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Permit .__ :, ,-- il �, CITY OF TI MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00549 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2006 PARCEL: 25111 CC - 00800 SITE ADDRESS: 10115 SW CENTURY OAK DR ZONING: R - SUBDIVISION: SUMMERFIELD LOT: 005 JURISDICTION: TIG Project Description: Gas fireplace insert. 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: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: 1 Owner: FEES SANDRA & JEFF NYLEEN Description Date Amount 10115 SW CENTURY OAK DR TIGARD, OR 97224 [MECH] Permit Fee 11171200E $72.50 [TAX] 8% State Surcha 11/7/200E $5.80 Total $78.30 Phone: 503- 314 -4899 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: ,�,��,(� , a . 1 Permittee Signature: _,5_.‹.. . PI 'N 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. FROM : DR. YANNEY FAX NO. :5037224413 Nov. 07 2006 03:04PM P2 11/07/2006 13:08 FAX 5035981000 CITY OF TIGARD II 001 I Mechanical Pe�nit. An ' at i13 I' U It i 5W Hail Blvd., 11 1. t1, t. I `,1 I , _, . City 1912 O �Tigard ATigard O R 97 � E Amy - , —Dt am \ . r _ /, + I J �I . .4 d, Ti 1� phone: 503,639.4171 FyG'S03.S98.1 Q ry Other Penul • r I r . t i: l7 Inspadloe Line: 503.639,41 t5 "NOV f 2006 I inta ;. Rig See Pima. Internet NM1VR tiga[d- Or.=oV tbr CITY OF TIGAR® Rig Se u Pima. tafot>butlon .. K' . ; i y ._ a t. , our' It • L ',;; . him! ,-fii ,1/77....i.••:., 4 , {" C, . !! , � ,�' :1', iii ,. tL %:'�. .al Y7 "'09 fr1' T..5E 0", 7°0„ . El New eonstrtwtlon • / + d ; hiort/ temtiarthpinobment Mechanical permit times pre ..: • . en the Value ofthe work © Demolition 1 "• w# performed. Indteate the value (rounded to the nearest dallier) of all J. . • .' , met:han {Cal materials, 'mimeo, labor, overhead, and profit. ?,;,.r,�• a ;'": s b1 :.,, kt;i,' - ; ;,; .: -,. ter , :; ,!! r1 . : t Value: $ I►l 1- and 2- family dw . to: 0 Coatnteroitl1/iredus riai 0 Accessary b Ft '�' '! 117 ulti- family ;, I] MOM buuilde D Ot1fe: Par special i�o�b►�olldn use checklist. • 'e 'v ... : A p� , , I 'I. i'' .'t .7"' I'j�,ll� A*1: 'I -' hI ., 41A ' ,Y''. ;'t'. !':'14: Pa, I Toad site address: `1' � i l y t t uv k )„ l f li , . lP t ief i t r dit9on err heat p1l _ }- acs mg ehopdn a -, eat I4 -00 City /St terLJP: I L q cu ( iZ �L� I Fumaoo 1 �.I ,.1 1.0 BTU( 14.00 Sac/bldg./apt tea.: 1 Ptvjctst rate: "J t I Pinnace 100,000+• BTU (du /vents) 17.90 Gas heat pump 1400 . 'ctrl att0et/directions to job site; ► . J i .I I /1 r► t • . 4 e y t /. Duct work 14.00 ,far ��'� HVtlru4ic hot water system 14,00 . Al 1 r r . / III . d MI�N.r7lt7 fcs den iel bola (radiator or �� ! ���� r � .I � t hydrntie) 14.00 al 1 . . J �I. Ilf t! �� /Il<��� ' . 10 e $ Untt haataa (fuel -type, not electric), e �l in- wall, Modena. euapended. etc. 10.00 _ • $ubdivjsion; Lot t7. • Flue/vent for any of above 10.00 tea.. 10.00 • Tex mop/peP no, J� Other feel appttancen _ ' �•I :': , Jlh « '41019 6 klig• t ¢ ; . 1 . • V:�.4,7 '' ., ' Water' heater • 10.00 • I J J ' • Gas fireolitel 10.00 iii r /A . r / r tI a L' • Flu vent ffr Water Ater or ens 1 _ j rcplacc 1 o_o n • . _ Lag lighter (pas) 10.00 T- _ Wood/pelletstove 10.00 _ Wood 1lreplece/iesert 10,00 Ir e t e , i r' , � :• Chat ney /liner/fue/vent 10.00 ' Odic l' 'Mil/,l + . ' . J Eavir LO.bb Eavitoemeetal eXhanar ct�d vca(11aHpa /� ��,pp /�1,� y � Range hood/other kitchen • • Ad , dm 11 ,1 1. l�V) / (/!A K equipment 10.00 City/State/ZIP t 1 I 67 <2 clothes dryer exhaust , - . 10.00 . • smglodtter ndlnult (bathrooms. Phone: V 1 — ) , . 0 ' 0 Fix: (7 J r 3 tag eaMpaktnlsnte. y rMI:mu) 6,$0 10.00 . Business name: Other 10.OD _....,..,.. -..,. bush Waft Contact name: t for fir! f)nr 1 Sian for each additional _ • Address' Furpa .etc —. ... _ . _ Gas heat . m , City/State/ZIP; i ' Well/Iaterfeieded/UAit heater • Phone ( ) Fax:: ( ) Water heater _ • Fireplace E-mail: : : :. c.`.` •• y , ; _ / , c Minas ■ . - C tr d / f B arbav Clothes dryer (gas) Address: i '. /_. V . t t , City/State/ZIP: �' � • ` . 7 8obperpi • Phone: I ' , %.? � � ' � � t � �T ' Minimum permit fie (1:71.50) / J Plan review (25% of permit firo) set r . / • awns etnohurge(8 %ofPermit fcc) . I J31 �� ,(/} • _ R , / / TOTAL PERMIT FEE let r r Authorized signature: L141-S `" -, / li it per'myna appl3�dee a Dino ih p.rmic is not eb rcd..�u�in tae 1 t irr, !/ro ,, / ... 7 • defer k bat b weeepted as • Print name; � i , � D . ,/ Fee meidrodotogv set by Tri- fount? Pull ding Industry �nty sen,toe soarfl L-llumine/rarela6GPaWIrtnpp.am IwQea6 440.46177 tt 1ro2rconvwael CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2006 -00549 .. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /117/2006 Phone: (503) 639 -4171 //, 1 Inspection Requests (24 Hrs.): (503) 639 -4175 AL INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7 :01Alvf PAGE: 40 SITE ADDRESS: 10115 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 005 TYPE OF USE: PROJECT NAME: NYLEEN DESCRIPTION: Gas fireplace insert. OWNER: NYLEEN, SANDRA & JEFF PHONE #: 55Q3- 314 -4899 CONTRACTOR: SHAMBURG HEATING LLC PHONE #: 503 -692 -5563 Inspection Request Scheduled For: Date: 11/17/2006 Pour Time: Code # Inspection Description Confirm # Contact # 4- : ge D 699 Mec:hanical final 039957 -01 503- 314 -4899 Corrections /Comments /Instructions: NI/ V r . . P, 6ss ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED Inspector: c- ii D ate: )) 17 D& Phone #: (503) 718- Z 6