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Permit
CITY OF TIGARD MECHANICAL PERMIT 1.: COMMUNITY DEVELOPMENT Permit #: MEC2009 -00154 T t G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/10/2009 Parcel: 2S109BA00900 Jurisdiction: Tigard Site address: 13655 SW MOUNTAIN RIDGE CT Subdivision: Lot: 0 Project: Purkey Project Description: Replace gas furnace and vent. Owner: FEES PURKEY, DENNY J & DIANE E Description Date Amount 13655 SW MOUNTAIN RIDGE CT Furnaces < 100K BTU 04/10/2009 $14.00 TIGARD, OR 97224 FlueNent For Any of Above 04 /10/2009 $6.80 PHONE: 12% State Surcharge - Mechanical 04 /10/2009 $8.70 Minimum Fee Adjustment - Mechanical 04 /10/2009 $51.70 Contractor: SHAMBURG HEATING LLC PO BOX 829 TUALATIN, OR 97062 PHONE: 503 - 692 -5563 FAX: 503- 691 -6855 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressue Total $81.20 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules Issued By: 1 ( Permittee Signature: ` , 24 Call 503.639.4175 by 7:00 a.m. for an Inspection 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. ( .4 04/,0,7/2009 10:02 5036916855 SHAMBURG HEATING LLC PAGE 01/02 ,. M8 hanks! et)rCilt )• ovED ,,,,„ OH ICI. (.',I g)'‘d 1 City of Tigard (� n �j ;.{ 13121 SW Hall 5 y4,, Tigatd OR 97223 D l - • Q R L A. Pamd No. - C • 0' © C\ � Phone: 03.639.4171 Pax: 503,593.14 — 7 2009 Other P ,;t T , `; y ,, bupection Line: S03.639.4I75 hrTinet: a'vr•trgard.a.gov o - NededAlsthret CITY OF TTIIG�ARD TY ❑ New Construction Addition/alt�aat onfrepincement Mec 1 perm .-- • ms baud on the value ofiho work TJCrrtOliTJon Odic porforme4 indicate tilt valve (Invaded to the dearest dollar) of all CATEGORY of CONSfROCITON meohearcal 'Or . . frt C - and 2- family dwelling ❑ Commercial/industrial ❑ Memory building '° ID Multlpfamily ❑ Master builder ❑ Other: WIS S Il�II+ORMAI[ON AND LOCATION •' Et Total Jab site address _ , Y. / .. Air coadio or halt pump City/State/ZIP: _ .- airy # ' 722 9 _ ._ ' Furnace 100 000 BTU dn aa/opr &v WA „ 8eers q `� 14 QO M • kite/bldg./apt no.: Project name: • Furnace 100000+9711 duce/ 17.90 CM SS 3[Rel/daCClioil to job Oar t ob site: 14.00 • MI 10,00 w drank hot lc ( rr �.,.,, 14,00 Residential boiler (: • dam or III . hydfonic) Unit haters (! not electric), 104 srepcndod. ate. 14,00 Subdivision: Lot nos Fluc/vcm for . of above / Ito . Tax map/parcel no.: Other: 10.00 , � Other feel a • tlaaoer, • D88CREPTION OF WORK Water heater 10.00 r , ?,,,, ri, di ° ! . _ / Cms p 10.00 Plug veal thf watt hcatorar gas fireplace • I::: Wood/pcllctscovc ME Wood fireplace/Incest 10.00 R>¢O>P>rR7y O TENANT - 10.00 Name: r Other t ,.. Address: / �/J /� /� Range bood/olhar kitchen c,Ly /SSaIC /�; -f ^ . f /Y�• / % / 42 6. ' rte Cleats ' Mon ' ( ,a) -6 /7 Pftx ( ) Stogie -duet exhaust (bathrooms, 'Q wPPL)CGpNT toils -, � .• . , ..,.,. uhf rooms) .: ❑CONTACT PERSON AttiO'mawlspase ins 1040 Business nettle; Other: 111M 10.00 Contact nand: • Fnel *VIM S5.40 11w fr*t!bur: S1A0 for each . dilional Adder: Pomace, eta 017/State/ER: caa !last MI MB Phone: ( ) — Watl/Sl txl/ullii heater 111111 :: ( ) wager terr • E: 111s CONTRACTOR Business Mlle: �l U 1 , , l7 j Mill Address �0 . v A, Other; Goy/ , O0 ,e, 4 0402... MECRANICAL P its* Phone: ( ) �r _ _ j Fax ( .s ) , _ 3tr12.50l �y V , S h' r �L�l% CCR tic : •f� i Plan review (25%0 permit the 'UMW Authorized Signature " 1°7 TOTAL PERMIT FEE wyg� �j / h This tlemrt aVtl>firtnen agtirea s . , ! q sot o ... ; , . this t -, Print Amme `� ' G . 51,,4 92.14. Date • Fos crNtodp�l4 atk� , reef hd a. dYa+¢h� ] 1&r ildi iftr of �•p�tApa.dm omoro7 V. / 6Y - by ty dla8 rndacty Scotto; Hoard o40. MO iot/COMAYEB)