Permit ' - '.' , 1 CITY O F TIGARD a RD MECHANICAL PERMIT
- • - � ; CITY O°+i COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00287
- •
> T[GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/18/2007
PARCEL: 25111 BB -02100
SITE ADDRESS: 10342 SW MCDONALD ST ZONING: R -12
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 001 JURISDICTION: TIG
PROJECT: NASH
Project Description: Install ductless mini split a/c system.
CLASS OF WORK: OTR 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: IT
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
NASH SCOTT Description Date Amount
10342 SW MCDONALD
TIGARD, OR 97224 [MECH] Permit Fee 5/18/2007 $72.50
[TAX] 8% State Surcha 5/18/2007 $5.80
Total $78.30
Phone: 503- 970 -8010
Contractor:
SHAMBURG HEATING LLC
PO BOX 829
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 692 -5563
FAX 503- 691 -6855
Reg #: LIC 126881
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: A / jj L / ,, • // Permittee Signature: C _ / I i t 1 en'
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
1
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.
May 18 07 06:58a Scott Shamburg 503- 691 -6855 p.l
t ley 01 A Tara /acm
13125 SW Hall Bird., Tigard, OR f ? 5/f f � c51� P ermit Na • M EaDO 4 - 002 • Phone 503.639.4171 Fee 503.5' " :. r t , ± o '' 1 vea Plan Review
Ckher Permie
lnspccrion Laic Laic S03.639.4t 75 Da t e R
Internet www. tigard.or_us MAY 1 8 2007 ,w r "�
ci f I Pepe: �r<
Cf Sopplcmeetal :Inman,
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❑ New cansbtictiot► C , ew
' tt11ahersUOOicep v _ : t Mechanical permit fees ' are based on the value of the work
❑ Demolition ❑ other. Is:donned Inerrant the value (rounded m the nearest dollar) of all
mecbmiwl nntetfala. equipment labor: overhead, and pNat : ,: ' - . -: • . • • • : • • i-A*poRy. OP CON 1RUCTjOIr1 ' - _ Value: 5
Q 1- and 2 -family dwelling ❑ Conwnercialrmdontinl Q Accessory building s .:•RE$1Dl:P1I7A .•Et iJIPMMME1Q i/raliFE3lSF ' ` --
❑ Multi- farnny 0 .master builder [] Other: For special agfonnoUion use cheeldbt.
JOB. SITE' Q - . • Dcscriptton 1 Qn'd Ea. 1 Total
.. ]- i. AND OCA'ItON - _ . aeadtgIeodinr
Job site a PI �� t'i) i-/C✓ f ea nlan sho.ins lisocoearl i 14.00 /7• a 6
City /State/ZIP: ! / a/O' , >Iri 9 //7i2 / Renew 100,000 BTU (duetskar r) 14.00
Suitcfbidg /apt no.: Project n , * ,,,. A � p Pomace 100,0004- on, tdaenrveetsl 17.90 .
1 "a��A. G Z Z U I ns 14,00
CtoSS sttect/dlremi0l,s to fob Site: 1 Dna work 14.00
s;'i!/ // / / _ _ *drastic horwarter system 14.00
-
a� Residential boner (radiator or
bydtonic) 14.00
-- .— Unit hunts (fael.type, not electric),
In -wait in-duct, suspended ere. 10.00
Subdivision: I Lor nn.: Ptucevent ffor any of above 10.00
Other
Tax DIV/puoel no - : J 10.00
Other fed appliance
• . _ • el. ; .DEStRIPTION OF` WOR2e :: ; ! . - Winer halter 10.00 1 Gas Maple=
/4 -71 Na 01/4-5-5 /W M G �p/ Flue vmt for macebearer or gas 10_06
U.
clan? I~tePlre a 10.00 .
I Log Illkia (rtes) 10.00
Woodhreil t stove i 10.00
Wood faeploee/mse t 10.00
Chinn Y/lmcrlllddvmc 1000
OPOT]l'•!Q ! N 1 E l i ' • •::.1`' .. ' . _. --- _[] :»Airrr -- • -- e
:: n � ) Othe 10.00
Name: ta7 � /vn1 . >Emiropmeatal exhaust and
Address: /0.3/Z 7 47[ /
- lbood/«1�r kitchen
oQaipvreat 10.00
City/StaterZe: ■ d Q � q �-� Clothes shyer exhaust 10.00 •
/0/0 Singieddt o a l: aunt (bathrooms,
Phone: ( ) 9 fa- v0 /0 Fax:( ) toilet dompmernenta. utility towns) 6.80
�. ••; :_ '.41:-1: Ardeferawlspxohim 10!00
Og -PPL�ICA79T CONTAC'1'iPEil`S014 : " : •
Othu 10.00
Business Dame: Fuel pipteg
Contact acme 55.40 far first 1oar; 51.00 for each additions
Address: Gas nest Damn -
City/State/ZIP: WalliSmoeodedhoritheater
I Water heater
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Email .
• • ... _ : - : .. olV1 � 'lt l / `C >L /
Clothes d (ass) -
Bumbeasacme: /s 1 4#LGf `#>f'Gl.. Lt ocher ' '
/�. �J c , _ :•- , IYBCCB/11r p8iil
Address: /2D /3CX £ ; Subtotal . f
Cit - 1, [/1J e- 9 7Qba Idiaimumparnit fee (S7ZS0) ,z •sV
Phone: ( .3) P —r'1�j Z'3 1 Fsa: ( /� bays Peon review (24% a€pcnnit t«)
* / � I StausnKhamn(» of Permit
TOTAL PERMIT
CCB lie: r TFEE 1 9 S. 30
She pow[c applicaltion smoke eta perde:t is not obtained wirbla 180
days a tm' a cue Was accepted as tomplda
AuthoriZed S - F setbyT,; Couary 8 a0 dia 6 1adu�y5c:w[m BO d
Print name: _5 b Dam 5 i� 0 .
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Ma 18 07 06 ;57a Scott shamburc 503-691-6855 p'3
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PO Box 829
Tualatin, OR 9 7062 ~7 {� ~^�--
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