Permit CITY OF' TIGARD
MECHANICAL PERMIT
1' , DEVELOPMENT SERVICES PERMIT #: MEC2005 -00028
� III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/18/2005
PARCEL: 25111 DA -14500
SITE ADDRESS: 15490 SW EMPIRE TERR
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING: R -7
BLOCK: LOT: 138 JURISDICTION: TIG
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: 1 DOMES. INCIN:
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 BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: AC replacement.
Owner: FEES
BARSOTTI, LISA Description Date Amount
15490 SW EMPIRE [MECH] Permit Fee 1/18/200 $72.50
TIHGARD, OR 97224 [TAX] 8% State Surchari 1/18/200: $5.80
Phone: 503 655 - 7558 Total $78.30
Contractor:
SERVICE NOW OF OREGON INC
404 SE BEAVERCREEK RD #228
OREGON CITY, OR 97045 REQUIRED INSPECTIONS
Phone: F Cooling Unt Insp
Final Inspection
Reg #: 7558 0110214
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.
Issued By: Kula t Permittee Signature: (6 Ca, �:---
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
SENT BY: ; 503 655 7593; JAN -18 -05 2:35PM; PAGE 2/3
Mechani��t,. 'er1(>r>i.it A{ a.. O '
City of Tigard • I' V Received
13125 W Hal Blvd„ Tigard, OR 97223 Date/Br '° /, - 6;5 /' t5
Phone: 3139.4171 Fax; 503.598.1960 JAN 1 8 21 p� Plan Review
Irrtsp : Line: 503,639.4175 w --,PA--' ' . y; f ` Date/By: Other
ww.ci- tigard,or.us - CITY OF TI 11 J- Data Ready/By; um Et S Page a for
BUILDING DIVISION NNotified/Method: Supplemental Information
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0 New construction n Addition /alteration /replacement mechanical permit fees* are based on the value of the work
❑ Deanuiition performed_ indicate the value (rounded to the nearest dollar) of all
❑ Other: materi
• u( , �, �,� •, kw s , : materials, equipment, labor, overhead, and ft.
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® 1- and 2- family dwelling ID Commercial /industrial ❑ Accessory building ' }' 'tinrt` ur + aril ri +t �� �' l 'l ,1�w ( w
❑ Multi-family or special information ormati •
Y Q Master build J arise checklist.
t 1, kn Other: F _
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., . x.. �`+N.,r..n..�w: 1 w:.na.�iv. +, v.S ,N:d. r9L2 5 i d s fu.iYPADY i 1 4 1t r. ; 1 a k l Y""r ` 1 , ' } tir es 1 � i
i.1r. lea a. -il ,,�_ , ri1—,,,,- ...,..r..1r..1i5„J,:e.. . ; (. ,1, 1 -- eating/ cooling
Jub site address: 'J AP / Air conditioning or heat pump
4. ^ (reouiroa site plan showing placement) 14,00 / I/
City/State/ZIP: 1 -
�x2 Jew �? (77 Furnace 100,000 BTU (dueta/vants) 14.00
Suite/bldgJapt. no.: I Project name:
r Furnace 100,000+ BTU U gams/vents) 17 -90
Gas heat pump _ 14.00
Cross street/directions to jab site: Duct work 14,00
Nydronic hot water system 14,00
- Residential boiler (radiator or
- hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended. etc. 10-00
Subdivision: Lot no.: Flue/vent for any of above 10.00 R
- Other: 10.00
Tax map /parcel no
i d i '1 ,ne, 14,L s Other fuel appliances P ` > 1, l =ry „) Vi;;,, r 417tt ui
►;,, 1 ,; „ :' . :il m`St c• `y a ra u s .; g,. i , , 4'a Water heater
..� i >�.�� rL.Su�ii�.�Lr:fi °�aJa ,.�� ".�f Satirnda>1F . t �, , � , � �, l ".' � S j I0 -00
G as fireplace 10.00
ifF Flu vela for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
k � ,' ¢i tir9 w1`d�` 1
f �i8 i i 'n {rbe 5 ? i t a'fr ( , { ar s, lir a:, aim,' aim,' /finer /tlue/ve
nt 10.00
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Name: /
' "°��+ Other: 10.00
1" l /'� A. 4_,,p_.377 0. _Environmental exhaust and ventilation .
