11060 SW COTTONWOOD LANE r
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11060 Cottonwood Lane
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CITY OF TIGARD BUILDING INSPECTION DIV
24-Hour Inspection Line: 639-4176 Business Lin : 639-417D MST —
BUP _
-_—_ _ F)ate Request e `�-- AM PM _ _
B. �
Location % /()("o 5V Co, �+^ -� Suite
MEC
Contact Person PI, 77> s1r/ PLM
Contractor_ — --_—_ — Ph SWR _ —
BUILDING -" Tenant/Owner _ _ ELC
Retairnng Wall ELR —
Footing Access: - - -
Foundation FPS
Fig Drain - - --
Crawl Drain inspection Notes: SGN
Slab - SIT
Post 8 Ream \ � - _
Ext Sheath/Shear
Int Sheath/Shear -----
Framing
Insulation ---- ---- - -- ---- __—___
Drywall Nailing _ � Si✓r v/zC /y�a� v,., � o n /�Q c� 10 01 e�r„
Firewall ----� — --
Fire Sprinkler V• b r ar T•'a n Gs„c/ _ 9{ r/T e .
Fire Alarm
Susp'd Ceiling _ _ le-G v 9q
Roof -
Mise --_—
PASS PART FAIL
PLUMBING
Post 8 Beam — -- —_ �---C— _.
Under Slab
1 op Out --- ----- - --- --
Water Service
Sanitary Sewer -
Rain Drains
Final - -- ---
,�
PASS PART FAIL
<TVUIJANICht —
Post& Beam .-_--
Rough In --
Gas Line -- -------— ___
Smoke Dampers
AS PART FAIL
ELECTRICAL —
Service _
Rough In -
UG/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 Mall Blvd
Catch Basin
Fire Supply Line [ ]Plea3e call for reinspection RE: - - ,- ( ]Unable to inspect- no accass
ADA
Approach/Sidewalk Date J
other _ _T-1 y"� Inspector . Ext :J ,(, Z_
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
CITYOF TIGARD MECHANICAL PERMIT
PERMIT MEC2001-00265
DEVELOPMENT SERVICES
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/23/01
SITE ADDRESS: 11060 "W COTTONWOOD LN PARCEL: 1 S134AC-02648
SUBDIVISION- ENGLEWOOD N0.3 ZONING: R-4.5
BLOCK: LOT: 214 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN:Y EVAP COOLERS:
TYPE OF JSE: S�= UNII HEATERS: VENT FANS:
OCCUPANCY 43RP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS/rOMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN >=100K BTU: <= 10000 cfm: — OTHER UNITS:
> 10000 cfm: GAS OUTLETS
Remarks: Replace electric furnace and add heat pump.
Owner: FEES
BONACKER, GERALD N JEAN E Type By Date Amount Receipt
11060 SW COTTONWOOD LV PRMT CTR 7/23/01 $72.50 2720010000
TIGARD, OR 972235PCT CTR 7/23/01 $5.80 272001000C
Phone: ___
Total $78.30
Contractor:
FOUR SEASONS HEATING & AJC
PO BOX 66409
PORTLAND, OR 972156 REQUIRED INSPECTIONS
Heating Unt Insp
Phone: 503-775-5919 Cooling Unt Insp
Reg #. LIC 48283 Final Inspection
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center Those rules are set_fQrth in OAR
952-001-0010 through OAR 952.-001-0080. You may obtain copies of these rules ordi rect stions to NC by
calling (503)246-91.89
Issue By: )\ I Lit L fi ;� id Permittee Signature:
Call (503) 639-4175 by 7:00 P.M. for Inspections needed the next business day
Mechanical Permit Application
Datereceived: 1�1 Permit no.:/yf(',Y+^/
City of Tigard Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard,OR�3 Date issued: By- Receiptno.:
Phone: (503) 639-4171 -
Fax: (503) 598-1960 �i Case file no.: Payment type:
Land use approval: Building permit no.:
I &2 family dwelling or accessory U Commercial/industrirl U Multi-family U•tenant improvement
U New construction Add it ion/al cration/replacement U Other:_
Job address: Q Q / �. , � Indicate equipment quantities in boxes below.Indicate the dollar
Bldg.no.: Suite no.: value of all mechanical materials,equipment,labor,overhead,
Tax map/tax lot/account no.: profit.Value$
Lot: Block: Subdivision: *See checklist for important application information attd
Project name: 60&1 r;, y o,, jurisdietfonIs fee schedule for residential permit fee.
