Permit CITY OF TIG
MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -00440
4 � ) I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/11/2006
PARCEL: 25111 CB -01303
SITE ADDRESS: 14870 SW 104TH AVE ZONING: R -3.5
SUBDIVISION: DEL MONTE SUBDIVISION NO.2 LOT: 017 JURISDICTION: TIG
Project Description: Gas line & venting to tankless water heater.
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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
JIM DEVERS Description Date Amount
14870 SW 104TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 9/11/200E $72.50
[TAX] 8% State Surcha 9/11/200E $5.80
Total $78.30
Phone: 503- 639 -9294
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: Permittee Signature: �� Q n
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business dy.
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.
Sep 11, 06 08:24a Scott Shamburg 503- 691 -6855 pal
P �„ i1�1 i �
1 lecnaI1icai Jt'E'1t nit ` li on N -- li • ' FOR oFF1cr_: t :SE ONLY
City of Tigard Reed (- 7 J r � t ; C�i /� Permft G Cif /it A. ; l3l25SW Hall 8ivd,Yi w ed . OR 9 7223 �� / `
Phone: 501.639.4171 Fax 503.59 &196 E i i 2006 Orrice P,�t�
Inspection Line: 503439.4175 U ,� 1�' t ' I • ( p a w Mi
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❑ New construction dztioo/alteta[iotT/ieplaceldent Mechanicsl permit fins' are based on the value of die work
piaforrnedl Indicate the value {rounded to the nearest dollar) of all
❑ Demolition ❑ Oa
'.'-.7: ::� mechanical traterf , equipment t.
.. : • .. - • tabor. overhead, and Profit
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:.. � - .. .. •G�( .QIfY OF COl!!S'TRIICTItNF ' •:::' ' � - : _, , _; _._:..: -_ .t ValttC S
t '
: : : - RAIV
DE177[A3164.0#1.
- family dweUiag ❑ CoMmereiaUindbosrcial El building /:Y8 8S�::
i
❑ Multi- family ED Master builder ❑ Other.
For special o!/omwtion use checklist.
Q1Y Ea. I Total
Description -
. . :.. , ;Joik sirk•OtEroOrAcioN AND LOc mOhI .. ..F : - : _ $atlttg/000lin
Job site address: L d L, (l Air conditioning or hem pump
_ (maim sift plan Awaits placceseat) 14.00
City /State/11p: //aid 02 Z2 .y' Barna e 100.000 HTU1dunslvcnra) 14.00
Suitc/bldgfapt do -: � 1lProject Pumice 10D,000- DTU (dnaahxins) 17.90
Oat Item pump 14.00 _
Gross strect/direerions to job site: Ductwork 14.00
Hdtnnic hot water system 14.00
Residential boiler (radiator or
hydreaic) 14.00
Unit heaters (feel -type, not electric), -
itt -wall, in-duet, a:upended, ate. 10.00
Subdivision; j 1 Or no.; Ftwavent for any of above 10.00
—
Other 10.00
Tax tnaplparcd no_: Other Ind appliances
_ - AESCRIPT1OIs OR':WORX •• - i .. W
. :. // ,.;- �'' -t' - . /� _.,r e[uhc.tcr 1000
a4 J ! [-4 d - < v /2:5 /z7 % � t -'_f,S fireplace 10.00 �. �, ! \/ Flue veal for water healer or gas
/ /1{' 4.: fireplace 10.00
•
Log lightcr(Res) 10.00
Woodfpellct stove 10,00
Wood fueplanainscrt 10.00
. .•.. PERTY. .: , t: ' ; -�" ' : '.: - - Chimueyninerlft Z O
10.00
. . - . Other-
10.00 _
Na I /U
j� me: J ,, y L Cr(f',,rS• . Eavfronmenal exhoint and ventilation
Address: / y ?C! /O L/�� Mange haoaratherkitdlea
equipment 10.00
City/State/ZIP: -Tyi, e,e. 42 j �`.- Clothes dryer exhaust 10.00 •
Phone: ( ) b_44 - 9� q L/ Fax: ( ) Single duet exhaust (bathrooms,
let o om>icsin, milk): to n rill rooms) 680
. • la, A
: PFUCANI' - ' i*::' ❑.• (7ONTAcr rTEIiSo!'1: -- .. i . Aniererawlspacc fans 10.00
Business name: 10.00
truer piping
Contact name:
55.40 far Gat four; 5L00 (breach additional •
Address: 1 ntnaee�ete
Gays heat Dana :
City /9tale/ZIP wall/stispeaded/imit heater
Phone: ( ) [ Fax:: ( ) Wafer halter I i 1% < _ i Y O
E -mail:
Fireplace '
.. :._.!:! : :. ... • •CON'tR _ ' ,...' B zbcsne
� £ b4ft"a ZGj �� Clothes dryer (Ras) -
Business name:
Address: /0 G Ox ls� v J ' t
:• i'' i; ..10 41iQCAc pitayar:BS1;S. -•
Ciry/State/zw ' — !! r I 04_, 7 7.06,,,-?—. _ Milstein! � , t
Phone: (51:0) C f�70t -.45d573 Fax: (6.) /ow 69 Maim= pam>i[ ice (f7z.50j �Z, 5V b O g/ Sate ha
review (25Sbafpenttit fe
CCB lie.: S �
i� ' te sfn>se (SS hofpetmit fee) 1
TOTAL PERMIT FEE. : v. 4c.
