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11070 SW Cottonwood Lane
CITYOF TIGARD _ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2001-00277
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 08/03/2001
PARCEL: 1 S 134AC-02649
SITE ADDRESS: 11070 SW COTTONWOOD LN
SUBDIVISION: ENGLEWOOD NO.3 ZONING: R-4.5
BLOCK: LOT: 215 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEAT7RS: VENT FAN!
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEM":
STORIES: BOILERS/COMPRESSORS HOODS:
FUEL TYPES _ 0 - 3 HP: 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: DRYERS:
RYERS:
FURN < 100K BTU: 1 AIR HANDLING UNITS C
— C D UNITS:
FURN >=100K BTU: <= 10000 cfm: GAS OUTLETS: 2
> 10000 cfm:
Remarks: Installation of furnace in garage. Includes vent. (2)gas outlets
Owner: _ _ _ FEES ---
JOHN HALSTEAD Type By Date Amount Receipt
11070 COTTONWOOD LN PRMT CTR 08/03/20( $72.50 2720010000
TIGARD, OR 972235PCT CTR 08/03/20( $5.80 2720010000
Phone: 503-52.1-1833 – --Total $78.30—
Contractor:
PIONEER GAS FURNACE
3615 NE BROADWAY
PORTLAND, OR 97232 REQUIRED INSPECTIONS
Gas Line Insp
Phone:249-5000 Heating Unt Insp
Reg #: LIC 36102 Final Inspection
This permit is issued subject to the regulations contained in Tie Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0080. You may obtain copies of these rules or direct questions to OUNC by
calling (503)246-9189.
Issue By: , , %l� Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
I I I U 1111 'I'III 12: :42 b \\ 50:1 511171 1111111 CI I1 III 111;11211 !viii I
Mechanical Permit Api>t Reation
Oate received: 3 Permit Ito
City of Tigard Project/appl.no.: Uxph�cdle
iyofTigard �
Address: 13125 SW Hall))Ivd, �IVFQ223 Date issued: -~� By: Recetpt-on
Phone: (503) 6139.4171 --- --- ---- - -
Pax: (S11.) 598-19611 r i C' (:ase fele no.: ---� - !'aynlrnl lyhe
Land use approval: Nnlldingpermilno,:
I i (�. ��'i'MLP-.
�sI Xe 2 family dwelling or accessory U Com utrcial/iudu.Itial a Multi-family UTCIIAnt inlluuverncnt
(�New construcliwi U Addi ion/alleraliult/replacvnlent U OUrer:
t
Job address: (' (kiw Indicate equipnu:ml tluautilics in Ixlxes I+rlow. Indicate the dollar
Bldg.no.: j_S1ite rt 0.: �---- value of all mecllmliall Inwrrinas,t•quipnlcnl lal.nlr,mrtilrml,
Tax rnap/lax lot/account no.: - - profit.value
Loc Ulock: Subdivision: *Sec checklist for important application in1oi matiun an(l
�� - - urisdiction's fcc schedule for residentinl 1unlit I're.
Project name: 1 ( Q�q ___. .-- I
City/county' i Ar : ' r
Description an�/1d/1 location
�of/work on peremiree:.�i1$fin lI c>s�LPy�._
12V�r_1��2 C__Gi1� `'_— . — Fvr(r11.) IOtat
. --- -V-^_�. --Est.date Ville Uf COmpICtiClll/IIISpL'C110a:--ii-- 7erjoinpleiin Ih Suipliun-- - 4), 1 111- ndy 1(n null
Tenant improvement or change c1f use: -- -- —----_-._
Is existing space heated or conditioned?U Ye; U '!" nit . (e) -_-
g(site plan requited)
Is exisUtg space insulated?O Yc; U No Tsl g IVit .s�yslelntn
13uaincas name: I' SInte boiler permit no.:
_. - LyYL�I.� (L-�' �)�lC� - -._ HI' __ _ lmllr-.rtl1'll/ll
Address: E 1�r1tAb: _ _ _ -_ 11re mo c ompern t act smn a etectuis
City: � St It.,,.��,, (J--t,ll': Mai lTi-5np(iTie-jj7RiiT&q-u1i s ieiinii rcquTrrT- _.... - --
Phonc: 1-ax: f7,mail: t�t e�p act a(arose tact t iil`Ulii
lncludingductwork) cat lnerIntYen UNo r`r.OD pry
CCD no.: ----- __ --..
