Permit IN
CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2018 00032
T 1G A 14 L) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/16/2018
Parcel: 2S1060001500
Jurisdiction: Tigard
Site address: 13464 SW BEACH PLUM TER
Project: River Terrace Northwest, Lot 201 Subdivision: RIVER TERRACE NORTHWEST Lot: Multiple
Project Description: Installing NC unit. Placement of NC unit must comply with manufacturer's requirements.
Contractor: ANDERSEN MECHANICAL Owner: ADLV LAND HOLDINGS LLC
16285 SW 85TH AVE#410 BY FORSUM, MICHAEL
TIGARD, OR 97224 7600 E DOUBLETREE RANCH RD STE 1
SCOTTSDALE,AZ 85258
PHONE: 503-992-6664 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 01/16/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 01/16/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/16/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
'�' 40, 0 GXPermittee Signature: C ✓oA ez7
r e �l�
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit IicatlO
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ligCity of Tigard �.��r...u9��61`��' Received
- Date/By: Permit No.:
° 13125 SW Hall Blvd.,Tigard,OR 97223 fi fL c-A0 //
Phone: 503.718.2439 Fax: 503.598.196Ui r, n p Plan Review Other Permit:
1 N�� 21 l)1 U Date/By:
TIGARD Inspection Linc: 503.639,4175 LL / "'tlJl_/
Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov ,GARDg
Notified/Method:
(.‘,11-Y '�,)l"' � lSupplemental Information
TYPE 0 0 COMMERCIAL FEE* SCHEDULE-USE CHECKLIST
►.t New constructionMechanical permit fees*are bason the value of the work
0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY Ole CONSTRUCTION Value:$
0 1-and 2-famil dweRESIDENTIAL EQUIPMENT/SYSTEMS FEES*
y llin g ❑Commercial/industrial 0 Accessory building For special information use checklist
®Multi-family 0 Master builder
0 Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION IieatinooAir conditg/cioningling:
1 46.75
Job site address:
34' n : w Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(duets/vents) 54.91
Suite/bldg./apt.no.:I t t Project name:River'Terrace Northwest 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:River Terrace Northwest Lot no.:1. Other: 23.32
i Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
'DESCRIPTION OF WORK Gas frreplace/insert 33.39
Adding A/c Flue vent for water heater or gas
fireplace 23.32
\ 1t . ; Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
r. PROPLrRTY OWNER Other: 23.32
I 0 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/crawispace fans 23.32
® APPLICANT 0 CONTACT PERSON. Other:
23.32
Business name:William Lyon Homes,Inc. Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name:Nichole Thorpei Furnace,etc.
Address:109 East 13th Street Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Vancouver,WA 98660 Water heater
Phone:(360)695-7700 l Fax::(360)6934442 Fireplace
E-mail:Nichole.Thor a of> onhomes.com Range
pP J g Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Andersen Mechanical Other:
Address:16285 SW 851°ave Suite 410 MECHANICAL PERMIT FEES*
Subtotal
City/State/ZIP:Tigard Or 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)992-6664 Fax:( )
State surcharge(12%of permit fee)
CCB lie.:217392 lO/G/(7 TOTAL PERMIT FEE a
// This permit application expires if a permit is not obtained within 180
♦ y days after it has been accepted as complete.
y-
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name:Nlchole Thorpe Date:1/12/2018
I:\BuddingTerm6AMEC_PemutApp 040113_doc 440.46177(11/02/COM/WEB)