Permit • r'
11 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00103
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/15/2007
PARCEL: 2 S 110 D D -02400
SITE ADDRESS: 10575 SW CENTURY OAK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT: 031 JURISDICTION: TIG
PROJECT: SIMPSON
Project Description: Gas fireplace insert & gas line.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
BOB SIMPSON Description Date Amount
10575 SW CENTURY OAK DR
TIGARD, OR 97224 [MECH] Permit Fee 2/15/2007 $72.50
[TAX] 8% State Surcha 2/15/2007 $5.80
Total $78.30
Phone:
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 B Permittee Signature:
Y� 1f { 7 �it'
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.
Febr.15 07 08:40a Scott Shamburc 503-891-6855 P • 1
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1 .l. S kfall Blvd., 7i gzarl OR 97223
,Er=wr , Plan Review
Phone: 503.439.4171 Pox: S03.593.1960 Odin Pcmxic
Inspection Line: S03.639,4175 Fite E
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Internet: www.ci.tigardor_us D Reedy "th.' es Sca ?*e2 fur
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PPR 1 s 2007
:-.... ' . ' ' •: .•-: , ::,_ . ; . ..:. -:..... -" • .
TYPE F o's?-rw€* :._-.--.:•..--. • - : -::: - :.: : • : ' :: • '. : cokatiteut itE°: S644141.1iR a .U .
0 New construction it;
in NtAIPAISKLIM Methameal permit fees* ate based en the value of the work
0 Demolition 0 Other: performed. lodleare the value (rounded m the nearest dollar) of all
merlumical materialk equipment labor, overhead, and profit
: - 1'...,; : ' . ' .-7 : ': .-... - -:*:::': '..-4.- i - g o *% 01. .: C 9v4tio i crIbN : --, .-: - • : .,: -: . '..::': "f" Value S
.. .. . •
ar- and 2- fimaily dwelling 0 Commercialfindasetial 0 Au:et:gory building .." .-...RPSIREAgLiciOnlviENXI:§WgiOrgit5".'.-;-51:
0 Multi-farnity U Master builder 0 Other: For special Wornsestitm are Aecitlisl.
DcscriPrio* QtY. Ea. 1 Total
doilf S1tTe 1 3%1417.10m1914..410 itOcAlloti: ..,:' ' i :..--... : : ' acatliteicoolinr
. .
,,
lob site address: / • .er _ -, ),. i., Air COaditiefthag ar heat pump
(vciwirta cite otansho.ipg pleccrecot) 14.00
Ci ,
ty1S1111erZEP: "ilia"-d c».- .92/z F.100.000 Bli.ljducisiversial 14.00 .,
Nnaace 1000004- BTU ime nrveres ) 17.90.
Suite/bldg./apt no.: 1 Project oar=
Gas heiT purcp 14.00
.nos i street/directions to job sitc Doer wodc. 14.00 - •
' liydronie hot water moan 14.00
Residendal boiler (macaw or
bychnoie) 14.00
Unit h Met! (fttel not electric),
in-wail. in-duct, suspended. etc_ 10.00
Subdivision: Lot no.: Plachrear for any of above 10.00
Othet;
Tax mapfparce1 Dm.: 10.00
Omer faciandiances
' . • .: . . .:"...: : .,' ; l:.- _ . - S1:341itietpr r".W: :: ..: . .... ...... 7 ■ .,: • .', s , ' " Warr heat= 10.W
- _
Crag &replace /1/ j 10.00 fl).
A alyet_ /11,..?/ e--.- ,_- b , Flue vent for wgter beam. or gas
fireplace 10.00 .
1 . 0 0 HIP= (FAO 10.00
Wood/pact stove 10.00
Wood firenteeermscn 10.00
- Chiraneyftinerinnetvem I 10.00 10 "e-'
::.:', i- ,.... .,-c • 1, , . ''.' . a 7tErgi ... :.- : ..: i -; :: . :... 1
Other 10.00
Nao7: - ... /pq...4 :, e , „........) EnvirOnmental exhaust and ventilation
. _
Range hood/other kitchen
Address: /051 ----- ,5, (l ki a )i.-- ,
rquipment 10.0o •
City/State/ZIP: :77re 4. 42 1- 6 ;fu, 6 , .°; ..- Z 0 c.-// Clothes dryer exhaust 10.00
- Sinste-duct exhaust thaintrooms,
Phone: ( ) Fax: ( ) toilet enmpartroents. utility towns) 5.80 _
. .
. . .. .. . . . , . . . .
. . • • • •• : ..: ..• V . 7 AniecraWISPace fans 2000
CONTACT , PERSON" " ' -: -
. . . • ' • .'' ' 13:A.PlilicigiT - - - ' : :: - a .. .,. . .
mow .
Othcr
_Susine.ss name: s.... 5/ hie., --,a-eez-/7 .j 4
/ &(---C. fael_pipleg •
5540 for first four; S1.00 for area addition*
Contact name: •
• Fornoce., etc. _... .
Address: 5././ .4 - ejC 7t-(-) Gas heat patan
City/State/ZIP: Wall/suspendedhmit heater
Water heater
phone: ( ) I Fax: : ( )
- Fireplace / 6,V0 5g0
Range E-mail: . -I
. . , .: • , : • i .. : - • ...;, . . : .. • CotaCTOR. . *. 5 - - - • . - . -:- ' • : : • : aothcs cfryer tit30
. i
. ,
Business nun= ‘...9% re.i td......c.... ...T.: . • .
• •
,,t, -..- ;.:., .,.. •
Ada-- ,0 40)Le.A_ 7 i s.....1 , tfo
City/State/ZIP: .---7-- oie- 49 7O( Knionon pcanit fee (572.50) /2. 5
'Phone: (g>3) (9 - 1
Fax: (60 491-Z1,5S Plan rcvieW C25% a Paola fee)
Slat* sutthaigc gni. of permit fee) . 5
. 81)
i lq/
cat lie.: El c.,, f TOTAL xisawar FEE 9R, .3
- oppiteatioa evicts Ira permit is not obtaisitit willt1n160
e r - . ' " dayl atm' it has bean accepted es complete. •
AtttbOriZed Stemitin . ,-Agrai d 111. _....-
c=imir.,affiffiffmtlinglii 13SW •‹. - 15 . Fe r'l&th°644:Y •
set by Tri County Building 10. Son", Board
0
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007- 00103
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2//5/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/26/2007 TIME: 7 :00AM PAGE: 79
SITE ADDRESS: 10575 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 031 TYPE OF USE:
PROJECT NAME: SIMPSON
DESCRIPTION: Gas fireplace insert & gas line
OWNER: S"IMPSON, BOB PHONE #:
CONTRACTOR: SI - IAMBURG HEATING LLC PHONE #: 503- 692 -5563
Inspection Request Scheduled For: Date: 2/2612007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699. Mechanical final 043015 -01 503-692-5563 `
Corrections /Comments /Instructions:
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Amer
n PA S n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Th Date: P-0 7 Phone #: (503) 718-