Permit (87) CITY OF TIGARD MECHANICAL PERMIT
� Permit#: MEC2019-00072
■ COMMUNITY DEVELOPMENT Date Issued: 02/07/2019
T I[ A i..L-) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S106DA11700
Jurisdiction: Tigard
Site address: 16668 SW SNOWDALE ST
Project: River Terrace East,Lot 116 Subdivision: RIVER TERRACE EAST Lot: 116
Project Description: NC installation. Placement of NC unit must comply with manufacturer's installation requirements.
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: 602-494-4031
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 02/07/2019 $46.75
Type of Use: MF 12%State Surcharge-Mechanical 02/07/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/07/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obt. a copy of the rules
or direct questions to OUNC by calling t .503.232.1987 or 1.800.332.2344.
; Permittee Signature. ��'
Issued By: /� �/� �� /�imixr.
/ Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application Foil.OFFI(t: OLUSE
City of Tigard
" PLerct 42
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' �` ate 3y. ,(//7 ^unit /
m / /_
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74
• f3125 SWIIA Blvd-"1igtt.CR2 ►tz L� , Man E.uscw
Phone: 503.718.2439 Far, SO;.SSS. aateEt} t11tzictnii/y.).57 lcr—
[X11 7 7
TI G A R D
Inspection Line: )03.639.41?5 ,' f 1 U Hate Re tdy:By. ma, 6I See Pale 2 for
Internet: www.ttgard-or,gov FEB ,--'1..)
1-otitier1 'kihad: Supplemental lnfe rnratinn
I"YYE iit,:04,,:,,,,tr..,,,,,--,,,,,,,,--r"'",77-777-i!i,-T,:j.E-. .,r� ` C-omiER tA'l:• `Eb`sscHEryytt `l.E C I t iaisT-:
tt- INrinf° i `(': { Mechanical perms fees*are based on the 1'rilue of the wort.
2I New construction 0 Additionaltenauonfreplacemenlperformed.Indicate the value(rounddedlo the nearest tlari nt'ait
0 Demolition Other: I mechanical materials,equipment,labor.overhead. tttd profit.
Value:$
CATE1 ORY'OF:c'ONFritti "flU1
<' RE,S[IOTiALLQLlPMENTJ54`5TEMSI'f;ES•
CI 1-and 2-family dwelling 0 Cottlmerciallinduxtrial 0 Accessory building _ Jar rspecial information use cheek list _
El Multi-family 0 Master builder 0 Other. Description ; Qty, Es. Total
JOBSITE . . .INFORMATIONASH•L(3GilTiOA
Ifeating'enntint::
Air conditinuine i 46.75
Job site address'. _ItalC0 zo 8- -S_W .5tEf4 64 57T Furnace 100.100 BTU t in ts'yents1 46.75
CityJStatelZLP:Tigard OR 97224 - Furnace 100.000+BTU tiled Wenn, 54.91
I teat pump _ 61.06
Suitelbldg.;apt.no.: Project name;'}Rt\ER TelrraeC.E.a-StDuct work 23.32
Cross street/directions to job site: 1 lie•dronic test water system 23.32
Residential boiler(radiator or
bydronfe) 23.32
Unit hint.ters(fact-type,not els cttic),
in-wall.in-duet.suspended,etc. 46 75
Flucc:'vent for any of above 23.32
Other: 23.32
SWbdi3riai011. Lot no.: L
Other fuel appliances:
Tax mapiparcel no.: Walet heater 23.32
D )€PT7P1f U ('1tl Gas fireplacefinscft 33.39
' flue vent for water heater or pas
_ _ - _-= - fireplace 23.32
l egtit}tterfeask . 23.32
_ Wood`pcilrt stove 33.39
d ,,4 e_ t4 / - Wood fireplace/insert r 23.32
t himney>1lner/fiuc!ccm 23,32
.. _
23.32
PkOti'FRTi OW?NIER C}lllct'
Q iE'\AiT _.
- Environmental exhaust and t'entllstnrn:
Range hooddither kitchen
Name: KbV i- �}t1D 4 blrUi I.3C�S t 14-Cp
equipment 33.39
Address; .�t, bQ`_E�pub\e` cQ art\ oaf ( 33.39
(�R- m.., p. Clothes dryer exhaust
Cit)15tate/ZIP! �,co -'~1sdao._.; Q12• 5 25 p Single-duct exhaust(bathrooms.
toilet compartmentsutility iiIiTms) 1 23.32
Phone: l pb2 (A4 (.},Ob, Fat ( ) Alticicrawispace fans ' 's3,37
_; l►YP'LECd►.'\I: -:ID`t'O14TACT Y�xxsOe
f}ther. 23.32
fuel i ing
Business name:Polygon N1,1.I,LLC
S14.IS for first faar,$4313 for each additional
Contact name;Jot a er-, S ;AAA A Furnace.etc.
Address: 1C3 --E,ro0.6.u)O y S4- k mac. 51O Gas heat pump 11
i ail suspended unit heater
City(State1Z!P:Vancouver,WA 98660 Waterheater
Phone:(360)695-7700 Fax::(360)693-4442 Fireplace
Barbecue r Ranee
E-mail: e.riesK t-su bra. 10.15 a� okesO r\Atryve5•i �Yyl i _—_��_.
.J . .
('ONIBACTOR _ . ;i . . Clothes drveriens) 1
Business name:Apex Air LW (Vier
14MECH-4AICAL PERhlIT-E£ES*.;:
Address:18004 ISR 72"a AveI Subtotal
1
City/State'7.1P:Vancouver,WA 98686 Minimum permit fee(S90.O0 i
_ Plan review(25%of permit fee) G
Phone:(360)342-8109 Fax:(360)326-1769 State surcharge(12%of permit leo
CCB tie.:203034 TOTAL PERMIT FEE j
thr permit al•ptieptiun evpira.if a permit is not obtained tvl#bin ISO
da:ssaf#er it has been accepted as complete.
Authorized signature: * Fee methodology. by'rn-County liednre tndustn'Service Board
Print name: 1 •{ 1 DDale: 1 O�6`2 j
I dt:rit3,n Pretn44Mt'.i'..t'txrnit:lrr_'aat 17 tttk 4+16-1,l'"r tt1P1/2(`04(u'snt
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16668 SW SNOWDALE ST, BEAVERTON, February 8, 2019 at
OR, 97007 8:40:48 AM
Record Type: Record ID:
Residential - Mechanical MEC2019-00072
Inspection Type: Inspector:
699 Mechanical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor