Permit `~ a CITY OF TIGARD
MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00140
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/13/2007
PARCEL: 2S 112CC -06400
SITE ADDRESS: 15867 SW 81ST CT ZONING: R -12
SUBDIVISION: BOND PARK NO. 4 LOT: 092 JURISDICTION: TIG
PROJECT: FOREMAN
Project Description: Replace gas furnace.
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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BOB FOREMAN Description Date Amount
15867 SW 81ST CT
TIGARD, OR 97224 [MECH] Permit Fee 3/13/2007 $72.50
[TAX] 8% State Surcha 3/13/2007 $5.80
Total $78.30
Phone: 503- 913 -0630
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: ` l� Permittee Signature: A�
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.
Mar 13 07 08:56a Scott Shamburg 503-691-6855 p . 1
t..194 as A Taro
1312S SW liall Blvd., Tigard, OR 97223
RECEIVED
... Phone: 503.639.4171 Ftur.: 503.398.1
InspecTion Line: 503.639.4175
1 p
/ nue itesrlyinr.
Internet www,erizigard.orms 9 0 AR
1 3 2007 :.... „..
CITY OF GAR I - -eic- tc.r 1
TG AR - Notifsecnsedseet S.upleszeutat Information
. . , .. niwn nmsioN
..., • , :. . :-:. . : . _ :. -,. I P/. • •Rr*WADR/4 : - :: ''...• .. ..' *: ' *.: ' * • • • ciiatiguA #4 r"seiPMIiR a galAigagatr ..
1D New Construct:loll 0/61ition/aiteraTiOn/replacematt hfcchenicai permit fees* are based an the vahse of the work
0 Demolition 0 Other podonned. Indicate the value (rounded ta the nearest dollar) of alt
eteebaeical Ivanctiala. raiment , overhead, and pro&
• :: ' •• labor ';:. ; : .: j'i , •--: .: '-':-,, :: 7 : 7 : • .. '..-! '.' • ' • . . F ., ;.. .... : • *... 1 ID . Val= 5 .
afril 2 dwelling 0 Commercial/industrial 0 Accegiorf building !." f.,-1101PEN1444PWIIIKEt.r.X1:POTEMSITIk4".'.
EI Multi 0 IV/aster builder CI oft= Fos specis" I atformation nse challs1.
Description I QIY- I Elt. I Toro
.. '. . ... • . -'-. -, . , ,;,, itoikstrt pataziomoit .Arqb 1..beknort: ...4 - i: .--: : : ' ReasliftfmainE
Job site add rwszc /5..cfb 7 ,, <57_5'-e• a Air anurnioning or Tux pump
kanuires site pun sheering eleccinena) 14.00
City/Ste te/Zill: - 12 - qa7d 04 9 ',,,,249.Y Fu.aniec 101).000 BTUIdeculverne) j i4• 00 Pi 44.
SuiteibldgJapt no.: `-'" 1 Pzoject nair= Pomace 100,000v BTU (ettivenos) 17.90 ,
_ Gast heat Damp 14.00
Cross atrectldirectians W job site: Dees wodc. 14.0D -
' lisrlmnie hat water Amon 14.00
Residential be Der (radiator or
brdscrde) 14.00
- - Unit Meters (feel-type, not claque),
a t-wall. in-duct, suspended. etc. to.00
Subdivision: 1 1.0t no.: Flue/vent for unY er above _ 10.00
*bac 10.00
Tax coap/pareel no.:
Otber fad Milian=
10.00
' Gas fireplace 10.00 .
g ( 9 a_5_7ci-cr7 A Le . Floe vent fur water boner or gas
nombiee 10.00 .
Lye Ueda WO 10.00
W let stove 10.00
wood Brepleedinscrt 10.00
. • ,. . . Chirrineyflinerfiluthear 10.00 '
4 ::: .::...: .'' ":: ....1 .:,,•• ':'.171:tra4APifl; -.:: ! -.. . : - - cam 10.00
Name: ado --. Teiii94,2 Enviromsteetn1 aerate* and ventilation •
• , ' Range hood/odur kitchen
AddOt5S: 1/4.... .4 - a,,rw a.5 .4 0 equipment 10.00
City/State/ZIP: Clotho dryer exhaust 10.00 .
•
Single-dues exhaust (bannoorns,
Phone: ( ) 1/3- 06,30 Fax: ( ) wiles onnwertmessts. utility zstauss) .. 6.60
•
. - • " • ." -• 17 - . • - -- !" . - i . . :1'ONXeLCT.aillIrobN ' - .• 4 : • AnfricrawisPacc fmns 10.00
•
10.00
.
Business name: Peetryne .-
Contact name: SS.40 for Ent four; SLOE* for each iddlilona
Furnace etc.
Address: Gas beat turnip
waRtsesnendediunit beater
City/State/Mt
Water heater _.
Phone: ( ) I FS= : ( )
' ritelgace .. •
RartRe
E-mail: •
.. ; - . :.„ ._., 7 ; . :titafrrEtXC --. - :. '
anthem dryer Gm) :
' Business name: , wyj "lac 9ac /
Other. .
,-- :
'' ' ''' • •'' '. b:1315C14141e.A1. - J.': ..-.....:: . • . , : i
Subtotal / °°
.. 0/e/ . 9 70bd-- Knismun peernit fee (57250) 7 . 5?)
, •
City/State/ZIP: -- a
Plan review (WA cif permit fee)
Phone: :3) Z:#9,9 - 5 - 5 - 693 1 F3x: ( 6 0 k9I - A r5.- 5 --
st.,...b..g. OM of permit fec) 5 .4
CM lie.: Akgy/ TOTAL veRrvirr FEE I
A0 :' - Thir permit applhanien expire as perma it ear amines nutial110
dim after it km been accepted m anaplete.
Authorized siguat % , Da = deilOP 12 '0 ,
Print name: .541 - 9a ■ Fee nenhodology on by Tri-Coanay Building tochisry Sender Dowd
11/
' CITY OF TIGARD
BUILDING DIVISION PERMIT #: IMMEC2007-00140
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1312007
Phone: (503) 639 -4171 t� u�i J ' 11
Inspection Requests (24 Hrs.): (503) 639 -4175 �'
INSPECTION WORKSHEET FOR DATE: 3/21/2007 TIME: 7:02AM PAGE: 48
SITE ADDRESS: 15867 SW 81ST CT CLASS OF WORK:
SUBDIVISION: BOND PARK NO. 4 LOT #: 092 TYPE OF USE:
PROJECT NAME: FOREMAN
DESCRIPTION: Replace gas furnace.
OWNER: FOREMAN, BOB PHONE #: 503 - 913.0630
CONTRACTOR: SHAMBURt3 HEATING L PHONE #: 503 -692 -5563
• Inspection Request Scheduled For: Date: 3/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final • 046142 -01 603 -692 -5563 Y
.
J .
Corrections /Comments /Instructions: -' � 6
)„,
c - 8/ s/
dr AV' AM/Mir
./ _
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
U FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: M KA/ Date: c Phone #: (503) 718-
■