Permit (186) CITY OF TIGARD MECHANICAL PERMIT
2 . ' COMMUNITY DEVELOPMENT Permit#: MEC2018-00053
T t GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2018
Parcel: 2S 106DB 14200
Jurisdiction: Tigard
Site address: 17435 SW FOREST HOLLOW ST
Project: River Terrace Northwest,Lot 142 Subdivision: RIVER TERRACE NORTHWEST Lot: 142
Project Description: Adding NC unit. Placement of NC unit must comply with manufacturer's requirements.
Contractor: APEX AIR LLC Owner: ADLV LAND HOLDINGS LLC
2210 W MAIN ST STE 107-272 BY FORSUM, MICHAEL
BATTLEGROUND,WA 98604 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 360-342-8109 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 01/23/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 01/23/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/23/2018 $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.
q.
Issued By: AZ `�, Li Kms"' Permittee Signature:
ccre— (.//a/Ilf' 7
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 A nnlicattin1L-i •'i---, ', .4. ''''..-' ' FOR OFFICE USE ONLY
A,l A '''' :,-,---''
....
-- City of Tigard Rc'ci.vcd i du /i Fr Pi:7i w c i I N:),I,(i. iae4 a er.COOS'S
: . 7 13125 SW Hall Blvd..Tigard.OR 47223 ji..4'.';',i 1 6 20'18 /
pl.!Le
• mon, 303.718.24.19 Fax: 503,598.1960 DatetSv Oilier Perimilk/Vdt() j 1-0(y)/r
TIGARD
Inspection One. 503.639.4175
'.;(t y" t.,,l- '„ t',.3",t'l.:''_. Date Readylily: tont litl Site Page for
Internet: www digard-orgov tt.-t it t-t,ti-it ft t blotificaMeditxl: Supplemental Information
i ::1-4Vil
fylechanieal permit fees*are based on the value of the work
New construction 0 Addition/alteration/replacement perlimed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead.and tofu.
',.1'..i..''.',..,- -n:diiiiii.ii-- iii. a.i1; :1=.,:_47,;;':-'1:;;,:: :,::-::::::::::Zi;
. . - - '- --------.-—----T------,.-------ff,------------,----------,.,
:.T
0 I-and 2-ramily dwelling 0 Commercial/industrial 0 Accessory building — For special information use-checklist. ,..
Ej Multi-family 0 Master builder 0 Other: Description 1 Qty. I_Ea. l Total
' . - - .--.. ' -- -- -•'. ------::--• ,r,--"'-'..-' - ,,-,--- .-.--:,', ,L1:-, Iieating/enolin :
:':. . 4011:91*RM4414;rtfti3N4t,LOCATIQrsittt:3t;t3t.tti.3.--zt..ttt:f3.:- ..3.3„. • , - g . —
, -• ,
Air conditioning REM 46.75
Job site address]'7 Li3s— \,,,,) Ftyresk. rtilaa.,,j .k..._
Furnace 1 oo.000 Bill 6.100,..4.0 R. 46.75*
CityiStateiZ IP:Tigard,OR 97224 Furnace 100.000+BTU(ductsIvolto .,4,91
— ileat pump 61.06
Suite/bldg./apt.no.: Project name: Vi\kr TcyffRi2.,_ 1\3 orionwes
Duct work 1111110=11
Cross street/directions to job site: Ilvdron ic hot water system IIEIIIIIIIIIIII
Residential boiler(radiator or
hydronie) 23.32
—
Unit heaters(fuel-type,not electric),
in-wall.in-duct,sits mded,etc,
..........
—
Flue/vent for anv of above 23,32
Other; ME 23.32 _
Subdivision:(2-Ne le' TeiWZACC. kts,)orkVIAA), -- Loi no, . 2.-
Other fuel appliances:
Tax map/parcel no.:
Water heater NM 2132
, „-,,,, , ,,,,,,,,--,_,,,_ ,,A,,:...-.„_•,Mcfarria-i,*-,0.E.AltAjkk,::,. :.-:-:-:.,:-_,:,-,;-,,T,::.:.H.,.-..„...:.-.--.. .,:-:..., . (MS itteplaCV,HISCII ,319
_
t\i\ST -
Flue vent for water heater Or gas
IA)11 0000
fireplace, ____. - 2332
Lop lighter(gas) 111111 23.32
. . Woodlpeilt.1 stove33.39
Wood firEtlacoinseri III 23.32
— - ---- —
Chimtievlinerillticiverit 23.32
23,32
dPROPERre:OVVNEWri',H:','."i'l,'-' .:-.-,7'.:;:--'--::': -::::::0'TENANT Other:
Invirunntrafal exhaust and ventilation:
Name:NO\IL Lzkr\cj tiaidactsi us ____ . Range hood'other kitchen
33.39
Address:-Awn *--
Clothes dryer exhaust 31,39
Cit}IS tateg1P-
..?). 7 S16
— — Single-duet exhaust(bathrooms,
toilet compartments,utility rooms) 2.332
Phone:CAL Li. (403( rax,( ) Atticicrtristspace fans 23,32
Id i APPLICANT j. - :-- -- -- --, 'ACT''PERSON'.-''' t--'-'t , UtheT. 23.32
. Futtipipingj
Business name:. " ' s '. ' '
- -I, te ., 4 ''.'IAA. a. ' SI4.1.5 for first four:$4.03 for each additional
Contact.name:mvc)cxzeaacsc,e__ Furnace.etc, _
Add _............._
LtIt. IIIIIIIIIIIIII ress: - o3 Nrtykawoy) ,,i- ludtE, s\,0
___. Wallisuspendedlunit heater 1111111111111.11.
CitylState1,11'..Vancouver,WA 98660
Water beater
. ,
Phone.(360)695-7700 Fax!:(360)693-4442 Fireplace
F-ntaRanee Fireplace- L .,,
_ .4A ' • I . sir- ' L '. . AI . 4111.' -.-..-11,....' Mak, Barbecue
c0.111RA ,.:.0 :..*i,::,;:::],:.,.z ]::•.. ',:..",-...: '.,:::-L -.:''':;,-.j•.:-.--,:t:', Clothes drver(gas) ME .
r
Other
Business name;Apes Air LI.C.
.. -7-' ''':'"--'1gf,ic *Piii.4!igtOPT,:rg.W1: '. :.:7::-,.,: :: '..:i.
Address:18004 NE 72"Ave
Subtotal
...,
_
CityiSiatelZIP:Vancouver,WA 98686 Minimum permit fee(590.00)
-------- Plan review(25%of permit lee)
Phone:(360)3424109 1-ax:(360)326-1769
State surcharge(12%of permit feet
,
t.(„13 lie.;203034
a/L-- -------------- TOTAL PERMIT FEE
Ihit.permit application tames Ka permit in not obtained within till,
nays alter it has been accepted as complete.
Authorized signature:
' Fee methodology set by Trittcourity Building industry Service Board
Print name: I I” . 1 I Date: 4-/1.14..
1 ,,mccPontitApp 0-M 1:i.d,w 4.io.1i,i 7 0 pr*:comvuni