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15920 SW OAK MEADOW LN � A,+
CITY
OF
T I GA R D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT 0: MEC2003•.00683
13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 12'1103
PARCEL: 25111 DC-12300
SITE ADDRESS: 15920 SW OAK MEADOW LN
SUBDIVISION: SUMMERFIELD NO.11 ZONING: R-7
BLOCK: LOT:619 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: �- DOMES. INCIN:
LPG 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 ,t3TU: AIR HANDLING UNITS CLU DRYERS:
FURN >= 00K BTU. <= 10000 cfm: OTHER UNITS: 1
1
GAS OUTLETS: 1
> 1000'3 cfm:
,9emarks: Install gas insert&gas fine
Owner: --- --- !FEES_.._-..._.___________._._
SCHAEFER, MAX L +AMY J Description Date Amount
15920 SW OAK MEADOW LN
TIGARD, OR 97?24 [MECH)Permit Fee 17_/1/03 $72.50
[TAX]8%State Surchul 12/1103 $5.80
Phone: 503-969-9024 __� �Y Total — $78.30 _ T
Contractor:
SHAMBURG HEATING LLC
PO BOX 82.9
TUAL AT'IN, OR 97062 REQUIRED INSPECTIONS
Phone: 503-692-5563 Gas Line Insp
Mechanical Insp
Reg#: LIC 126881
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W This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore, Specialty Codes
and all other appli^able laws. All work will be done in accordance with approved plans. This permit will expire if wotw is
not started within 180 days of issuance, or if work is suspended for more than 180 nays. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-00
7 r
Issued By: ��2Z Permittee Signature: (j
Call 1,503)639-4175 by 7:00 P.M.for inspections needed the next b sl ess day
Dec 01 03 11 ^ 24p ShamburC HeatinC hO3-691 -6855 p. 2
Merhnniad-P'ermit icon
T Daterecefyed: Permit
city Of i igar 1 tr ojwwaPpl.no.: M Expire date:
City raj"Tigard Address: IV 25 SW I-I Blvd,Ti ,Vq*123 pate ism ed: — By: Rxeipt no•:
Phone: (503) 639-1171 y -— —
Fax: (503) 598-1960 O � F��GPPU N Case Fle no.: Paymenitype:
Land use approv al: O w`c'�O BuiM Ing permit no.:
I &2 family dwelling or accessory L2 Co amercial/industrial U 14ulti-family 0 Tenant impr.r,emeni
U New construction U Addition/altemtiotJreplacerlent Ot O.:xr:
Job ad2 indicate equipment quantities in boxes brslow. Ind' the dollar
Bldg.no.: Suite no.; value of all mechanical materials,equipment,labor,overhead,
Tlot/sccou:r.rto.: P,--fit.clue$
Tax tearltax
ax Biv_w:^ Subdivision: 'See chrcl.list for important application information and
Lot: t,rtutle: jurisdiction's fee schedule for residentl.i permit fee.
City/county: d Z1P:Qat r
i Description and location of wort-on premises:
Fce('a.) TrNd
Eat.date of completionfinspection: aez oW Asa.art
Tenant improvement or change of rise: Air handlingunit CFM
Is existing space heated or conditioned?O Yes U No r c on n s to an rc Treat
Is existing space insulated?13 Yes U No tent n o ex t ng HVAC system
comptcsson —'
5t/rte butler permit no,:
Bus.ness name: ' ,_/4419 � HP . Tons DTIJlH _
,.ddr+ess: A47 >!-d _ l5iWamoke damper uct smoke detectors
City: State: 2 ZIP: - &sco cut um (s an u
Phone: Fax: E-mail: nein rep acs umac rner
Including ductwork/vent liner 0 Yes L2 No _
CCB no.:/Z/o�'�/ nsta rep ac rz etc beaters—
City/metro tic.no.: S _L___---� — wall,or floor mounted _----
Name(peas � t]etailtlerotr_a _se_c_t ot�icr an_ na-x
Absorption units .S-
'T^—U
-)
HP
,Na
-
Co ressors _ HP
Address-. _ __ _ eartx 4m a i nwrl v d au:
City: State: ZIP: A fiance ven, _
Phone: / Fax �! erex Host
otrdt, ype Y ars. uc a asmat
hood fire suppression system — -•
Name: �f �!! Bxhaust fan with ai le duct(bath fans) M
AC
Mr i ling address: /57f xo .,s.,r� est stem mt from, n or
anti es up to ou +)
PAPIRM
city. Is Q!!!:- ZIP- Q1-._�� T -.--LPG = ,tNo 5•y10
Phone; Z Fax: E-mail: e n tactl additional over is
(schematic tequ
Number..r outlets
Name: Ot eer��prll,�ei or a pose .
CL Address: Decorative :ace •Ov
State: 21P•
City: _ to et stove
N Phone: E-mall:
Applicant's
Name sprint):
J /
m Na an;mLdkllons acccp acdil cards.oleme call Jmltlldlon For mow ideneMlm. MiniPermit m fee
................$
,! Notice:This permit appticalion Minimum fee.. .. . S .7 1. '� ...__
fya*t-" U MasterCard expires If a omit is not obtained
C9 xP P Pion review(at — %) $ —
lti credit card nambrr: -- - --L-�-- within 180 days after it has been
J e.r res Y State surcharge(8%)....$
Norm r at ane 1 c a accepted as complete. ..$ � �
TOTAL .....................
—`
Cardhokler 4 Aararart 4404611(41AXWOM)
CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)635-4175
0% 0 MST
INSPECTION DIVISION - Business Line: (503)63'8-4171 SUP —___—.-__----- --
Received — ._—.-_Date Requested�. l � �� AM ---PM _---____ BUP __2--_�------------ -
Location _�_
S ��,,d Suite____._ MEC
Contact Person _ --
Ph SWR
Contractor — ---
Ph wrfw iey ELC
BUILDING Tenand
Footing
ELC
Foundation Access: ELR
Fog Drain _
Crawl Drain SIT
slab Inspection Notes: _J—
Post&Beam
Shear Anchors __-
Ext Sheath/She �-��-----�-_-�-
Int Shevth/Stis -
Framing —
Insulation --
Drywall Nailing --
Firewall
Fire Sprinkler _
Fire Alarm
Susp'd Calling
Roof — ---
Other: --
Final —
PASS PART FAIL
oLUM13ING —
Post&Beam --
Under Slab
Rough-In _
Waiter S-,�i vice —�—
Sa wary Sewer
Ra n Drains
Catch Basin/Manhole -
Storm Drain
Shower Pan
Other:
Final
PASS -- AFL
F'ost 8 Beam
'dough-In -
Gas Line -
Smoke Dampers
n
Fes- PART FAIL
N ELECTRIC
Service
J Rough in ----
m UQ'Sieb —_ --
Low Voltage
JFite Alarm
Final Reinspection feE of$__-_— ---iequired before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART_ FAILUnable to Inspect-no access
81TE — Please call r reins�actic n RE: .-_�_ _ [-
Fire Supply Line 2
ADA v 3 Q _ _ In Ext ---
Approach/SidewalkDate) /
Other: _-_--- PO NOT NEMS`,IE this Irlspeetion record 6*m the job sloe,
PASS PART FAIL