Permit . CITY OF TIGARD /
MECHANICAL PERMIT
11 li
° ^ , COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00652
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2007
PARCEL: 2 S 114 B B -10800
1 SITE ADDRESS: 16072 SW 104TH AVE ZONING: R 12
SUBDIVISION: SWANSONS GLEN LOT: 049 JURISDICTION: TIG
PROJECT: SHOEMAKER
Project Description: Gas line to new free standing gas stove.
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: DOMES. INCIN:
NAT 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:
OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
BONNIE SHOEMAKER Description Date Amount
16072 SW 104TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 11/7/2007 $72.50
[TAX] 8% State Surcha 11/7/200 $5.80
Total $78.30
Phone: 503 -531 -9144
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: '
y:
g Permittee Signature: 0'-it e .
l
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.
11/07/2007 11:32 5036916855 SHAMBURG HEATING LLC PAGE 01/02
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CITY OF TrGARD
BUILDING ; DIVISION PERMIT #: 1vI C 007- 00;52
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: . 11/7/ 7, 007
Phone: (503) 639-4171 M,1u�1, iiii
Inspection Requests (24 Hrs.): (503) 639 -4175 = JJ
INSPECTION WORKSHEET FOR DATE: 11/14/2007 TIME: 7 :02AM PAGE: 65
SITE ADDRESS: 16072 SW 104TH AVE CLASS OF WORK:
SUBDIVISION: SWANSONS GLEN LOT #: 043 TYPE OF USE:
PROJECT NAME: SHOEMAKER
DESCRIPTION: Gas line to new free standing gas stove.
OWNER: SHOEMAKER, BONNIE PHONE #: 503- 531 -9144
CONTRACTOR: bHAMBURG HEATING L.L C PHONE #: 503- 697 -5563
Inspection Request Scheduled For: Date: 11/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 059431-01 503 - 631 -9144 Y
Corrections /Comments /Instructions:
IP PASS I I PARTIAL APPROVAL ❑ CANCEL — NO ACCESS
❑ FAIL IP CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,41114, ,.. _,,,,
Inspector: Date: 1/— /4 -ei. 7 Phone #: (503) 718- `2., ')
CITY OF TI'GARD
BUILDING DIVISION PERMIT #: MEC2007 -00652
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/712007
Phone: (503) 639- 4171u " +I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/14/2007 TIME: 7:02AM PAGE: Ci4
SITE ADDRESS: 16{72 SW 104TH AVE CLASS OF WORK:
SUBDIVISION: SWANSONS GLEN LOT #: 049 TYPE OF USE:
PROJECT NAME: SHOEMAKER
DESCRIPTION: Gas in to new free standing gas stove.
OWNER: SHOEMAKER, BONNIE PHONE #: 603- 631 -9144
CONTRACTOR: SHAMBURG HEATING LLC PHONE #: 503.692 -5563
Inspection Request Scheduled For: Date: 11/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 059431 -02 503- 531 -9144 N
Corrections /Comments/ Instructions:
PASS
PARTIAL APPROVAL CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: • ! Date: // 1 ? Phone #: (503) 718-