Permit . 1q
Ale CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00542
��'II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/3/2006
PARCEL: 2S114AD -03300
SITE ADDRESS: 08932 SW WAVERLY DR ZONING: R -12
SUBDIVISION: WAVERLY ESTATES LOT: 032 JURISDICTION: TIG
Project Description: Install gas insert & gas piping.
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:
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
ROGER SMITH Description Date Amount
8932 SW WAVERLY DR [MECH] Permit Fee 11/3/200E $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 11/3/200E $5.80
Phone: 503 244 - 6348 Total $78.30
Contractor:
SHAMBURG HEATING LLC
PO BOX 829 REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
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 OA' • -401 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1 -800 32 -2344.
Issu - By: � � / f • Permittee Sign • ture: _, �� /
Call 503 - 639 -4175 by 7:00 a.m. for inspe hat b
c ns 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.
Nov 03 06 10:03a Scott Shamburc 503-691-6855 p . 1
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I 3 I 2.1 SW Hall Blvd, Tigard, OR 97223 ED
Moue: 503.639.4171 Fax 503.59e54 Rao Review
Oihrr Pamic
Inspection Line: 30.1.639.4
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\124.pfliA mottgalftanavaik 1 7 / Sapplementat Information
.._..._ • : ; . : . :. -• 1 . •.: : • ' . COMMERglAll tipt a gigtiVelcrair .
0 New construction a" ••• 1 1 - lacemoet Meeluatical pecolit fees' me bmed on the tialue °few work
0 DemoittiOn .RAIMO 1 pafonned. Indicete the value (namsfed n' the nearest dollar) of all
anathanical notteriala, equipment. tabor. oveliesek mad Profit
• .: • ":: :":: -: : 4 1 - .i :''::...- " . •-••• ' ' 7 : - •-• ' " - . ' .'"
Vita= S
a - and 2-family dwelling 0 Cormnereiaifindostriat 0 Accessory building ?..• r..RootteottiAtiorao*i@wrgkthigis6
0 Multi-family 0 Master builder 0 Other: For spatial asfannation
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sae checklist
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Job site address:
&mires aim gin slawirmalennut
isc 14.00
city/StatelZIR -. 1702/7" 4 22 91 2. Z g Funnice 100,000 ETUlductrAerzal
14.00
Suite/bldg./am no.: --' 1 Project name Pomace 100,000/- BTU fitacenverits) 17.90 ,
ree
Cross stmet/directions to job site: Gas hear pu 14.00 -
Doct Tooth 14.00
- 1
Hirchunk hor water system 14.00
Ihrsidendal belies (nailer or
bythenie) 14.00
unit hews ((neLespe. not electric),
in-mall. in-dua, nuspetttled. etc. 10.00
Subdivision: I Lorna: Predawn for any of above 10.00
Other: _ 10.00
Tax map/parcel no.:
Ober feel appliances
' . • •:. - , .::" : : • ; ; i:. - Jlii:SCT.R7101e or:worrx .: . ;7 L'... ;- r . : C '' ' ' Water boa= 10.00
A)Jtelei //9,6ert 4 ; 4 :y4LS VO .5-e/e: OM AMR= in_Sece
Rae vont for water heater or gas i taco Io. 0, ' •
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Ateolme 20.00
Log lighter (au) 10.00
Wood/pellet mac 10.00
Wood Bteplacermsert ..... 10.00
. '1 :.. • .... 8-laaprzine.:04,TEA - ..• : ,; - : ' : i. I .. .' „ . . -* ! a -i • ' • .. • 4- • :.. • . andaeWlindffladotort / _ io.00 ,A.: t'-'
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N i ( e _.< ei - - - ‘,.... 5/ '7 ; wu Environasestal exhaust sod yearn:Won '
Range boodfothorkiteluss
Address g4 ,5 a.241.).."., 10.00
0 9U;PMCAT _
ary/Sfate/ZIP: -- lfle 0 ,e. 9 ...4 Clothes dryer exhaust , 10.00
•
Single-dna exhaust (lineatooms„
Phone: ( ) , ,Z.9V - &jc;/;j Fax: ( ) toilet ennoseraneem utility looms) 6.80
• . ; -. ,Erip•por _ ... . .- :' ;- Pi-ti•Or lipryori ,. • - : ;::. . AnSeJensorlspace ISasa 10.00
, Othoe 10.00 _ .
Business mune: Fuel airlift
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MAO thr lira fear; SIM fee Loeb additional i
Contact name:
Nonce. etc. _ .
Address: Gas heat sante L
_
City/Stater/1P: Wal 1/suspended/or& beam .
Water homer
PhIMM ( ) I Fax: : ( )
Fungi= / _ ' - 5,4f 0
E-mail: Rave
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Bizinds mow: ‘.. 9.4 Ron hag 9Ve 1 ,66_,
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Address: /90 ,60x g
Subtotal 0 Ya
City/tate/MP -
: aArf_./(.1 Ole- 9 zoo
maim. pew* fee 072-$0) 9A 57
ph (90) 44.0 ...5-5z 1 F (6113) kW-4475S- fIats review PS% a fPelmil fee)
Sate 'archaise OM et permit feet -*"; g4.7
CCB lk.: Ax TOTAL Mawr SSE -1.1(.._30
, ' ma walk appal:Wan cgfIres Ila permat b eme obtaisted wIthlta UM
.,
dies state It his bow accepted MS ceraptete.
Authorized sill:mein=
J • Fee mahoecaoey se by Tri-Coaam Wading /noway Sande. Boirrd
1 Print na .54t - ..,57,49444191-.-------1---- eggigla -
CAR'
Y OF TIGARD coo,,
ILDING DIVISION PERMIT #: MEC2006-00642
. 125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2006
Phone: (503) 639 -4171 ,�,11r
Inspection Requests (24 Hrs.): (503) 639 -4175 '!!+� 'I I..
INSPECTION WORKSHEET FOR DATE: 11/13/2006 TIME: 7 :04AM PAGE: 106
SITE ADDRESS: 08932 SW WAVERLY DR • CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 032 TYPE OF USE:
PROJECT NAME: SMITH
DESCRIP.,TION: Install gas insert & gas. piping.
OWNER: SMITH, ROGER PHONE #: 503- 244 -6348
CONTRACTOR: SHAMBURG HEATING LLC PHONE #: 503 - 6915563
Inspection Request Scheduled For: Date: 11/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 039581 -01 503- 810 -2232 N
Corrections/Comments/Instructions:
G/O G 4Ns L -N 1 6 7 a 9 70- 3 ® fi. is-- ,
•
PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / ►A'V Date: \I 2 I ) 0�Q Phone #: (503) 718- 1,5'