S►�Q.� - -- _----------__- __ Tilstn rep ac rc ac tentrrs-suspcndctl,
City/metro wall,or flour mounted
Name(please print): v Q k- �\cat�mr u ant c of Tert nrTi-i i'urnncii
CONTACT t c gets on:
Absurption tmits _ _ U1 UA l
Narnc: -C�1 ���7Ju1te1 r'hillcrs _.. 1)p -
Adrltess: r��r 1 - - - rm,,,
reR -
�s�Rr�r-- - - --.------- - - enta ex Iaust and venl)Iat mn:City: State: :!III: vew
Phone: Cux: P-mail ust - -- - - ."._ll - - ---
nod s• ypc VhrsTliciicli/Tinrnint - -
J hood fire supplcssion syxlcin
Name: 'r� �,j f Q(,1 _- Exhaust fan with xingle ducat(batll Ione) -, - ------
Y-
Maill_n address: x tl fled system a;arirota eel ng ni-AT:
city: ; I Slate il}': � ,1 ' _ u p p ng andistribution(tit)In out etq)
- - Ty}rc: _ LI't.l M1U _ _Ofl S,.qV.
Phone: ` Pax: 1.-mail l trier piping each aUt11110na11N �Ul1IIC14 ~- -L
Process piping(se Icmml le required) _—
Nundlcr of uuticls
Name: Ziilie�liiie-Ti arprnee at req-`-uTiteirl - -- -
- - - --
Addrt:ss: I recon alive fireplace
City: Insert-type --
--
"
Phone: Fax: --
'T�it
Applicant's signature: ale: �t --
Name(print): - -._------
NM Idl J,riulieUom accept erulii emir,ptetrse cdl Imlallcnun fol mar lu'onunHon. - - y�——_- Per snit fel• .. ......_. ..
(]Viso OMxsterCurd Notice Ilikpennil applicatimi Minimum Ire..-... . .. ..$
expires if a permit Is nol ubtahted Plan Inview(at "1.) 1
Cudit crud numbec-�. - -_
Front,- %vllhiu !80 days aRct it hnq been t --
�"-Horne n�cmdh`Cam of ol et,�'iown nn el�:ie ii i w`fi` uceerled nn complete. TOTStale AI�ur.. arl;e(RIX,) . .. -_
-- -edgnallre — At�onn'1 4111161/IN(IDa.1N11
I I l i iii i . �Ir�
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE; 1 & 2 FAMIi_Y DWELLING FLE. SCHEDULE:
TOTAL VALUATION: FEE: Description: r�rice- -
_ Table 1A Mechanical Code Anif
_
$1.00 to$5,000.00 Minimum leo$72.50 ' -�_ Uly (Eo) 7�1ii1
$5,001.0f)Io$IO,000.UO 72,50 for the first$5,001.00 and 1) Funiace to loo,000(!TU ----
$1 52 for each additional$100.00 or Includingducts&vents - __ _ ___ 14m �(
traction thereof,to and Ircludin0 2) Furnsice 100,000 DTU+ - -
_ 510 000.00. _
Including ducts 6 vents11.40
.00
511,0011to$25,000.00 $148.50 for the first$10,)OO.OU and 3) Floor Furnace -
$1.54 for each addil+onal$100.00 or +nciud)n vent _ 14.00
fraction Iheroof,to and ircludinU 4) Suspended healer,wall flouter __
_ .$.2.5,01)0.00. _ or fluor mounted hooter _I4.Un
$25,001.00 to$50,000.00 $379.50 for the first$2;1,)00.00 Ti-Ki- 5)`Vent not Includod In appllance permit - - --
$1.4.5 for each addillons'$1U0.00 or 680 -
___
traction thereof,to and lrclurlln® G) r1 R__epair units - ----
_ $50.000.00_ 12,15
$50,001.00 and up $742.00 for the first$50, 00.00 end Check all Ill- aprrly Duller1-i-
lirti nli
$1.20 for each addl(iona $100.00 or For Item);1-11,deo or Pump Gond
-- _- frac0on IhereofL._--- a _ footnotes below. CoW �•
__ _ 7)<31+(':absorb unit y -- - " - ---
ASSUMED VALUATION_S_pER_ APPLIANCE; - to 1uoK IJTU 14 00 _
- 8)3-15 HP;absorb --
- r I Value Total unit look to 500k BTU '
boscrlaUon__ _ __.1 211 _. T1L Amount - - ---._ 25.80
