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15930 SW GREENS WAY
CITYOF T I GAR D _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2004-00397
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 6/22/2004
PARCEL: 2S110DD-01200
SITE ADDRESS: 15930 S\N GREENS WAY
SUBDIVISION: SUMMERFIELD ZONING: R-12
BLOCK. LOT: 088 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF" UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: H3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/COM/.PRESSORS HOODS.
FUEL TYPES _ _ '0 3 HP: 1 DOMES. INCIN:
ELF v 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 -30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 5() + HP:
FURN < 100K BTU: AIR DANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks:
Owner: FEES _
ELSNER, CURT Description _ Date Amount
15930 SW GREENS WAY \1I I I I Permit I aye 6/22/2001 $72.50
TIGARD, OR 97224 1 \\ ` State .;urchnr 6/221200 $5.80
Phone: 503-0909-9015 Total $78.30
Contractor:
SERVICE NOW OF OREGON INC
404 SE BEAVERCREEK RD#228
OREGON CITY, OR 97045 REQUIRED INSPECTIONS _
Phone: 1 -(,55-7593 Final Inspection
Reg #: Li -7559 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 ')regon 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.
c
Issued By: i Permittee Signature:—Ld
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next baasiness day
Mechanical Permit Application ,
City of Tigird Received �9���
Da1dDy /25C;GQ Pennil Nu.6
13123 5W Hell Blvd.,Tigard,OR 47223 sJ-7
Phone: !!3.639.4171 Fax: 503.598.1960 Plan Revievi
UateMy Oilier Pennu
Inspection Line: 593 639.4175 pale Ready/By rD - _ rurn - --
Internet: www.ci.tigard.or.us y y ® see Page 2 for
Non ied/Mcil,al. Supplemental Information
�lv+gh+x �•—Q '' i'� � �CQI1��t�t�Cf l}'?•�EE 3(;11 D L
[�New cultstruction Acldilion/alteretion!rcplacemcnt Mechanical pemtit fees•are based on the value of the work
❑
performed,Indicate the value(rounded to the nearest dollar)of as Drmoliliolt ❑Other: mechanicP1 materials,equipment,labor,overhead and profit
ar value Sto MW
--
® I-and 2-family dwelling 0 Commercinl/industrial ❑Accessory building +� +�
Multi-family For special in/ormarion use Checklist
Y ❑Master builder ❑Other: 7MM
Qty, Fa Total
frSITE INfOItp(A�)QI Q lifaOilY.r10,�,1w .sir,=} a. t ,.,:, n�/coolies _
Job site address: 15930 SW Greens Way Air conditioning or heal pump
_ rt oires,ile Ian showin Incemcni -1 14.00 _
city S1.11C/11', Tigard, OR 97224 Furnace 100,000BTU(dtiels/vetus) 14.00
Suite/bldg./apt.no.: Project name: Furnac_o 100,000+Ul'U(due /vents17.90
Oes Itrat�tuntp 14.00
Cross street/direclions to job site: Duct work 1400
H dronic hot water system 14,00
Residential boiler(radiator or
It dronic 14.00
r- �— Unit healers(fuel-type,not electric),
in-wall induct sus ended etc. 10.00
Subdivision:
ision: S U RIRIP..L f e 1 C3 Lot no.: Flue/v.nl for any of above 10.00
-- - Other: 10.00
Tax map/parcel no.: Other fuel app
Ilancea
Wafer heater
ai 44DESCRIPTION(101 1YO& •�! ' , ��I Nor 1 10.00
Gas lirelace 10.00
flue vent for water heater or gas
Replace A/c fireplace 10.00
-� [Log lighter(gas) _ 10.00
- --- -- ��—___
Wood/pellet stove 10.00
Wcod fire loce/insen 10.00
� tr ' ^�'� ";��1fI�ANT- Chimne piner/Oue/vent 10.00
K +, •j�],;PROPEItTY 01,. R; + _
— Other 10.00
Name: Curt E 1 clie r FuvironmenlsIexhaust and ventilation
Address; 4L� _ — Itange hood/other kitchen
_ cr ul meal MUD
City/State/ZII': Clothes dryer exhaust 10.00
503 — —-- Single-duct exhaust(bathrooms,
rhone:( 9 6 6-8 01 5 Fax:( ) toilet compartments.utility rooms) 680
'` n �hLICAN'C ilk ' 4 �RSQN. ABic/crawls ace fans __ 10.00
Business name: Other: 10.00
-i
-- _- Fuel i In j
Contact name Kathy Price _ S5.40 for first four;S1.00 fur each addlllonal - 1
Address: / f t rnace.etc. —
Gas bun pump
City/Stnlr211: Wall/suspended/unit heater
Phone:( ) I'ax;:( ) Water healer --
E-mail:
Fireplace _
_
Range
( '` CONTRACTOR r R . '• :arbecue
Business name: Servi6e* Now of Oregon c kitties dryer,, ng S) - ^
Other.
