11105 SW COTTONWOOD LANE N
0
Ln
N
E
C-)
O
clt
c+
0
7
E
O
O
M
r
a�
m
1
i
11105 Sf9 COTUONWOOD LANE
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639-4171 --
i 14 iiUP
—__ Date Requested (Z'��� —AM PM BLD
Location_ ( I C�? Cc rov) 1 quite MEC
'f �q«-� ZZO
Contact Person C� f�!� Ph q 2 � PLM
Contractor Ph SWR _
BUILDING 1-enant/Owner V ELC
Retaining Wall ELR
Forting Access: —
Foundation FPS
Ftg Drain _ -
Crawl Drain Inspection Notes: SGN
slab
Post& Beam - ---� -�'- ----- SIT
Ext Sheath/Shear
Int Sheath/Shear - ----_-
Framing - -- - -- _
Insulation ---
Drywall Nailing ��---.- -_ _-��^-
Firewall -
Fire Sprinkler
Fire Alarm
Susp'd Ceiling --- C �
Roof
Misc
Fiiial
PASS PART FAIL
PLUMBING
Post& Beam -.-- ---�� - - --- __
Under Slab
Top Out ---- - - - --- ----
Water Service
Sanitary Sewer
Rain Drains
Final -
PASS PART FAIL
Post& Bearn --------- _ _ __
Rough In - -
Gas Line --- -- - - -._ -- -----
Smoke Dampers
PASS PART FAIL
E-LEc
CTRiCL - ----- -- -- -- --
enllCe
Rough In -- --
UG/Slab - -
Low Voltage
Fire Alarm
F - --
AS / PART FAIL
Backfill/Grading --- ---- ---- --- - _-- -._-____
Sanitary Sewer
Storm Drain ( Reinspection fee of$-_- _ -required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line f ) I'lease call for reinspection RE.-_ [ j Unable to inspect no access
ADA
Approach/Sidewalk / �^
Other Date1 �_ Inspector Ext
Final T
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYITY O F T I G A R DELECTRICAL PERMIT
PERMIT#: ELC1999-00320
DEVELOPMENT SERVICES DATE ISSUED: 5/26/99
13125 SW Hall Blvd..Tigard, OR 97223 (503) 639-4171 PARCEL: 1S134AC-02631
SITE ADDRESS: 11105 SW COTTONWOOD LN
SUBDIVISION: ENGLEWOOD NO.3 ZONING: R-4.5
BLOCK: LOT : 188 JURISDICTION: TIG
Proiect Description: First branch circuit
____RESIDENTIAL UNIT TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: — PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/FDR: 601+amps - 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W/SERVICE OR FEEDER: �— PER INSPECTION:
201 - 400 am is 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 ama: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLA_N REVIEW_SECTION _
1000+ amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
L__Reconnect only: SVC/FDR >=225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
KATRINA MARTIN OWNER
11105 SW COTTONWOOD LN
TIGARD. OR 97223
Phone: Phone:
Reg#:
_ FEES Required Inspections
T;rpe By Date Amount Receipt Elect'I Service
PRMT ETON 5126/99 $35.00 9J-315689 Elect'I Final
5PCT BON 5/26199 $1.75 99-315689 N
Total $36.75 0 I '�1� I A L
This Permit is issued subject to the regulations contained in the Tigard Muniapal Code. State of OR 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 by the Oregon Utility Notification Center Those
rules are set orth in OAR 952-001-0010 through OAR 952-001-0080 You may obtain copies of these rules ordirect questions to OUNC at(503)
246-1987
Permit Signature: ` Issued By: ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ` --- DATE: J �CI±it, L _
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ DATE:_- _
LICENSE NO: �_�� �_ -- __-- —••_-- _Call 639-4175 639-4175 by 7:00pm for an inspection the next business day
CITY OF TIGARD Electrical Permit Application Plan Check
13125 SW HALL BLVD. Recd By
TIGARD OR 97223 Date Recd
Phone(503)639-4171, x304 Date to P.E.
Inspection (503) 639-4175 Print or Type Date toD T
Incomplete or illegible will not be accepted Permit# r _
Fax (503) 598-1960 Called `^
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development_______ _ Number of Inspections per permit allowed
Name(or name of business) KatY'�,rx. `L. M7,,( Service included- Items Cost Sum
Address ILLL> J \1 U��l�u OGl taY�C 4a. Residential-per unit
City/State/Zip `� 1000 sq.fl.or less $110.00 _-____ 4
1-1Each additional 500 sq ft.or
Commercial ❑ Residential ® Limited Energy $25.00
Each Manufd Home or Modular —
Dwelling Service or Feeder $88.00 2
2a. Contractor installation only: —
(Attach copy of all current licenses) 4b.Services or reeders
Electrical Contractor
Installation,alteration,or relocation
.