Furnace to 100,000 Ul'U,including 0,55 9)15-30 HP;absorh - - -- ••--
ducts fir vents unit.5.1 mil BTU 35.00
Furnace> 100,000 BTU'Includinp 1,170 10)30-50 HP;absorb -
ducts 8,vents unit 1.1.75 roll 01 U 52.20
Floor furnace Including vent _ -`fl55 - 11)>501•fP:absorb ---
unit>1.75 mll HTU I
Suspended f lealur,wall hooter or g65 - 87.20
floor mounted hooter 12)Air handling unit to 10,000 CFM -- �-
Vent not included in applloancrt T45 - 10.00
13)Alr handling Imll 10,C�U CCM+ - --
_Eormlt -
Repair units17.20
_ 80a _
- -- __ --- - _ _
<3 hp;absorb.unit, - - 14►Non portable evaporalc conlAr -
to look BTU 10 Uo
3-15 hp;absorb.unit, _ 1 700 - 15)Vent ran connoc(od to a single duel -"- --
101k to 500k DTU _ 6.80
-_ - 10)Vanilla1-11sT_1 -_ --
15.30 hp;absorb.un±1,:iUtk-to-I - 2,310 - -- "- ' yulem not Int uden - --
mil.BTU a Ilanco penult to 00
30.50 hp;absorb.unll, 2,�0U _ 17►Ho served by mechanical exheus!
1_1.75 mil,BTU _ __ _ - Moo -a
>50 hp;absorb.unit, -- 5,725 18)Donlesli.btcinerolors ---- --
>1.75 mil.ETU _ 17,40
Air handliny_unil to 10 000 cfm 19)Contlnerclsl or intktslrinl type inulnerolor -"
Alr handling unit>10,000 cfm- _ 170 __ 00.95
Non- enable soya Qrato cooler - - -- 20 Othor units,Including wcwd stoves +- 5 -`
- -f' -- -- y._ 050 )
Vent fan connected to a sinQlo dual
448 _ 10.011
Vent system not Included in - 058 "-` �� � 21)Qas plping one to four ouflels -"`--"-"
a Ilanco permit 5.40 t �
Hood served-y_mecGonIfi- exex5-5
Domestic Incinerator _ _ 1.00
Commercial or industrial inranerator _ 4,590 Minimum Pemlit Fes=72,60 SUf310T/11. "-
Other unll,Including wood stoves, Gib -
Inserts,etc. 8Y.3tata Surcharge -
t3as Ipaing_1ou'tlels 300 -_- g
-- - _ _ -_
Each additional outlet _ G3 25•�L(')sell 12evlew Fee(ol leu fold s -
-" -- Required lel At.l.coliveerclal panniLs on1v
TOTAL COMMERCIAL TU7AL RESIDENTIAL PERMIT rfwE:
VALUATION:
Ulhcr.�i pn�l�er����cA;
1 Insprtchr,ns tlUhltlp of rytlfllla)hr14fI1Pg3 fNllll!t fnuninnnn chatgn lwrr hour)
$12.50 pot hntiv
Inspuchoos for which no lee la spurrlkWy Ardirninrl (minhrNlrn chirtl,11nll hour 1
$7250 ilor finer
{ Additional plan tnviPw toquited by rhvntjw%.140111tnl,ni fnV101113 lu plans(mhihnimr
rhtM90-010 NA flout)$72.50 pot hum
'Stale Contrarlor Boller Cetlili,atlon regvhnd for unlls ?Oak R 111
Resldontlal NC requires 211e pian showrnp placemenl of unit
i:ldstslfronnsbnech-fees.doc 10111/00
OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639-4175 Business Line: 639-41" fMST
�Q BLIP
Date Requested AM_ _PM BLD
Location � �' 7 U 1��=� �'� � Suite ;.qi:C c:( - p o.Zz
Contact Person Ph _ PLM
Contractor Ph ,��I t- Sir, C— SWR
BUILDING Tenant/Owner ELC _
Retaining Wall ELR
Fooling Access:
Foundation FPS
Fig Drain SGN —
Crawl Drain Inspection Notes — ----
Slab ---— c_c�1 � — � ;/j �c i SIT
Post& Beam n Tnn`�'/M—�J --
Ext Sheath/Shear C ) (E (G- `—
Int Sheath/Shear -�
Framing
Insulation —
Drywall Nailing /0 7 ,�IvK.1„V� 1,u I'Adh
Firewall
Fire S orinkler —
Fire Alarm
Susp'dCeiling ,r 105 Jr t4f�.uu -_
Roof
Misc.