City/county: —Tile.ell— zip: 971 Z MITt
Description and location of wor on premises: t t
l 4 I'cc(ea.) Total
Est.date of completion/inspection: DeKdpdon Oty. Re%.oniv Res.onI)
Tenant improvement or change of use: Air handling unit CFM(jam ' I iU c C' _
Is existing space heated or conditioned'?U Yes U No it conditioning(site plan require ) _
Is existing space insulated'?1.1 Yes U No Alteration of existing C system _
Boiler compressors
k]iK§lL'k'IURIM 1101 X11111 Ell'Is
State boiler permit no.:
Business name: /�ia — HP __—Tons BTU/II
Address: Q C Fire/smoke dampec iter smo a electors _
City: o, Sta ZIP; eat pump(sue plan required)
Phone; - -/ Fax: ,S-5• I E-mail: nsta /rep ace urnac unser /
Including ductwork/vent liner U Yes U No
CCB no.: yQ Z V 3 Instal rep ac re ovate heaters-suspended,
City/metro lie.no.: �pp�/ _ wall,or floor mounted
Name(please rint): C Vent for appliance other than furnace
Film W—461@1 e gerat on:
Absorption units _ IiTU/H
Name: �„*, Chillers----- HI, -
Com ressors __ HI'
Address:
AI roineeota ex ust allvent at nn:
City: State: ZIP: Appliancevent
Phone: Sv3 '7S* 5-9/ Fax: E-mail: ryerezfaust _
21 c s,Type res. itc en hal.mat
hood fire suppression rystcm _ --
Name: —j a f ,, Q ):cr 44 0✓r a O Ex
haust fan with single duct(bath tans) — —
Mailing address: L Ex laust 5 stem a art rom icating or AC
CitY State: ZIP: _ ue p►p ng adistribution(up to Mitts)
_ 7ype: LPC Na Oil
Phone: -c ) J �" I a� E-mail: ue tin each additional over 4 outletsrocestpiping(schematic require 1
Number of outlets
Name: ter listed appliance or equipment: —
Address: _— Dccorativcfireplace
City: State: ZIP: *Insertp-e—, iiPhone: a mail: iG lltet sicive
Applicant's signature: Date: 79� a/Name (print): - �—
Nor all jurisdictions accelN credit cords,please call jurisdiction for mare intantari at Permit fee.....................$
❑Viso U Masten and Notice:This permit applicatir.,n Minimum fee................$
expires if a permit is not obtained pian review(at _ %) $
Credit card number __ ----__--- i tl within IRO days afle•it h.a been
State surcharge(8%)....$
--------- -- accepted as c om lete.
