Permit (79) CITY OF TIGARD MECHANICAL PERMIT
INs Permit#: MEC2018-00099
■ COMMUNITY DEVELOPMENT
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/13/2018
T t c;,1 I+.Dg Parcel: 2S106DB15500
Jurisdiction: Tigard
Site address: 13110 SW AUBERGINE TER
Project: River Terrace Northwest,Lot 155 Subdivision: RIVER TERRACE NORTHWEST Lot: 155
Project Description: Adding A/C unit. Placement of NC unit must comply with 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 02/13/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 02/13/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/13/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to 0 C by calling 503.232.1987 or 1.800.332.2344.
Issued By: ��/7. i' / /���,� i� efmittee Signature: cCe-� €--7fil Cp)72.--1
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicaRECEIVED FOR OFFICE USE ONLY
City of Tigard REEe
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N .. 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 12 2018 Dil // PermitNo.:Phone: 503.718.2439 Fax: 503.598.1960 w ✓v l (A CitJV/
Inspection Line: 503.639.4175 Other Permit:
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TIGARD p ��� V� �IUi��� ateB .., ,, f,`../
Internet: www.tigard-or.gov
BUILDING
{{ /± r� ,l (�A F Date Ready/By: runs: See Page 2 for
t!(l_®1N DIVISION
°�. Notified/Method: Supplemental Information
e _. -TYPE,OP WORD. COMMERCIAL FEE* SL HJi DULE= USE(` 'CKLIST
Mechanical permit fees*are based on the value of the work
®New construction 0 Addition/alteration/replacement
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF`COATSTRCTIOPT • Value:$
® 1-and 2-family dwelling 0 Commercial/industrial _ RESIDENTIAL EQW1aNT/iSYSTEMS I~ S*
❑Accessory building For special information use checklist.
0 Multi-family 0 Master builder
0 Other: Description
Qty. I Ea. I Total __
JOB SITE 4iNiFoRmATION AND LOCATION,., Heating/cooling:
N Air conditioning 1 46.75 46.75
Job site address: t C
rNj �llA�e��\ P r -rFurnace 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.: ii LI I 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 I Lot no.:ic-S Other: 23.32
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
DESCRIPTION OF wotu Gas fireplace/insert 33.39
111 / Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
, ® PROPRTEY OWNER TENANT :Other
i 1 123.32
Name:ADVL Land Holdings,LLC Environmental exhaust and ventilation:
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,
Phone:(602)694-4031 toilet compartments,utility rooms) 23.32
Fax ( ) Attic/crawlspace fans 23.32
®'APPLICANT 0 CONTACT PERSON ' Other: 2332
Business name:William Lyon Homes,Inc. Fuel piping:
Contact name:Nichole Thorpe $14.15 for first four;$4.03 for each additional
Furnace,etc.
Address:703 Broadway St Suite 510 Gas heat pump -
City/State/ZIP:Vancouver,WA 98660 Wall/suspended/unithcater
Water heater
Phone:(360)695-7700 1 Fax::(360)693-4442 Fireplace
E-mail:Nichole.Thor a Range
p @polygonhomes.com
Barbecue
-r.. ',. .-..H CONTRACTOR
�.... _ . _.. , Clothesdryer(gas)
Business name:Pro Heating and Cooling,Inc Other:
Address:2095 NW Aloclek Dr Suite#1103 1�7ECHAPTICALYERMIT,FEES*
Subtotal
City/State/ZIP:Hillsboro OR 97124 Minimum permit fee($90.00)
Phone:(503)443-5692 I Fax:(503)941-5075 Plan review(25%of permit fee)
CCB lie.:209001
State surcharge(12%of permit fee)
TOTAL PERMIT FEE
/ This permit application expires if a permit is not obtained within 180
Authorized signature: , L � days after it has been accepted as complete.
L * Fee methodology set by Tri-County Building Industry Service Board
I Print name:Nichole Thorpe I Date:2/12/2018 I
r:\Building\Permits\MEC PermitApp 040113.doc 440-46I7T(11/02/COM/WEB)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13110 SW AUBERGINE TER, SHERWOOD, February 15, 2018 at
OR, 97140 12:16:19 PM
Record Type: Record ID:
Residential - Mechanical MEC2018-00099
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor