Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00142
TIGARD DATE ISSUED: 3/19/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103CD 06800
SITE ADDRESS: 11655 SW FAIRVIEW LN ZONING: R - 4.5
SUBDIVISION: TERRACE TRAILS LOT: 028 JURISDICTION: TIG
PROJECT: EMERY
Project Description: Replacing existing electric furnace and heat pump.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
ELE 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
LLOYD EMRY Description Date Amount
11655 SW FAIRVIEW LN
TIGARD, OR 97223 [MECH] Permit Fee 3/19/200E $72.50
[TAX] 12% State Surch 3/19/200E $8.70
Phone: 503 -639 -6604
Total $81.20
Contractor:
SMITH HEATING & AIR COND
14212 S MUELLER ROAD
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -227 -5550
FAX 503 - 632 -7227
Reg #: LIC 52754
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B 1� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
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.
03/17/2008 12:38 5036327227 SMITH HEATING PAGE 01/01
Mechanical Permit, Application r(!1; ("4.1.14.1... 1 .r i l'i:A , _ City of Tigard coy El ° ; (�� Permit Ne.:� ? C ?v ° ,
.. 03/
't 13125 SW HMI Blvd., Tigard, OR >Ii • . ew v r^'
1.. Phone: 503,639.4171 Fax: 503.5 a;,b68 � °
i , te /B , Other Permit:
1nepection Line: 503.639.4175 i p
A AR Dgtc Ready Ely: Sufis: ® Sr a Date 2 for
Internet; www,tIgard - or,goy 1 V1 ,` t Notlnad/gt hcd; Supplemental Information
(.51 i a T IG P ` ,
TYPE OF ,,o. • . 0 A ■ ' r COMMERCIAL FEE* SCIIEDfVLE - USE CHECKLIST
❑ N ew construction Mechanical permit fees* arc based an the va(ao a1? &e werk
�ilddition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolltlon ❑ Other: mechanical materials, e. i.men labor overhead, and ...fit.
CATEGORY OF CON 1RUCFR N value ..
el- and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building RESIl1EN L EQUIPMENT FEES*
For apse /al /rformatiom tia check /tat,
0 Multi - family ❑ Master builder ❑ Other:
Description Pa Total
JOB SITE INFORMATION AND LOCATION ; ; 43.w. c 01 I
Job site address: // S j.- it/ e: f ,./.4.4"e- r• r par• on rig or heat pump / NEI
r• •uirm else •1ae allow( damn= 14,00
City /State /ZIP: '7 ,q,e_ /. , ea g, 9 7 2 z 3 Furnace 100,000 BTU (ducta/vmtt) 14.00 /1 GV
Furnace 100,0001 BTU (ducts/vents) 17.90
Suite/bld5Japt. no.: Project neutte; Gas heat um 14.00
Cross street/directions to job site: Duct work _ 10.00
Hydro her s7em 14.00
Resid ential boiler otwat (radiator or
dronlc 14.00
Unit ll, In- (: el -type, not electric), -
in-well, in -duct, sus. ndcd, etc, 14,00
Flue/vent for any of above 6,0
Subdivision: Lot no.t Other: 10,00
Tax map /parcel no,; Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
�c 'Z-4 C e /' i /-/� Gas fireplace 10 .OU
X �G � T.Q / � Flue vent for water pastor or Ea
fire.laoa 10.00
,Z £ ,/ ti 7 "4/ io_ 11:Suter :as 10.170
oo
Wdhellet stove
W ftraplaciz/msort - 10.00
23 PROPERTY OWNER ❑ TENANT
Chiron /liner/flue/vent 10,00
II her 10.00
Name; ..//0/�j 4 Environmental cxhau t o Aventilation
Address: -- 574/,' �,y /,c / r / �' l , e / �. A' Range hood A ier tchcn
c 10
City /State/ZIP; '77& t , / )> q 7 , 2, Clothes • crcchaust 10. 00
Single • uct exhaust (bathrooms,
,Phone: ( 03) 1x39. o4 Fax: ( ) toilet compartments, utility Tr(ns) 6.30
0 APMCAN;<' ❑ CONTACT PEF4soN Attic/crawls .ace fans 10.00
Business tlditte; Other, MEM
Feel i in,
55,40 for Iitat tbnr $1.00 fir each additiional
vas ling .0 1.1
Wall/ us'ondcd/unftheater Min=
Phane:( ) MINEMIMIEM 11251.1.11111M
1Y:,¢
CONTRACTOR Bertlocue
Businees name: „ ,i?" r'/-/ A/E/iry //1/6y- Q' <1 i ,_, -�yCr Clothts dryer (gas)
= Mil
Other:
Addre tt t /4/7 / . / ��e a .4 ,R c,/ • MECHANICAL PERMIT FEES*
City/State/ZIP: k' 6 • a , y a , e 9 7 e, . subtotal if1 e7d
Minitmtm erntit fee (572,90) 7 .r. S0
Phone: ( - 5p3) ,Z 7- SS.i c7 Fax; ( 3) h 2 - 7,7 Z 7 Plan mview (2S% of perrnitfee)
CC13 tic„ S 2 7S 4 -. g / ea 3 . - 9 - e , State surebarze (12at, of permit fee) eq. 7Z,
TOTAL PERMIT' FEE i/, 7
Authorized Si *1,natu . , _ . Thus permit application aspires if a permit is not alrtalpad Rltliln ISO
days after it has been Acceptett as eamplctc.
Print name: /cri e•/l,47 E‘,_ -..5 i 9.,c Date: - F_ /,e fig • Fee methodology aei by T}t.- County Building Tntlimity Svrriec Boon!
I1 tBuildinglPermitseMuC- PermBApp,doo OVI ?/07 440- 4617T /ad/GOM/WEn)
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CITY OF TIGARD
BUILDING DIVISION • PERMIT #: IMEC2008- 001
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ?119/2008
Phone: (503) 639 -4171 . ,� �i X 1 1 .
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/2/2008 ' TIME: 7:00AM PAGE: 58
SITE ADDRESS: 11655 SW FAIRVIEW L.N CLASS OF WORK:
SUBDIVISION: TERRACE TRAILS' LOT #: 028 TYPE OF USE:
PROJECT NAME: EMERY
DESCRIPTION: Replacing existing electric: furnace and heat pump.
OWNER: EMRY, LLOYD PHONE #: 503-639-6604
CONTRACTOR: SMITH HEATING & AIR COND PHONE #: 503-227-55W
Inspection Request Scheduled For: Date: 4/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6% Mechanical final 067533 -01 503-227-5550 N
Corrections /Comments/ Instructions:
a' ' 1 0 06 — 63 0 /S i r- e--C-:
/
oAi - S cT `i i 1 Ai S G'�Z7`Zz '''
PASS ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
Cc / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / Phone #: (503) 718- Z� 6 /
.