�Tlls) 4Z�y40
Final
PASS PART FAIL
PLUMBING
Post& Beam
Linder Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final ---------_`_
PASS__ PART FAIL.
ANI
Post&Beam .. - _-__
Roush In
tLn_�. --
Smoke Dampers
-in ---- ---- - - -----
AS5 PART FAIL
EIEECTRICAL --
Service.
Rough In
IJG/Slab ---- - — — ------- ---
Low Voltage
Fire Alarm
Final - - ._- - ----
PASS PART FAIL_SITE
Backfill/Grading ---- —------- --- —
Sanitary Sewer
Storm Drain [ Reinspection fee of$— _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Suppler Line f )Please call for reinspection RE: — — [ J Unable to Inspect-no access
ADA
Approach/Sidewalk Date L 7, , / Inspector Ext
Other
Final
PASS PART_ FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF TIGARD __MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2003-00627
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 10/27/03
SITE ADDRESS: 11070 SW COTTONWOOD LNPARCEL: 1 S134AC-02649
SUBDIVISION: ENGLEWOOD NO 3 ZONING: R-4.5
BLOCK: LOT: 215 JURISDICTION: TIG
CLASS OF WORK: Al.l 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:
OTH Y 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:
> 10000 cfm: GAS OUTLETS:
Remarks: Install wood stupe.
Owner: _ FEES _ --
HALSTEAD, JOHN Description Date Amount
'11070 SW COTTONWOOD LANE — —
TIGARD, OR 97223 %1FC1II 11c]11111 Fee 10/27/03 $72.50
TAX] 81.,titate 10/27/03 $5.80
Phone: n.�_.�?I ti()()u _— Total $78.30
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005-2129 REQUIRED INSPECTIONS
Phone: 503-646-0409 Woodstove Insp
Final Inspection
Reg #: LIC 51469
This permit is issued subject to the regulatior s contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable laws Al: work will be done in accordance with approved
plans This permit will expire if work is not stj rted within 180 days of issuance, or if work is suspended
for more than 180 days ATTENTION Orec.)n law requires YOU to follow ntles adopted in the Oregon
Utility Notification Center. Those rules are ,et forth in OAR 952-001-0010 through OAR
952-001-0100 You may obtain copies of (hese rules or direct questions to OUNC by calling
(503)246-669j
Issued By: Permittee Signature: L ci_ 1J_V .A-i I( „(
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
/ Mesfinnicai.Permit Applicntion
City of Tigard Proiectlaopi.no.: P.xDift date:
o%Ttrara Address: 13125 SW Hall Blvd.11gard•OR 972?3
Phtmc: 1503) 639.4171 Dstcissucd: By (). cta
Rcptno.:
Fax: (503) 598-1%0 Guetile no.: Paymentrype:
Land use appx-vai: Bwidingpernutno.:
R ,
Url'
.4c family uwciline or ac:c-;-.svty ❑(;utnmerciaYndtucnal O Multi-family q Tenant improvcmcnc �
Q Nva,consuzuctton CiOMditionialterauororeolacament Q Other.
�111i!!Sll 11 W-s i u ;I=
Job address: //o 7O_-Z � qgQqC�p N, Indicate equipment quantities in boxes below. Indicate the dollar
Bldg.no: iSoite no.: value of all mechauical malenals.equipment.labor.ovciitcad.
Tax marvtax iouaccortuit nc.: profit-Value S .
Lot jBlo'—Subdivision — •See checklist 2or unpottant application mtormanon and
Projectname: & �- iurisoitxion's fee schedule for rtsi&ntial permit fee.
Cityicounty. ''-�r��.� ZIP. ��_�� tat
Desert sits 1 ano t nt work on pr=-,,cz: S_rs S�/ 2'
. � Fee( )I ro
Fst-trite of compietiowinsncction: Uiescrimift Qty.I Re-only j Rmonly
Tenant improvement or chance of use:tinHVAC--
Is exisspace heated or conditioned. Q Yt_e :il,io Air conditioning(Sim Elan regouta)Air handling unit _ _CFk( 1 I I
1a existine space insuL ted?O Yes 0 No Alteration or existing V Arysteci �--�
VAC
w t � 6oiler�catupressors �
Busin,=name: rAV
State boiler pvmit eo.