Address: 404 S eeavercreek Rd N 228It t. aD E 11ANIC`ALrPFRhiIT,FE
(it% ,l.tezll' Oregon City, OR 97045 Subtotal
Phone:(5031 655-7558Fax:( 503 655-7593 I._ Mminfumpermit fee($72.30) 72. 50
Plan review(25%of permit fee)
CCB tic.: 1 1 021 4 -5 dale surcharge(8%ofpermit fee) f
— TOTAL PERh11T FEE �. 0
Authorized signature: ,� I his permit oppiicalio-t c%plres Ira permit is not obtained within 190
j days after 4 has been accepted as complete.
Print name. Kath P i ee U ae: 15/ 0 4 Fee nicihodology,set by Tri-County Budding Industry Serv,ce Board
i�Imldn,g Pp„nat�ICC•penn,1App doc 12/01 440-4617T(I II02/COAVWED)
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CITY OF TIGARD 24-Hour
BUILDING Inspection Line: (503)639-4175 MST
INSPECTION DIVISION Business Lire: (503) 639-4171
BUP
Received � hate Requested /—/ 77 AM.—__-- _ PM _--____ BUP
Location (/ 7g Suite_ ------ '(Eck •�6D�-8��
Contact Person Ph(— -) ' - PLM
Contractor _ — _- . .__—__
-- --- Ph(---- ) --- —--- SWR —
BUILDING Tenant/Owner - -__--__ - - ELC —
Footing ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain 11 SIT
Slab Inspection Notes: ----
Post&Beam
Shear Anchors —
Ext Sheath/Shear -- - --
Int Sheath/Shear _ —
Framing --
Insulation
Drywall Nailing — �-
Firewall
Fire Sprinkler - --_--- —�
Fire Alarm
Susp'd Ceiling _ --
Roof - - - -.—
Other:
Final - - —
_PASS PART FAIT_
-
PLUMBIN_G -- - -- -- —
Post&Beam
Under Slab -- - - --
Rough-in --
Water Service - —
Sanitary Sewer `�1
Rain Drains
DrainsCatch Basin Basin/Mari ile
Storm Drain —
Shower Pan _
Other: —
Final
PASS PART FAIL
_ C_HA _M_ -- - _ -
Post Beam
Hough-In w —
Gas Line
Smoke Dampers -
n
PART FAIL -
L — -
Service
Rough-In -
---
UG/Slab
Low Voltage y� -- --- --------
Fire Alarm
Fi I Reinspection fee of$_ required before next Inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
BITE - F-1 Please call for reinspection RE: Unable to inspect-no access
Fire Supply Line _ !�
ADA Date V 1'4y) Inspector r t,��ti,l.�l- '�--- Ext---
Approach/Sidewalk --- - - -
Other:
Final DO NOT REMOVE this Inspection record fr the Job site.
PASS PART--FAIL //