 Project name:River Terrace Northwest 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:River Terrace Northwest Lot no.:164 Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION VF.WORk Gas fireplace/insert 33.39
Flue vent for water heater or gas
Adding A/c fireplace 23.32
MST2017-00116 Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROI'FI�I'OWNER Other: 23.32
d TENANT` Environmental exhaust and ventilation:
Name:ADVL Land Holdings,LLC Range hood/other kitchen
equipment 33.39
Address:7600 E Doubletree Ranch Road 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
APPLICAN _ _ ] CONTACT PERSON Other: 23.32
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
Range
E-mail:NIchole.Thorpe@polygonhomes.com Barbecue
CflNTRACTCR = Clothes dryer(gas)
Business name:Pro Heating and Cooling,INC Other:
MEClIANICAL PIs`1 l flT FEES'
Address:2095 NW Aloclek Dr Suite#1103 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 lic.:209001 TOTAL PERMIT FEE /ea.Pv
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Nichole THorpe Date:12/19/2017
I:\Building\Permits\MEC PermitApp_040113.doc 440-46I7T(I1/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13174 SW AUBERGINE TER, SHERWOOD, December 21 , 2017 at
OR, 97140 9:31 :58 AM
Record Type: Record ID:
Residential - Mechanical MEC2017-01006
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor