Permit CITY TIGARD MECHANICAL PERMIT
r DEVELOPMENT SERVICES PERMIT #: MEC2005 -00625
.� I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/4/2005
PARCEL: 2S115BD -00100
SITE ADDRESS: 11584 SW ROYAL VILLA DR ZONING: R -12
SUBDIVISION: LOT: JURISDICTION: URB
Project Description: Add heat pump to existing furnace. Unit cannot be placed within required setbacks.
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SFM 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
CAL -AM PROPERTIES Description Date Amount
11200 SW ROYAL VILLA DR [UMECH] Permit Fee 10/3/200E $72.50
TIGARD, OR 97224 [UTAX] 8% State Surcha 10/3/200e $5.80
Phone: 503 968 - 1280 Total $78.30
Contractor:
SMITH HEATING & AIR COND
14212 S MUELLER ROAD REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Phone: 503 227 - 5550
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 By: Permittee Signature: 6'(/ /9/ e - 7 /OA/
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.
09/29/2005 20:43 5036327227 SMITH HEATING PAGE 05
Mecb.anical Permit Applicatio s® t Fort OFFICE' ONO
C of Ti R i ve d 9 3 e 0..—‹ . ; p u N. :i`'IECaoOs -406. •
13125 SW Hall Blvd,. Tigard, OR 97 .� ` j a Plan Revie /, /
Phone: 503,639.4411 lax: 503.598, n ".: LO . ,, : - a ry' �, I 1p Datc/ny: Other Pennit/95���5 40/x09
Inspection Line. 503.639.41 ICI
h -1 ril I I bate head /ti : taxi!: p1
' Y Y Sec Page 2 for
1ntemet: www,ci,tigard.OLIIS c �e Notifled/Method: zit& SlrppleinenlalInrurmntion
J 1 ON
tt� 1C, r t1 1 �ii ,>- I 1\ ll a u tk ° i ; ij "'•s ,.4Zt:C ar ,•
6_ -,[ 1 i, i y 1 ! ^,:li' r a l. ' IC r ,. ,
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0 New construction ►1. ddlti btati ;._,.. 1, 1 1, } r ar i o he value 3 to o it
Mechanical permit fees* are based on the value of the work
't,�l on /rcplacemelnt P
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other
ea n'c
;4, a F i , � i1 _' r l T � } 1 } p 7th r ,� + r r "
\ 'T t t r , � 1 ,. a l of materials, pa ten , overhead, 11 p fIC.
�
n � N 1 d yr 7 11 .'S C� l)u} t tl �: ,... C: aq . l` i 11 f,3 l a.. k 1 (� y' ' Value: $
p , ` r 1 � J m lsec( laorad profit.
�_ j , i;.1q. . ., 1 • s r iC N .,: I . '''•'• .,,- =i 1, r ,- i. ! "' J , I ' . ,. i I1,j 2F-777.7,7777 ' t a - 1� + � T ' °� r q F ltf r( , ./1 )/ •
/,4 I. and 2- family dwelling ❑ Commercial/industrial 0 Accessory building '' -`' 3 , r- -' L1�(7 • ' ' f ) pt� 3 - . .. ' - '2 -2y�, l , tl , l ) ,•
❑ M Uitl- family ❑ Master builder [r Other;
For spec /a! fnformurlon use checklist.
Qty. 1 Ea. I Total
I., H�1 Pu I• • t ` II , i f - v Cc 1,r y i , ° 1 r ) `,' } a r'.1 1 r , Description r
`I'-'! li, i ri � I \,., .fV�L l ..1, b j + /,':' 'r ,• ',-/.4' ,1 lYN � i�I�. F . ij :.: ; l r r:7D1 5 :1n! i' . ••/ '•:.) f " � 4 7'I
+' ,.. ,: �........., h ; ... 11�� .. ..11!��_ ._.. *_ ai • • S r. ?;! {i.!� � r r t S;"•�._ [f 1 u . f�Calht� /COOliilp,
Job site address: ' 8 SV\/ r U a IT • Air conditioning or heat pump
(requires site plan showing placement) ' 14.00
City /State/ZIP: 17 G o ) (/ Q 17�' ,a Furnace 100,000 ETU (ducts/vents) 14.00
Suite/bld /a 1. no.: J p Furnace 100,000+ BTU (ducts/vents) , 17.90
S P Project name: �o�d v lI a - Coos•heat pump I La C.:�v. c. ' 1 14.00 (, L b DO
Cross street/directions to job site: Duct work 14.00
Hydronio hot waterrystem 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),,
in -wall, in -duct, suspended, etc. 10.00 '
Subdivision: Lot no.:
Flue/vent for any of above 10.00
Other: 10.00
Tex map /parcel no
Other fuel uplfa
( l p t 1 llces
R7:,-7E'-,'":7;;T: j " ilp77/51211p �P, , at't, b :1r; 7 n ) ■ 1 ' l ilrf �'�li ['t� Nlf} - C(1, i It I� F ,ti �r t t i'+ t g a { 7 h; Water heater � 10.00
..... r . _, l__.[ i ; ._ _1. f r ,, )1?„,.... L i• , J 1 •.1 � . r1 . i [ r,� i hrrs .
Gas fireplace 10.00
• �1. 4 I • Flue vent for water heater or gas
•• _ fireplace 10.00
Log lighter (gas) . 10.00
Wood /pellet stave 10.00
Wood fireplace /insert 10.00
wiM ' ,
+ ;,, ,„ gait ; 0 f t , +7 l it t 1' ' ' 7 r 1 �� ,) 'r' It vii ,, � . 7 r Chimney /liner /flue/vent
` F 10.00
,./ l tr i + I :-1 }�f ,1.'. ' /I� 1, ( f � }'' lflr 77t k . ' r ' l rYr ,l . / tit �1 1�(1 - 0 1 . k ' + 1:44 , 7 � •
L., _: _r_ _ t , � . I a J Yz h4 -, I n � l�� , t 1."2:i:. ... Ifjf
' / Other: _ 10.00
Name: (^, / 9y,y- / • -/O ir"..9 . Environmental exhaust and ve'tilotion -
Address: /� /„ ` � I C j 1 ,# Range hood/other kitchen
At , eJtuipment 10.00.
City/State/ZIP: "`' e - 1 �I 0 -- _ Clothes dryer exhaust 10.00
Phone: ( •M •• ax: Single -duct exhaust (bathrooms, .
� ¢ ; : „. r �� _ ) toilet compartments, utility rois) ' 6.60
r 6 on _
fi r 1 + ,� - 4t 1'I . „ Rl+ I' . il; , 1 ,, , nn ,, i ?l � , i , , ti N�p� "'tr ��c a f 1 r "fir Attie/crawls )a ce fans 10,00
�. :
�} 1 ' 11 nn � , I
Li vd .k.,.. ! 1 r ri �. r.. - .. . . . 7, , .. t .l 1 ,.a I” ;, r { �FS' y{ :1l llsr i..:' -- J
Other: ; j 10.00
Business name: .
- -- -... ., rue! pipin g _
Contact name: 55A0 for first four; 51.00 [ur each additional
Address: Furnace etc.
Gas hen yump •
City/State/ZIP: WalVsuspended /unit heater
Phone: ( ) I Fax: : ( ) Water heater
B -moil: Fireplace
^� s ; r - Range
•,r3 *1 i dK4 a Y�l�ll l fi �, s ? � 1 t `I` 1 ° t i � " �':,�, ti >rr,r" ' --' -/ 1 , kr I �^- + r
� 7 t '4 iec.,f . +�'Ir2 1 M:u`t { � l �J�� i i� �'fG hi] �'. �i'.;.�'�it > 1 fl(.�t 1 ,{ y k � 10 , r ! o t'tk�. � 9 Barbewe
�.,.�. �s. �:. r, ,,u ., .,1: f ttl.,.•: ,
V ` J. • Clothes dyer (Ras)
Address: / l Ai tQ \ J • i y / u.c._iler. / 1�1i.11' 'lt�� }. ilt+rtWyV 4 .. d � s l�p i idy� t nA �1 '4 i,i NYfY,
Cit /State/ZIP: , .• . ' D • Q 6 Subtotal r co 0
Phone: (50 ) 'I -- Minimum permit fee (572.50) rf e)
Plan review (25% of permit fee)
Cep lie.:
State surcharge (8% Of permit fee) r1 se)n
TOTAL, PERMIT PEE 7, • RO
Authorized signature: This penult application 03 Wes it n per111it Is not obtained within 180
_ days lifter II lids been accepted as complete.
/ r - I Date: /..3Q /OS ' fee ulelhodologY set by Tri- County Building Industry Service Board
1: \evikliag\PermIri 4EC- PamilApp.doo lv07 . 440.466lrrll11o2/COM/Wae)
09129/2005 20:43 5036327227 SMITH HEATING PAGE 04
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