Permit (188) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2018-00052
T GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/23/2018
Parcel: 2S106DB14000
Jurisdiction: Tigard
Site address: 17477 SW FOREST HOLLOW ST
Project: River Terrace Northwest,Lot 140 Subdivision: RIVER TERRACE NORTHWEST Lot: 140
Project Description: Installing 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.
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Issued By: Permittee Signature:
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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.
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Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard ii'''', 1 3 ZO13 Received /' A 7 /-
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a Phone: 503.7182439 Fax: 503.548:1alt:
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TIGARD Inspection Line: 503.639,4175 ..:••. t I! :-1,,'.7 '''. ',:,',, , : Dine ft,ovisy, farin la See aae2ier
litterner www.tigard-or.gov '--'"' ' ' lintifiedasteMod: Supplemental Information
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Mechanical permit fees*are based on the value of the.wort;
SI New construction 0 Additionla Iteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials.equipment,labor.overhead,and tont.
Value;S
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IcitTEGoRr OF.COIVS'TRIICTIO1*:::,•*:!:,;••-,s.--:c.'t,L,• -..::::: - ;-.. ,-. .-- -- .: ,, ,
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1:3 1-and 2-family dwelling 0 Commercial/industrial 0 Actvssory building For special information use thedlist. 7
EI Multi-family 0 Master builder 0 Other. Description i y. Ea. Total
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.-'. .•;. 1,:,-!..:i..i.f„,-..•:. •..10)i,..-;00tiiitoottkiki..05*.A*iii:AiefkiiiK :,::.:. .-?:::::-'7:::.1'.7-':-::':' ::1'. 11"fi"k°°11"' —
Air conditionin a , 46,75
Job site address;i'1411 v\I %resit- tiokLOW %.I.- ..
Furnace 100.000 BTU idneis'yents) all 46.
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City/State/Z.1P:Tigard,OR 97224 Furnace 100.000+BTU rttrietsfventi,) 54.91
—
I teat pump 61.06
Suitelblitlapt.no.: Projecl name: Viger -R,Kace, isaDrhevwes-k-- Duct nett 23.32
Cross streetldirections to job site:
jj1-dronic hot water system 23.32
Residential boiler(radiator or
•
h1111
ydroniel111
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Unit heaters tract-type,not electric),
in-wall,in-duct,sus ended,me. 46.75
Flueisent for any of above 2:37
- Other 23,33 Mil
Subdivision:124,ier Temrace..0,,,)ortvu4._ Lot°° 190
.Other fad appliances: ......._
Tax snap/parcel no.:
Water heater 23.32
d : .:: ::'•:::: ..r..:::.:: !..:1:.:A. ..:.1*,,,:titinilti6700.iiie:. ‘:::';''"...-; '•;,:'-::'•.L;,:'.-:,:;'''',?..':-;;;1.7.:....' Gas fnenlaectinsert .3.39
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Flue vent for water beater togas
* ' cti._ 1-. 01e2_ — fireplace _ 23.32
Lop lighter(gas) 23.32
Wood/pellet stove 33 30
Wood fireplace/insert 23.32
. Chirrinevilinertflucivent 23,32
2.3.32
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Environmental exhaust and ventilation:
Name:NO\it, LA1)0 tiolcAto9c, Lis, Range hood/other kitchen
cum.omen, 33.39
A"r°5 -1kft P_D-_..."At9. .-ketataara,,esc,',,Sci__Ve Clothes dryer exhaust 3339
Ciry/StateiZIP'. A Sinele-duet exhaust(hathmoins.litola 4 . ' ak. a 7516
.--
toilet compartments,utility rooms) 23.32
Phone:
f ffar- _-4o! i..Uf'.a.V./.. Fax:( )
Attiecrant.gae fans 23.32
. ..
.'.:. :•..:. '':[;•:-.•-::,';:El 'AO44,e4ktST:.'' -:.:::f.7:."'''':': h f :-.':1:-:.irilc.:::-.E.:L.Olitt.'4e*'..-Or*skii4::::::.,,z...:,::;-:--;.: Other 23.32
Business name:4J t 1 i*aryl,- Of\ Voyles(T.( C.....
$14.1.5 for first four:$4.03 for Oa additional
contact name:IN) )..\.cie!"\rtOtive..._
Furnace.etc,
.........____
Gas heat pump
Address:1 0-1.3 tbvtiaotwav) srit. awe- s\,0
_____, Walltsuspendcdfunh heater
City/State/ZIP:Vancouver,WA 98660 4
Water heater
Phone:(360)695-7700 Fax'.:1360)693-4442 Fireplace
II
Range
E-mail:
' 1 II' - I. '. .,IPA All- AA sks Barbecue
..- ;-.--...:,: ..F -::::,;:.-:1: . •...-..J ,,,t,_::.....:;., .0(..)71110 :, 0 ::,:.,::':.7-...1' 7_:,_:,:_- ;;:::". '-:.,--":-.--. -,-;-..:-_,:;',:.,..',.._._ Clothes dryer lees)
Business name;Apes Air 1.1C Other
,. ,... .: . :_:NiEcilANicAi.,,E0m01.4,5*,::Y1.. 't.','. l•::.--
Address:18004.NE 72"Ave
Subtotal
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City/State/ZIP;Vancouver,WA 986Minimum permit fee(590.00)
86 0 _
,
— - Plan review(25%of permit fee)
Phone:(360)3424109 I Fax:(360)326-1769
State surcharge 112%of permit foe)
CCB tic.;203034
TOTAL PERMIT FEE
- - This permit application expires ire permit is not obtained within UM
data after it has been accepted an complete.
Authorized signature'
* tee meditrialogy scl hy Tri-Cisunty Building industry Service Orad
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Print Male: I lift_ ',.fDote: *I-
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