200 amps or less $6000
Address -- --------- _-- 2
201 amps to 400 amps $8000 2
State _-_Zip_____ 401 amps to 600 amps $12000 2
Phone No fir)1 amps to 1000 amps $18000 2
Job No. Over 1000 amps or volts $34000 2
E!ec. Cont. Lice. No. Exp Date Reconnect only $50 00 _ 2
OR State CCB Rep No. Exp Date—--__ __ 4c.Temporary Services or Feeders
COT Business Tax or Metro No Exp Date____..-,..- Installation,alteration,or relocation
200 amps or less $50.00 2
201 amps to 400 amps $75 00
Signature Of Supr. EIBC'n—_ �_ 401 amps to 600 amps $100.00 2
Over 600 amps to 1000 volts,
License _No. ___ _ ____Exp.Date_ see"b"above.
Phone No _ _ 4d.Branch ClrcuHx
New,alteration or extension per panel
2b. For owner installations: a)The fee for branch circuits with
purchase o/service or
Print Owner's Name L" L..mtf\AIN feeder fee.
Each branch circuit $500 _ 2
Address 111 5W (-nb)The fee for branch circuits —
City-"� _ State ' Zip1:1-121D3 _ without nurchese of
PhoneNb S a(-1 -,Z;k Z)! — service or feeder fee.
First branch circuit $35.00 5!� t
l he installation is being made on property I own which is not Each additional branch circuit $5.00--
intended for sale, lease or rent 4e.Miscellaneous
_ (Service or feeder not included)
Owner's Signature A �a, Each pump or irrigation circle $40.00
'T Each sign or outline lighting $4000
3. Plan Review section (if required):
Please check appropriate item and enter fee in section 5B 0.Each additional inspection over
4 or more residential units in one structure the allowable in :.t the above
Service and feeder 225 amps or more Per inspection $35.00 _
—_—System over 600 volts nominal Per hour _ $55.00 _
Classified area or structure crn!eining special occupancy In Plant $55.00
as described in N E C Chapter 5
5. Fees:
Submit 2 sets of plans w;th application where;any of the above apply, 6a.Enter total of above fees °L,
Not required for temporary constrnr:tion s,� �rvice . 5%Surcharge(.05 X total fees) $ _
Subtotal $
NOTICE_ 6b.Enter 25%of line 6a for
Plan Review if required(Sec 3) $ _
PERMITS BECOME VOID IF WORT(OR CONSTRUCTION AUTHORIZED IS Subtotal $
NOT COMMENCED WITHIN 180 DAYS,OR IF CONSTRUCTION OR WORK
IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY ❑ Trust Account
TIME AFTER WORK IS COMMENCED Total balance Due :
I \DST\ELEC98.DOC REV 4/98
CITY
�� T���R� - MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC1999 00227
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 9
1513
PARCEL: 1 S134AC-02631
SITE ADDRESS: 11105 SW COTTONWOOD LN
SUBDIVISION: ENGLEWOOD NO.3 ZONING: 13-4.t;
BLOCK: LOT: 188 JURISDICTION: TIG
CLASS OF WORK: ALT 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:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 -50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: — AIR HANDLING UNITS _. OTHER UNITS:
FURN >=100K BTU: 1 <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Remarks: Furnace & gas piping
Owner: FEES _
KATRINA MARTh4 Type By Date Amount Receipt
11105 SW COTTONWOOD LN PRIOT BON 5/26/99 $25.00 99-315689
TIGARD, OR 97223 5PCT BON 5/26/99 $1.25 99-315689
Total $26.25
Phone:521-9225 �✓/
Contractor: / �w
(Vlir �c �� /T ;4_
BECK HEATING
2612 NE 15TH AVE
PORTLAND, OR 97219 _ REQUIRED INSPECTIONS
Gas Line Insp
Phone:288-2406 Mechanical Insp
Reg #: LIC 00059554 Final Inspection
ORIGINAL
This permit is issue-' act to the regulations contained in the Tige rd Municipal Code, State of Ore
Specialty Codes and 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 ara set forth in OAR 952-001-0010 through OAR 952-001-0080.