Authorized si�mnuc / �, r'
71 . 1 . ,canon appfeao.n lapin* It a parfait is sat coolant within 180
- // days ant. it ass bean serept d .c cotsplete. •
I Print nano _5' S�4 I Date 411g7 7 �j — Y / - t - Fee a tihadolegY Baby Tri onnb Building industry Srnlre Bond
•
CITY -OF � ~^
��mm n-��m TIGARD
BUILDING DIVISION ' _. ''
��.��""°~� �"°"=.~~". PERMIT � ��2�G0�4O
| � ��
| 13125 SW Hall Bkd�.11gar Tigard, OR A7223 DATE |SSUED� 9Y11/2O�� .
Phono�(50O)039'4171 �
Inspection Requests (24 Hrs.): (503) 639-4175 u7.1A AJ1.
•
, INSPECTION WORKSHEET FOR DATE: 9/12/2005 TIME: 7:01Ah4 PAGE: 22 .
SITE ADDRESS: 14870 SW 104TH AVE CLASS OF WORK:
SUBDIVISION: DEL MONTE SUBDIVISION NO.2 LOT #: 017 TYPE OF USE:
PROJECT NAME: [E}/ERS
DESCRIPTION: Gas line & venting to tanidess water heater.
OWNER: DEVERS, JIM PHONE #: 603-63.9284
` �ONTR0CTDR� �M�NBURG HEATING LLC PHONE #: 503-692-5563 .
' Inspection Request Scheduled For: Date: 9/12/2006 Pour Time: '
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 036880'01 503-692-6663 Y
Corrections/Comments/Instructions:
.
^ I | PARTIAL APPROVAL 0 CANCEL I I NO ACCESS
| I FAIL n CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
|napectoc ��*��~^� � Date: Phone #: (503) 718-
'
`' '
.s
CITY OF TIGARD -
f BUILDING DIVISION r PERMIT #: MEC2006.00440
J 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/11/3006
Phone: (503) 639 -4171 - u +gyp i ' .�
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 9/12/2006 TIME: 7 :01AM PAGE: 21
SITE ADDRESS: 14870 SW 104TH AVE CLASS OF WORK:
SUBDIVISION: DEL MONTE SUBDIVISION NO.2 LOT #: 017 TYPE OF USE:
PROJECT NAME: DEVERS
DESCRIPTION: Gas line & venting to tanWess water heater.
OWNER: DEVERS, JIM PHONE #: 503.6394294
CONTRACTOR: SHAMBURG HEATING LLC PHONE #: 503- 091 -6563 •
Inspection Request Scheduled For: Date: 91120006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 036380 -02 503- 682 -5563 N
Corrections /Comments /Instructions: �y --
( rr cAS O,�e.� ( i' ` i- ! (- 1 ,- .:1: /7"1-- Ii //////A.
PASS n PARTIAL APPROVAL n CANCEL Ill NO ACCESS
I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 9
Date: #: (503) 718- 2-9-4-S ..-----*/