Permit (23) CITY OF TIGARD MECHANICAL PERMIT
1111 ° COMMUNITY DEVELOPMENT Permit#: MEC2016-00179
T EG.ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/17/2016
Parcel: 2S1060001600
Jurisdiction: TIGARD
Site address: 17255 SW HOLLY RIDGE LN
Project: River Terrace Northwest, Lot 21 Subdivision: 2002-032 PARTITION PLAT Lot: 3
Project Description: Adding front and rear covered porches and new window openings to sales trailer.
Contractor: APEX AIR LLC Owner: POLYGON NW WHL LLC
2210 W MAIN ST STE 107-272 109 E 13TH ST
BATTLEGROUND,WA 98604 VANCOUVER,WA 98660
PHONE: 360-342-8109 PHONE: 360-695-7700
FAX:
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 03/17/2016 $99.76
Class of Work: ALT Type of Const: Plan Review 03/17/2016 $24.94
Occupancy Grp: Occupancy Load: 12%State Surcharge-Mechanical 03/17/2016 $11.97
Stories: Info Process/Archiving-Sm$0.50(up to 03/17/2016 $0.50
Project Valuation: $1,500.00 11x17)
Fuel Air Handlers
Fuel Types: Units< 10000 cfm:
Gas Pressure: Units> 10000 cfm:
Furnaces Boilers&Compressors
Furnaces< 100K BTU: 0-3 HP:
Furnaces>=100K BTU: 3-15 HP:
Floor Furnaces: 15-30 HP:
Unit Heaters: 30-50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $137.17
Hoods: Comm Incinerators:
Required Items and Reports(Conditions)
Woodstoves: Gas Fireplaces:
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire/Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • ..ittee Signature: �!
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE 1'SE OyI.I
Received
City of Tigard
Date/By Permit No.:
71
13125 SW Hall Blvd.,Tigard,OR 97223 y `� 1` �� i
Plan Review�� � Date/By: Other Permit: 10
Phone: 503.718.2439 Fax: 503.5pSsl �(P
K _A A.
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris: n See Page 2 for
Internet: www.tigard-or.govNotified/Method: 7"7-+4 Supplemental Information
MAR 2O\r.
b r
`'
coMivlE ;���. VSE of the work
CHECI LIST
' oo �w G 1 ..
� �� Mechanical permit fees*are based on the value
❑New construction Addition/dt�ip• performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: DUU1tr mechanical materials,equipment,labor,overhead,and profit.
Value:$ 1d7
'Iw'A"I'1 GOR ;OF Cole n,',E lul. - RESIDEN'TIALEQVW M fSVSTE $I ES*
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist
❑ Multi-family ❑Master builder 0 Other: Description Qty. Ea. Total
JOB SIITI'1NFORM4TIO?$ I� Heating/cooling: J
Air conditioning 46.75
7
Job site address: '762,5,5 $L4i �'i-�
lI � [� �
, I• Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: / /� _0 Furnace 100,000+BTU(ducts/vents) 54.91
`` Heat pump 61.06
Suite/bldg./apt.no.: 1 Project name: � ."'T"--- I LLQ 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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DE RIPTIOI OIR.'4 RE Gas fireplace/insert 33.39
Flue vent for water heater or gas
L.2Ct--1.JO471-1C- \o1Jt P1tJ -T 1C)N.) fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39 -
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
1t• ROP*RTY 0'OWNER ❑. 11N�T Other: 23.32
Environmental exhaust and ventilation:
Name: j =.1.....-, f. o��S Range hood/other kitchen
equipment 33.39
Address: t bp, E I N Clothes dryer exhaust 33.39
City/State/ZIP: Vpc1.�Co0u0e.... Aja., Ot&(oCo0 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(3u°) cc:As _ '1--1L•� Fax:( ) Attic/crawlspace fans 23.32
APPLICANT - ACT PERSON Other: 23.32
Fuel piping:
Business name: e��
"/' 111.112- L-LL $14.15 for first four;$4.03 for each additional
Contact name: -i-Tp.,\ e.( Furnace,etc.
Address: 721 O t..... Hil,t.IJ C�_ ' T I '1.2-12 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: ? /,' u 1..)4._ q , Water heater
Phone:(3t...0) 34 i-151 dG/ Fax::( )526._1.•74.1 Fireplace
Range
E-mail: � i_t e s Al a_e_c,•(o r Barbecue
rD01'ICT11F Clothes dryer(gas)
Business name: j y Nt EL t WC Other:
\ MECFIAI*AL PERMIT PEES*-
Address: z2,10 l.7 t 1,... <.. �1` - ILD-1 .. 2_712_ Subtotal
City/State/ZIP: z. L. _ A.po0lt_,fl ti j Ct�J(ot�1f Minimum permit fee($90.00) et di ..7�
Plan review(25%of permit fee)
Phone:(360) 3�2.,_e Ic:py
// Fax:(3t�32(, - I 1(p'i State surcharge(12%of permit fee) /i• /7
CCB lic.: Z�-s 3L( S fq ii. TOTAL PERMIT FEE ���./ 7
/, , This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: Fee methodology set by Tri-County Building Industry Service Board
Print name: -T-5_‘. y Date: s ,
I:\Building\Permits\MEC_PermitApp0401 13 doc r 440-46171(11/02/COM/WEB)
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