Permit (184) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2018-00940
TEG RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/05/2018
Parcel: 2S 106 DA10500
Jurisdiction: Tigard
Site address: 16904 SW BIRDSONG ST
Project: River Terrace East,Lot 105 Subdivision: RIVER TERRACE EAST Lot: 105
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 12/05/2018 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 12/05/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/05/2018 $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 952-001-0,'m Yo. may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
C.
Issued By: � er ee Sign. ure:
*Art' _.
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.