Address: Range hoodlother kitchen
_.._ equipment _ - 10.00
City /State/ZIP: • Clothes dryer exhaust 10_.0_0
•
Phone: ( ) r/ r Fax: Single -duct exhaust (bathrooms,
..7 ( ) toilet compartments utilit moms ) 6.80
� � m J �c ! y � �_- Y
t il1J % i'. �:',w'� 1 . ! � Vi i u.: �'aiS ♦fi 1,+7i4d {iv �'.r 1 'ttl �,?"" 1 l. ,uC +. 3LJf �i,na� tt�i,:'�,F i u , A:;1 Attie% ace fans 10.00 rawls
i� `�( � �,� "l4$rr �y11�',r i„t t v�i.3; ��� � °�j u(,��'+4- "1�'`� °ii 1 t:�[t -
w'- a „�t�� i P
Business name: Other 10.00
Fuel piping
Contact name; SS.40 for first four; $1.011 for each additional
Address: / Furnace, etc. •
Gas heat pump •
City /Slate/ZIP _ _ Wall/suspended/unit heater /
Phone: ( ) Fax: : ( ) Water heater
— Fireplace
E -mail _
}, ; wK Range
i '.'[!''',..'' i °K•" )>•;� 0+r`t�s•.} .Q't Ae rggK !II:. - .';: , ..,)ii' "' ;'', &; ;'„ r'','=.' Barbecue
Business name: Ld i . 91<1.-, Clothes dryer/gas)
Address: . / (� p # Al marzi.. 1.,,,,,,,,,, Dinar pip p " p► ups
Ci ty /State /Z1P: {)/�-� ,9 /)1(/ /' 7. 97.0/5. -- Subtotal M .,era ,w,.ti,.,.,.,.h
Phone: ��,7 } ) ( _ -2 r � � j) • 's 4 _ )Minimum permit fee ($72.50) 3�
CCB lie,: I/n /C0Y �� State surch fee) permit fee) .
surcharge (8% of !'
TOTAL PERMIT FEE
Authorized signature: � This IKvrnll 4pp110111 on expires it a permit is not obtained wit is rill('
� ` days after It has been accepted as complete.
Print nam f7 e: * f y am PR e l I Date: / — I 7 O e • Fcc methodology set by Tri•County uuuWing Industry Service Board
i:Utuild4ly,Perwi)sM1LC- PernmApp dA, 12/W 4404617T (t Ma/COM/WEB)
BY: ; 503 655 7593; JAN -18 -05 2:35PM; PAGE 3/3
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CITY OFTIGARD
BUILDING DIVISION .1 PERMIT #: MEC2005.00028
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/16/2005
Phone: (503) 639 -4171 kap
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/20/2006 TIME: 7:11AM PAGE: 75
SITE ADDRESS: 15490 SW EMPIRE TERR CLASS OF WORK:
SUBDIVISION: APPLEWOOD PARK NO. 3 LOT #: 138 TYPE OF USE:
PROJECT NAME: BAR SOTTI
DESCRIPTION: AC replacement.
OWNER: BARSOTTI, LISA, PHONE #: 503- 655.7558
CONTRACTOR: SERVICE NOW OF OREGON INC PHONE #: F- 655.7593
Inspection Request Scheduled For: Date: 4/20/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Post/beam mechanical 004910-01 503 -698 -1915 N
Corrections /Comments /Instructions: ,
��� ea � L !44 � �.� � !./f � G. S 3 q 7/e) `�—
�7(/
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: Date: 4- ' i_.c Phone #: (503) 718-