Name or cardholder u shown on credit card S P p TOTAL . $
—� Cardholder signature — Amowtt 4101617(MUICOMI
MECHANICAL PERMIT FEES
COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE:
TOTAL VALUATION: FEE: Description: Price -I otal
$1.00 to$5,000.00 _ Minimum fee$72.50 Table 1A Mechanical Code Qty (Ea) Amt
$5,001.00 to$10,000.00 $72.50 for the first$5,000.00 and 1) Furnace to 100,000 BTU
$1.52 for each additional$100 00 or including ducts&vents `- 14.00 -_
fraction thereof,to and including 2) Furnace 100,000 BTU+
__ _
$10000.00 including ducts&vents 17.40
$10,051.00 t_o$25,000.00 $148.50 for the first$10,000.00 and 3) Floor Furnace
$1.54 for each additional$100.00 or including vent - 1400
fraction thereof,to and Inrluding 4) Suspended heater,wall heater
$25,000.00. _ or floor mounted heater 14 00
$25,001.00 to$50,000.00 $379.50 for the first$25,000 00 and 5) Vent not included in appliance permit
$1.45 for each additional$100.00 or - -- 6.80
fraction thereof,to and including 6) Repair units
_ $50,000.00 _ 12.15
$6-600 .00 and tip $742.00 for the first$50,000.00 and Check all that apply: Boiler Heat Air
$1.20 for each additional$100.00 or For Items 7-11,see or Pump Cond
fraction thereof. _ footnotes_below. _ Comte" '•
7)<3HP;absorb unit
ASSUMED VALUATIONS PER APPLIANCE: to 100le BTU _- 14 00
-___ - -- - 8)3-15 HP;absorb
Value Total unit 100k to 500k BTU 25.60
Description: _ _ Qty Eat mount g)15-30 HP;absorb
Furnace to 100,000 BTU,including 955 unit.5-1 mil BTU_ _ _ _ 3500
ducts&vents 10)30-50 HP;absorb
Furnace>100,000 BTU including 1,170 unit 1-1.75 mil BTU_ 52.20
ducts&vents 11)>50HP:absorb
Floor furnace IncJudinq vent -T 955 - nnit>1.75 mil BTU 87.20
Suspended heater,wall heater or 955 ---
12)Air handling unit to 10,000 CFM
floor mounted heater 100o /Er
Vent not included in applieanee 445 13)Air handling unit 10,000 CFM+
permit _- _ 17.20
Repair units _ _805 -
14)Non-prntahle evaporate cooler
<3 hp;absorb.unit, 955 10.00
to 100k BTU 15)Vent fan connected to a single duct
3-15 hp;absorb.unit,- --- - 1,700 _ 6.80
101k to 500k BTU - -- -
15-30 hp;absorb.unit,501k to 1 2,310 161 Ventilation system not included in
mil.BTU _ appliance permit 1000
30-50 hp;absorb.unit, 3,400 17)Hood served by mechanical exhaust
10.00
1-1.'15 mil.BTU
>50 hp;absorb.unit, 5,725 18)Domestic incinerators
17.40
>1.75 mil.BTU - 19)Commercial or industrial type incinerator
00
Air handling unit to 10,6cfm ' 656 _ _ 69.95
Air handling unit>10,000 cfm _ 1,170 - -
Non- ortable_eva orate comer _ 656 20)Other units,including wood stoves
I0 00
Vent fan connected to a singe duct _ _446 - - -
Vent system not Included In 656 21)Gas piping one to four outlets 540
appliance ermit- - _ - -- - - ---
Hood served by mechanical exhaust - _ 656 - 22)More than 4-per outlet(each) 1.00 _
Domestic incinerator _ _ 1,170 Minimum Permit Fee$72.50 SUBTOTAL:
Commercial or industrial incinerator 4,590 $)Z i C'
Other unit,Including wood stoves, 656 8%State Surcharge S -
inserts,etc__ _ $O
Gas PIPin�l4outlets _ _ 36_0
Each additional outlet 63 25;4 Plan Rrview Fee(of subtotal;
Required for AU_commercial permits only
f d_T_A in COMMERCIAL TOTAL RESIDENTIAL PERMIT FEE: $
VALUATION: J 7
Other Inspections and less:
1 Inspections outside of normal business hours(minimum charge-hyo hours)
$72 90 per hour
2 Inspections for which no fee is specifically Indicated (minimum charge-halt tour)
$72 50 per hour
3 Additional plan review required by changes,additions or revisions to plans(minimurn
charge-one-half hour)$72 50 per hour
"State Contractor Boiler Certlilcation required for units>200k STt1.
"Residential A/C requires site plan showing placement of unit.
i'\dsts\forms\mech-fees.doc 10/11/00
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