Permit (180) CITY OF TIGARD MECHANICAL PERMIT
2 ' COMMUNITY DEVELOPMENT
Permit#: MEC2018-00932
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/03/2018
[ �' Parcel: 2S106DA10400
Jurisdiction: Tigard
Site address: 16944 SW BIRDSONG ST
Project: River Terrace East, Lot 104 Subdivision: RIVER TERRACE EAST Lot: 104
Project Description: A/C installation.
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: 602-694-4031
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 12/03/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 12/03/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/03/2018 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to f. •^ •- rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001 I if 6. You m. obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: lzitz.....t..,e__ -----7 ---- Permittee S' ature: =�j ,....,--
Call 503.639.4175 by 7:00 a.m.for the next av • ' pection dat•.
This permit card shall be kept in a conspicuous place on the job site until compl'• on of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application ., l I)1(45l 1 It l 1 I
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Oared( f suer P°1114.PlS7' !b- t i O
33123 S hall Blvd„Tigard,OR 9"2')3
Phone" 3133.71$.234 � 3.39fl_ll
Inspection Line: 303.639.4173 '2 ).J 1? ' taae headvitly, atm 10 Set Pap 2 kr
Ilrttrnet; www.tigard-or,gov Notita 3«3 aa' happleawituil larrirmation
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►tea New construction 0 Additionhdleittionfeigliceinent performed.Indicate the value(rounded to the nearest doflar l of all
I rualitia rt Other: mechanical materials, t,lir,overhead,and profit,
alae:x
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0 i-and 2-fainily dwelling 0 Con Contnterviatlinditsirial 0 Accessory building For taus ase rkeriiiitt
4 Multi-family 0 Master builder 0 Other: 1 scr= aura •° Ea. Total
3413 •., ste I
Job 46 75
site address \�s2.C1L-\L\ D.A.) qua`,C'v«•c, ?� f a 19(100 0 Bill tc €sige t 46 75
(Its/State/ZIP:Tigard,d,OR97224 100,000+it Furnace 100,tRIG'd v t 91
I eat pond IIIII 61 05
Suitethld .lapt no: Project name:Polygon at '12.,.;..zw–-V..,,,:.,,,,,.-v--,-a-<_..L. Duct work 23.32
Cross street/directions to job site: s ,,z ir' ,7r-='S,c_ie, --1U c1 t1 rlrc nic hot maters tart 2.3.32
Itcsrtfla3boiler(radtntca or
hvdronie) 23.32
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fireplace/insert III 23,32
Ch' • 411asulltielyeta 23.32 MI
.,,,,, .„, Environmental exhaust and ventilation:
Saaure:Poly 4 EI],1-LC Range hood/other kitchen
,'rill, t33.31
Address. 109 East 13"Street __....__ _ Clotho s d `er exhaust 33 34
SL Its fStat&71P:Vancouver.WA w. itrr educt meatshaust amara
��,�.�..� utili 3 21.32
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i Contact name:Angela{.rajewslti 1'urttace,etc ��
Address. 109 East 136 Street Gas heat
pump
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City State°LIP:V'anentiver, A 9 water beater
I Phone.(60) -77 Fax v;:#�!6?3 t2 Fin..la,c
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l 03tastta.:ss name:Apex Air LLC f 31111 r
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Address:18004 NE 72” Ave Subtotal
minimum mit fee t'34t)U0
F £ttv�Statc; li':'�satracrter,��� 86 __
Plan res icw(23.aofpermit feet
i Panora: (360)342 10}9 fax:(360)3264769 State surchor e t 12%of permit feel
1 Ct.B iic-,203034 TOTAL,PERMIT FEE
__ 1121., _ _. . 114 permit apalleatiou means if a peratit 6 set obtained nine%a ISO
days atter ft has twen ampatel as opiate.
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City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16944 SW BIRDSONG ST, BEAVERTON, December 4, 2018 at
OR, 97007 10:52:28 AM
Record Type: Record ID:
Residential - Mechanical MEC2018-00932
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor