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Permit CITY OF TIGARD MECHANICAL PERMIT • ' • • •.-'• COMMUNITY DEVELOPMENT Permit #: MEC2009-00658, , • TIGARD 13125 SW Hall Blvd., Tigard'OR 97223 503:639.4171 • Date ISsued: 12/10/2009 Parcel: 2S111,CC08000 • • Jurisdiction: Tigard • • Site address: 15795 SVV'GREENS WAY Subdivision: Lot: 0' • Project: Boucher ' Project Description: Install gas line,and log set. Owner: FEES • BOUCHER, BARBARA • Description Date Amount . 15795 SW'GKENS VVAY - TIGARD, OR 97224 Log Lighter (Gas) • 12/10/2009 $23.32 ' Fuel Piping • , 12/10/2009 814.15 PHONE: 503-670-4600 12% Stthe -.Mechanical 12/10/2009 '81(h80 • Minimum Fee Adjustment Mechanical 12/10/2009 $52.53 Contractor: • SHAMBURG HEATING LLC, • PO BOX 829 tOALATIN, OR 97062 ,PHONE: 503-692-5563 FAX: '503-691-6855 • Type of Use: SF Clissi Work: ALT Type of Const: 'Occ'upancy Grp: Stories: • • Fuel FiJel Types: Natural Gas • Gas'Pressue: • - Total $100.80 Required Items and Reports (COnditions) • This permit is' issued subject 10 the regulations contairiedimthe 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 started within 180 days of issuance, or if work is suspended for more days.,ATTENTION:rOregon law requires you to follow the rulevadopted by the Oregon Utility Notification.Center. Those rtiles are,sei forth in'OAR 952-001-0010 through OAR 9,520010i00.. You mayobtain copy of the rules or direct questions to OUNC by calling 503:246.6699 or 1.800.332.2344. Issued By: u iin 0 Permittee Signature: Ca111503.6 by7:00 a.m. for an inspection,that'businesS day. This permit card shall be kept in a conspicuous place on the job site'until'coinpletion of the project APprove required on the job site at the time of each inspection. • x`2/09/2009 12 :23 5036916855 CEIVED SHAMBURG HEATING LLC PAGE 01/02 97223 Mechanical Pe 4 , n� Perrault Application � 4 . h 1 a „!rc i►l;li e u �l 2',V a., . f , T ,; 11 pF d P' r�.a�2 �tan -' 1N - n a te. iF� sM� d.�" - '�va�' »t �3 1. ► `2 ; ��� City of Tigard DEC 09 2009 .. t Permit No.. ; o i W 13125 SW Hall Blvd., Tigard, CA y �� u kb; - ' 6 Ylau IteWaw Other Permit: ; Phone: 503.639A171 Fax: 503.598.1960-1 � T T! OF TIGARD p�aar> t 41:1-1t41:": maptctien Line: 503.039.4175 ) DIVISI !r pN t)atc 1Zcad r see Page 2 for ,: . .a° Internet; www.ttgard- or.gov � No , A SupplementalInforaiatnu ' 'ti O} . WORK . COMMERCIAL FEE • 'SQWDULE USEC EC'tCS'1., ❑ New consttvction Additionfalter itinn/reElaeemcnt Mcchzuttcal permit feos° arc 17ased:OA tl a vatic of tilt work Derrtvlition petfgrmed. ixubrala1be (roundecEto ,n thecarest dollar) of alt': El © Other: • mecltanicat matcinalsp egdiptrient„,labor, overhead. and ofit. Y € 0 ial/itxd #ON : IDAf EQUIPIItENT /S*S1 „JEMS • • ,,_., J �ATECrQRX UF, L'1 and 2 - famil dwellin Commercial/industrial ❑ Accessory building ESR' 0 Multi- family ID Master builder ❑Other: ' special rnfotmalfon use checklist ]]escrf on • Qty Ea;, Total JOB SITE INFORMATION AND- LOCATION , - ., - - �C� ~�~ �° t Air conditioning Job Site address: j S (? 4f r t w ic_site:lan sbowin , tweuicni 46.75 City / State/LIP: Q Furnace 1()0 BTU (dic+ -- 26.75 - furnace 101/000+ BTU duets /vents 54.91 Suite/bldg. /apt. no.: l Project dame_ Hem pump. 61.06 Cross street/directions to job site: Ductwork 23.32 m w _. .H drone hot water smero 23.32 Residential boiler (radiator or hydrouic) 23.32 -- - - Unit heaters (fuel type, not electric), T in -wall. in- c}uct sus, -nded etc. 46.75 _- Subdivision: • Lot no.: Flue/vent for any of above 23.32 Oilter: _ 23.32 Tax map/parcel no.: Othetldel appliances • - " " - <P1'FON-'.o r WO Water heater 1 23.32 Gas fireplace ....._._ 33.39 ._. /1 I lly .:L , • / 0 5 __ , Jw :Flue vent £cir water Beater or gas "- fireplace _ 23.32 mm Log lighter (gas) 23.32 Wood/pelletstove 33.39 Wood fireplaeedinsert 23.32 . Chi tnney/liner /Aue/verlt 23.32 IOPERTY OWNER _��/ 2332 Name-6a.-/W-1: ' Otte.' / Environmental exhaust awl ventilation Address: /5 6 ' equipment Range m e nt a/otlter kitchen __ Cquipmcrtt 33.39 City / State/ZIP. �`�/ Clot �� (�Z, 9��� �- ties dryer exhaust _3339 (5b3) m r Single -duct exhaust (bathrooms, Phone: (5 3) 7/ -" �b F ax: ( ) toil t, cgrnparpnen m ts utility orns) 23.32 .'.0.: APPLICANT .:0 •CON'T'ACT PERSON Attic7craw)3pace fans 2332 Btzsincss name: L o, !?lt� �,w_ Other: ..,- .V:�:. 23.32 e „ 6 i! Ford Piping Contact name:. - . $14.1$ for 11rst four; $4.03 for tact) additional Address: Furnace; etc. _ __ -- -.- . Gas heat pump City!State/ZIP: Walt /suspendecUtniit heater Phone: ( ) -, Fax; ( ) _,. Water heater =„ , _ 1 S . (Fireplace /o,� / l'415 /' E -mail: m" Rams -_._. _ CON> a(tACTUR Bart)ecue c� 1 Clothes dryer as Business Hartle: L t�ti`~?6 � !7 �' t l� L - . w Address; /0 ‘;X gi... ME(aHGarnc:Ai .l'E1R1►11I:FIEES* s� / • n-- �- � -...- .air..:. City /State/ZIP: - / O, - 9 2 . Subtotal /y, / �.. Minimum permit fee ($90,00) g0 1 7 1 ° m " ( 3 - & 3 1 ) 4 75'3 - 714 , 0,3 . Pat._ (3,1'3) 1.9 / -Gif 5S ,...�_. Pian review (25:0 o£perntit fee) CCB lie,: /a26 State sutchargc (12% of permit fee) /C, to 1 TOTAL PERMIT FEE /00. 05 / / � 1 , 7 Fr Thu prrmif apys a riot complete. expires If a permit b ri at ivlvttn 440 Authorized signatu - . • C, /O 7/ L.[ days : after it has been accepted at corpplete. e. Print name: . ... Date:,��7_ 9 0 9 • Fee methodology set by Tri County Building Industry Service Board (1 )1 01 k 1.-A,(L