Permit CITY OF TIGARD MECHANICAL PERMIT
'. , COMMUNITY DEVELOPMENT Permit #: MEC2011 -00370
TICrARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/05/2011
• Parcel: 2S110BA06600
Jurisdiction: Tigard
Site address: 12102 SW WILDWOOD ST
Project: Smith Subdivision: Lot:
Project Description: Install heat pump. Unit must meet 5 minimum rear and side yard setbacks.
Contractor: SPECIALTY HEATING & COOLING INC Owner: SMITH, VISTON & SUSANN
7500 SW TECH CENTER DR #130 12102 SW WILDWOOD ST
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 620 -5643 PHONE: 503 - 620 -5416
FAX: 503 - 681 -0793
FEES
Specifics: Description Date Amount
Heat Pump 08/05/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 08/05/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/05/2011 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility ■• "ca ion ': .ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0090. You may obtain a copy of the rules
or di -ct questions to OU • • .. g 503.232.1987 or 1.800.332.2344.
Is . ued By: / Permittee Sig 'ature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
AUG/05/2011/FRI 02:20 PM <6 FAX No, P. 001/003
4\
Mechanical Permit Application # FOR OFFICE USE ONLY
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Cit of Tigard dTigard,OR972 c$, >) c \A Received 0
, tirma pal Permit No.; m ,
.1, 25swHalialv., A ,'--,D.,a e tcZY v : ,
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• .. Phone: 503.718.2439 Fax: 503.598.4'4 ..,. e x 0 ., 4 -.. b it lir-tate/Br; Other Permit:
Inspection Line: 503.639.4175
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T 1 GARD ( Z . .t. -- -1 er N. 4 PDate Ready/By: Iurit: gd See nee 2 for
Internet: www.tigard-or.gov \% *'''' ,.t., 4 Notified/Method: Supplemental Information
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;?' :tik'' . 4,... -;) 440,,. - 6,. : 44 -' ,. : .:4 " ,i Ng: d . , .. , C 44' S.
''''. ' '''. '''.•:. • ' .. ''''''''''' ...:A. ''''' . ''' '''.• ''""'''"' . Mechanical permit fees* are based on the value of the work
El Ncw construction a Addition/alteration/replIcefient perforrned. Indicate the value (rounded to the neatest dollar) of all
D Demolition []Other: mechanical materials, equipment, labor, overhead, and profit
Value: $
Akt.40.404W mvo:
[E] 1- and 2-family dwelling El Commercial/industrial El Accessory building For special information use checklist.
13 Multi-family El Master builder III Other: Description I Qty. I Ea. I Total
Ate 4:1•44:01100RWOM,X*0,4.00,0WW;I:i....t,160 Ai i - Hea a t o ifi n g d l i c ti ° 0 , 1 °I i i , in : '
Job site address: g 10 s0 u i' tc L St (requires site plan showine p15cemen5) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State/DT': 1
. Furnace 100,000+ BTU (ducts/vents) 54,91
Suite/bldg/apt, no.: Project name; Heat pump
(requires site plan showing placement) 61.06 b
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hyclronic) 23.32
Unit heaters (fucl-type, not electric),
Jityiall suspended, etc. 2E15___
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other: 23,32
Tax map/parcel no.: . Other fuel appliances:
:4,i.NfcMG. 3 iZg'5)*S. Water heater 23.32
Gas fireplace 33.39
• I 61:', 1 \a `...ip _ .' ! AI •,. .„0.,10 Flue vent for water heater Or gas
- -4 I • I fireplace 23.32
La; li:htcr ...as 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23,32
1040 ‘,. . ,... • , :, * - - - , v •-•.-t. — .....,-.. ,.....,!..: .Y0f °;.i' :,;:•':,,.% "N:...i,,.. ,, 0. ,: 4 Chimney/liner/flue/vent 23.32
: "A o PtRM- 0-w "' It'112: ' "222 'J'L ''''''. ' - ViVV0 o t h er:
23.32
Name: Viston & Susan SMIth R3.1216
Environmental exhaust and ventilation:
Address: 12102 SW WildWOOd St Range hood/other lcitchen .
Tigard, OR 97224 equipment 33.39
City/State/Z11
.50314:5416 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: ( ) toilet compartments, utility rbOmS) 23.32
0 Attic/crawlspace fans 23.32
Other: 23.32
Business name:
Fuel piping:
Contact name: .
$14.15 for first four; $4.03 for each additional
_ . .
Address: • Furnace, etc.
Gas heat pump
City/State/ZIP: . . . Wall/sus • ended/unit heater
Phone: ( ) Fax; : ( ) Water heater
--- Fireplace
E-mail:
Range
''"v ..:::..,. ':::.",•::'''.r:•. 1,:40??„ Ba eme
Business name: Specialty Heating & Cooling, Inc Clothes dryer (gas) -
0/ Other:
Address: 7500 SW Tech Center Dr #130 '' .': 7 . : ::; :'`,.• ••
City/State/ZIP; Tigard, OR 97223 Subtotal (01 ,010
Minimum permit fee ($90.00) CIO' 00
Phone: (503) 620 Fax: (503) 598
Plan review (25% of pennit fee)
CCB lie.: 66578 State surcharge (12% of permit fee)
TOTAL PtIZMIT ftt I do ,E
,:) , This permit application expires if a permit Is not obtained within 190
Authorized signature; - 44, I Ag• I le days after It has been accepted as complete.
ft.--
Print name: Suzie James I _
Date:13 - 11 " Fee methodology set by Tri-County Building Industry Service Board
lolauilding\l'ermilaUmMC-PermitApp.coe 09/09/10 440 I7T ( I 1/02/COMAIVE B)
AUG /05 /2011 /FRI 02:20 PM FAX No, P.002/003
SITE PLAN
FL
P
PL
I4! W/ t p P 5 (', i o
STREET •
•
NOTE -- Please show the following on the site plan:
• Location of Indoor Unit and Outdoor Unit
• Indicate how the flue will be run (thru the roof — out the sidewail — etc)
•: Indicate with dotted line how the lineset will be run and approx. distance
• Indicate how the condensate will be run
7500 SW Tech Center Drive
Sp ecialty Tigard, Olt. 97223
fIPATtNG & COOLING INC. (503) 620-5643 Fax: (503) 681.0793
www.specialitvheatin_,com
IVi:'I'U UUt conlortfm imtil y , aryl