Addie-s./ HP Tons--13T U/H
__.2 75 L�ewVere�wwl Rr_i� l-ireismokecampers+ductsmote acsccton
City C'tluC'AJ, (state:QR I ZIP: '?7CCLT eatpumptsimpliatequurdl- - -�---�
phone /ttMMq A&nW" E-Mail: lnstailhtptacetumiwnurner
G��S�Z"1_I Fa ��K—' including ductworklvent liner O 1'u O No
CCB no.: - e��,3 C9- lnstatllrepiacurtiocatene exa-impended,
city/metro tic.no.; wall,of floor mounted
Name(pie-Lw.Mm): � n/e. �� FAvphancevcm
vpuance other an furnsrr
_
e/ n units BTLM
�1ame__QQ*1/ /7'4G r` C -- - Re -
i-• ---- v- HPAddress: etftla)atlaamr and iresulation:
Pbone: Fax: E-mail: aust --- -- —
1 Hating,aype��Jtei- Critri2mat
hood fire suppression system _ l�
Name: a �ti Eahansr fan with Tingle duct(bath fans)
Mr,ilin ress: 4Z O 7O S aunt system aparttiom hC31tntt or AC
�Uh 1HPInR aft es rnp r^a outlets i I -
Ci ty:-7- A j$-tat-e7d�/ �L t Type- LPG NG Ol
P1 one .�ax: I E-mail: Fuel uiAinq each additiottai ovtt 4 outlets 1�JJ
a rcem popes i scnem3ac required l
Number or outlets
hTddh ---- S ----- ---'---- a hst ,Vpuasoe er ttgsopmetst
AddiSes� _ Decorative fuealace
Citp:- State: Z1F' Msert-type
or Fit. g�j"`^-_ -•�-yoodstovvoeile1inove------ _ _-� a 00I�CI»�
thher I I
Applicants signature:t~ Date p Uty� ---
Name ipnnt) 4 —�-
Na o0 jmtfLrnup r:ceta resit rte,pin=dl
NoticeI1ti5 reTtnit anplicauan `PtTTrat fee
M�4L:d Minimum fee
__------..........
.SS
-
C-.,eriii cam eu�ea-
z / rsanr If a permit a nut obtained Plan review t at _ etnl 3
F1pyr, I within 180 davit after a has ixen Stave sumhame 13%)a ....
c S
ty .SdD
ciu1-tees rnrnoiete -
TOTAL ............-......
...
Aaieeae
k'aeAndes nesnoaa
--- +naeit reaxran
� I
i
CITY OF TrGA9D 24-Hour
BUILDING Inspection LinL-: (503)6o9-4i75
INSPECTION DIVISION Business Line: (503) 839-4171 MST ---
BUP
Received Date RR osted AM PM BUP _
Location Suite MEC - _
Contact Person _- )�z� A, Ph ( ) (,, �� _ (Q�4
i _
PLM
Contractor`.__ Ph( ,` ) — SWR
BUILDING —� Tenant/(:wner _ fT �- I �`1 G1 O ELC
Footing - --
Foundation Access: ELC
Fig Drain ELR
Crawl Drain ------
Slaw Inspection Notes SIT
Post& Beam -
------
ShearAnchors
Ext Sheath/Shear _
Int Sheath/Shear --- - - --- —
Framing --
Insulation -- _
Drywall Nailing -
Firewall
Firs Sprinkler - _ ---- ___- ---- -._---
Fire Alarm - -
Susp'd Ceiling -- - -- -- _
Roof -
Other
Final
PASS PART FAIL ----
PLUMBING
Post� Beam
Under Slab -
Rough-In
Water Service
Sanitary Sewer
Rain Drains --- - _
Catch Basin/Manhole
Storm Drain
Shower Pan
Other - — -
Final
PASS PART FAIL —
MECHANICAL
Post 8 Beam
Rough-In -
Gas Line — - - -
SUjoe Dampers --- ----. - - - ---- ------- ----
Fin
AS.S' PART FAIL - --- -
ELECTRICAL
Rough-In
UG/Slab -�--W—- —
Low Voltage
Fire Alarm
Final
PASS PART FAIL Reinspection fee of$.__ -- _required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE _ , Please call for reinspection RE: _ Unable to inspect- no access
Fire Supply Line
ADA
Approach/Sidewalk Data 7�-3C7 -0.3' - Inspector ,
Other:_
- -- - -_ Ext --
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL