11080 SW COTTONWOOD LANE it
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11080 SW CdM'ONWOOD LANE
CITY O F T I O A R D MECHANICAL
DEVELOPMENT SERVICESPERMIT
PERMIT #F.
. . . . . . . : MEC96-007;:�:'
1312 'SW Hall Blvd., Tigard,OR 97223 (503)639.4171 DATE ISSUED: 02/25/98
PARCFI.. : 1S134AC-02650
SITE ADDRESS. . . : 11080 SW COTTONWOOD LN
SUBDIVISION. . . . : ENGLEWOOD N0. 3 ZONING: R-4. 5
BLOCK. . . . . . . . . . . LOT.. . . . . . . . . . . . . :216 JURISDICTION: TIS
--------I----------------------------
CLASS OF WORK. . :Al-.T FLOOR FURN. . . . : 91 EVAP COOLERS: 0
TYPE OF USE. . . . :SF UNIT HEATERS. . : 0 VENT FANS. . . : 0
OCCUPANCY GRP. . :R3 VENTS W/O APDL: 0 VENT SYSTEMS: 0
STORIES. . . . . . . . : 0 BOILERS/COMPRESSORS HOODS. . . . . . . .. 0
FUEL TYPES-------------- 0-3 HP. . . . : 0 DOMES. INCIN: 0
:GAS 3-15 HP. . . . : 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15-30 HP. . . . : 0 REPAIR UNITS: 0
FIRE DAMPERS?. . : 30-50 HP. . . . : M WOODSTOVES. . -. 0
GAS PRESSURE. . . : 50+ " 0 CLO DRYERS. . : 0
NO. OF UNITS---------- AIR HANDLING UNITS OTHER UNITS. : 0
FURN ( 100K BTU: 0 10000 Cfm: 0 GAS OUTLETS. -. I
FURN ) =100K BTUs 0 > 10000 cfmi 0
Remarks : Installing gas piping
Owner: ------------------------------------------------------ F E E-S ---------------
KENNETH HAYNES type airount by date recpt
11080 SW COTTONWOOD LN PRMT $ 25. 00 B 02/25/98 98-303584
TIGARD OR 97223 5P(-_'T $ 1. 25 B 02/25/98 98-303584
Phone #:
. Contractor: - -----------------------------
HOLMES INSTALLATION SERVICE
RAYMOND FLANDERS ----------------------------------
SW 141ST AVE #55 $ 26. 25 TOTAL
BEAVERTON OR 97005
Phone #:
Req 0010224
------- REQUIRED INSPECTIONS ----
This permit is issueO subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, Aate of Ore. Specialty Codes and all other Final Inspection
applicable laws. All work will be due in accordance with
approved plans. This permit will expire if work is not started
within IN days of issuance, or if work is suspended for more
than 10 days. ATTENTION: Oregon law requires you to follow rules
adopted by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952-801-*I0 through OAR 952-00I-8888. You may
obtain copies of these rules or direct questions to OLIC by calling
(e03)246-9187.
Issue BY : .14a11llPermittee Signature A'001—,
Tr_ -"*---,-,____---_
......................I.................................4 ; ; +++,......4
Call 639-4175 by 7:00 p. m. for inspections needed the next business day
++4-F+-#...........4•...................................4•.... .................... F...
Plan Check 0 _
CITY OF TIGARD Mechanical Permit Application Recd Bye
13125 SW HALL BLVD. Commercial and Residential Date Recd
TIGARD, OR 97223 Date to P.E. _
(503) 639-4171, x.304 Date to DST
Print or Type Permit# ^� � .
Called
Incomplete or illegible applications will not be accepted
Name at:.avelopmeTt/Pro)ect Description
(e i _ Table to Mechanical Code QTY PRICE AMT
Job St")illiddress SudeO A) Permit Fee -0- -0- 10.00
Address /I of 0
B!dgn City/State zip 1.) Furnace to 100,000 BTU 6.00
including ducts&vents _
Name(or name of business)/ J 2.) Furnace 100,000 BTU+ 7.50
Owner t. ,ti?�7 h / /v 4.,-,t-S _ including ducts&vents
MailingAddress 3.) Floor Furnace 6.00
I 0 r 5 u1 Co qur1/��-)o N including vent
wState rr zip Pho 4) Suspended heater,wall heater 6.00
�� 1� S � �� J or floor mounted heater
Nem or name of business) 5.) Vent not included in appliance permit 3.00
Occupant Marling Address 6.) Boiler or comp,heat pump,air cord. 6.00
to 3 HP;absorb unit to 100K BUT-
City/State zip Prone 7.) Boiler or comp,heat pump,air cond. 11.00
3-15 HP;absorb unit to 500K BTU"
Contractor Nine 8) Boiler or comp,heat pump,air cond. 15.00
b4-1 e S 105 T Gt ( c'/1 15-30 HP;absorb und.5-1 mil BTU**
Prior to permit mnbng Address 9.) Boiler or comp,heat pump,air cond. 22.50
issuance,a copy s 5 N(' 1/.4 _30-50 HP;absorb unit 1-1.75mil BTU"
of all licenses �rtyrState zip Phone 10.) Boiler or comp,heat pump,air cond. 37,50
are required if ��0 e (f✓ 01,A. 27 7 b tj ' y 31 ` >50 HP;absorh unit 1.75 mil BTU"
expired in COTYregon Const.Cont Board Lic p Exp 016 11.) Air handling unit to 10,000 CFM 4.50
database f 0 L
Architect Name 13.) Non-portable evaporate cooler 4.50
or Mailing Address 14) Vent fan connected to a single duct 3.00
Engineer CMy/!tete Zip Pharr, v 15 j Ventilatior system not included in 450
_ __ ____ _ appliance permit
vDeschhe work New O Addition Alteration O Repair O� 16) Hood served by mechanical exhaust 4.50
to be Jone Residential O Non-re:'_dential O
Additional Description of work 17) Domestic incinerators 7 50
18) Commercial or industrial type - - 30,00 -
__ Incinerator
Existing use of 19.) Repair units 450
building or property
20.) Wood stove 4.50 -
Proposed use of 21.) Clothes dryer,etc. 450
budding or property
22) Other und,3 - 450
Tyoe of fuel-oil O natural gas LPG O electric O 23) Gas piping one to four outlets 2.00
I hereby acknowledge that I have read this application,that the 24 j More than 4-per outlets(each) 50 -
information given is correct,that I am the owner or authorized agent of
the owner,that plans submitted are in compliance with Oregon State QTY.SUBTOTAL
laws
Signature of Owner/Agent Date *SUBTOTAL
20A 5%SURCHARGE
Conte arson Name r -Phone PLAN REVIEW 25%OF SUBTOTAL.
TOTAL ,^
i.lrnechpcnt doc (rev 9 i 7 'Minimum permit fee is S25+5%surcharge
"Residential MC requires site Dian showing placement of unit.
L-z�
CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 6394175 Business Phone: 6394171
/
Date Requested: v2 —.;27-L?G�/ .M /�(� P.M. MST: _
1,ocation:_1 � �� BUP: MM
Tenant: J y�, Suite: p Bldg: _ NEC: —W T --
Contractor: Phone: �ya — 0 / PLM:
Owner: _ Phone: ELC: _
EI.R:
SIT:
BUILDING BLDG(con't) PLUMBING HANK ELECTRICAL SITE
Site Post/Beam Post/Beam Cover/Service Sewer/Storrs
Footing Roof UndFl/Slab c o Ceiling Water Line
Slab Framing Top Out as Rough-In UU Sprinkler
Foundation hisulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C [IG Slab
Shear/Sheath Fire Spklr/Alm Crawl/Found Ir Heat Pump 1,ow Volt
Approved Approved Approved Approved Approved
Appr/Sdwlk Not Approved Not Approved Not Approved Not Approved Not Approved
FINAL FINAL ' 1'1`N — FINAL FINAL
0 Call for rein M Reinspection fee of S _required before next inspection 0 Unable to inspect
Inspector:— -- —__— Date:_ Z—2-7F Page _or. _
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