You may obta, - :oples of these rules or direct questions to OUNC by calling (503)2.46-9189.
Issue By: t ' lt.�' _ Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for inspections needed the next business day
Plan Chec #-
CITY OF TIGARD Mechanical Permit Applica`ion Plan ChecK# ►�,-r---
13125 SW FALL BLVD. Commercial and Residential Date Recd `By
-�� `
'TIGA RD, OR 97223 Date to P.E.
(503) 639-4171, x304 Date to DST
Print or Type Permit#SEC /77
__ Incomplete or illegible applications_will not be accepted Called
Name of DevelopmenVProject Description
Table 1A Mechanical Code Qt Price _Amt
Job Street Addr.rss^ sunetl A) Permit Fee 10.00
Address �..i�O Rt? 11 Furnace to 100,000 BTU
includingducts&vents see footnote 1,2 6.00
Bldgq city/stete Zip 7 2) Furnace 100,000 BTU+
C�Q g/ including ducts&vents see footnote 1,2 7.50 1
Name(or name of business) f 3) Floor Furnace
Owner ��.T�l �� /�/J,G 7 ; includin vent Y_ see footnote 1,2 -_ 6,00
fdamng Address --- 4) Suspended heater,wall heater
or floor mounted heater spe footnote 1,2 6.00
/0` > -•- ,j C-AVcJ 4i 5) Vent not included in appliance permit
CA/Stile .J1 Zip Phone 3.00
_ �� r2✓� (//'� C/���� �f 2C� Check all that apply: *Boiler Heat Air
Name(or name ofbusinessF For items 6-10,see or Pump Cond Qty Price Amt
footnotes 1,2 Comp •'
_�- - 6)<3HP,absorb unit to
Occupant Mailing Address 100K BTU 600
7)3-15 HP,absorb unit
City/state —Zip Phone 100k to 500k BTU _ _ _ 11.00
8) 15-30 HF;absorb
unit 5-1 mil BTU _ 15.00
Contractor Name [/ 9)30-50 HP;absorb
(SEC-)( r7`T �" 6 unit 1-1 75 mil BTU _ 22.50 _
Prior to permit Mailing Address 10)>50HP.absorb unit
issuance,a copy .2_Lp J Z /��. •�- /S -7,`�f� >1.75 mil BTU 37.50
of all licenses City/state Zip Phone 1 1)Air handling unit to 10,000 CFM
are required if �-Z i L_..1 J.� >�/ ' '�� Z VE _ __ 4.50 _
expired in COT Oregon Conet.Cont.Board Llc N Ex Date 12)Air handling unit 10,000 CFM+
database 7 qj �� - ZS 7.50
Architect Name 13)Non-portable evaporate cooler
4.50
or Mailing Address- 14)Vent fan connected to a single duct
3.00
-.__ 15)Ventilation system riot included in
Fngineer city/state zip Phone appliance permit 4 50 _
16)Hood served by mechanical exhaust 4.50
_
hescribe work to be don,n _
17)Domestic incinerators
New O Repair O Replace with like kind Yes fj- o O _ 7.50
Residential O Commercial O 18)Commercial or industrial type incinerator
3000
Additional information or description of work _ 19)Repair units
4.50 _
20)Wood stove
NOTE: For Commercial projects onl j.Units over 400 lbs require _ — 4,50
_ structural gas talcs _ 21)Clothes dryer,-tc.
Type of fuel oil natural ga LPG O electric O - 4.50
_ ( C-_( u j-(_) Ci -`4 J 22)Other units
I hereby acknowledge that I have read this application,that the information _ 4 50
given is correct,that I am the owner or authorized agent of 23)Gas piping one to four outlets
the owrer,that plans submitted are in compliance with Oregon State laws See footnote 1 200
24)More than 4-per outlet(each)
Signature fer/Agent Date .50
CIO,' n G��Ulf S �( _ Minimum Permit Fee$25.00 suBTOTAL
Contact Pe son Name Phone �-
_ 5%SURCHARGE 2 .
PLAN REVIEW 2.5%OF SUr,TOTAL
FoonoI a for commercial projects only: - T Required for ALL.commercial permits only
1. Pr.,vide full schematic of existing and proposed gas line and pressure TOTAL �+
2 Provide drawings to scale showing existing rnd proposed mechanical 2�
units T �A _ , 'State Contractor Boiler Certification required
-Residential A/C requires site plan showing placement of unit
I\mechperm dot rev 02;4199