11595 SW NORTH DAKOTA STREET-2 1S ViOMV0 HiSON MS 9696
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11595 SW NORTH DAKOTA ST
CITY OF TIGARD MASTER PERMIT
DEVELOPMENT SERVICES DATEI ISSUED: 03/31/999-0087
13125 SW Hall Blvd.,Tigard.OR 97223(503)6394171
PARCEL: 1S134CA-00105
SITE ADDRESS. . . : 11595 SW NORTH DAKOTA ST
SL1BDIVISION. . . . :BARTON ZONING: R-4. 5
BLOCK. . . . . . . . . . LOT. . . . . . . . . . . . . :002 JURISDICTION: TIO
Remarks: Family room addition
---- --------------- — BUILDING — - ----- --
REISSUE: STORIES.......: 1 FLOOR AREAS------- BASEMENT...: I if RIQUIRED %TBRQ'.S--- RF(IIItED----
CUASS OF WORK.:ADD HEIGHT........: 13 FIRST....: 421 if BARAGE.....: I if LEFT..........1 5 SND)KE DE7ECTRB: Y
TYPE OF USE...:SF FLOOR LOAD....: 40 SECOND...: A if FRONT.........s I PARKING SPACES: I
TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSNENT: I of RIGHT.........:
OCCUPANCY GRP.:R3 BDRM: I BATH: I TOTx----: 421 if VALUE..Is 35111 REAR..........: 23
PLUMBING
SINKS.........: 1 WATER CLOSETS.: I WASHING MACH..: I 1A1MDRY TRAYS.: 1 RAIN DRAIN fts I TOM........s I
LAVATORIES....s 1 DISHWAffFSS...: l FLOOR DRAINS..: I SEWER LINE fts I SF RAIN DIWINSs 1 CATCH BABINB..: 1
TUB/SHOWERS...: I GARBAGE DISP..: I WATER HEATERS.: 1 WATER LINE ft: I BDM PREVNTR: 1 GIEAI£ TRAPS..: 1
OTMER FIXTURES: I
--------- —_------- MECHANICAL
FUE1 TYPES----- FU RN ( MINK ..s I 8011./CMP 13MP: I VENT FANS.....: I CLOTHES DRYERS: 1
OAS FURN )=111K ..: 1 UNIT HEATERS..: 0 HOODS.........: 1 OTHER UNITS...: I
MAX INP.: I BTU FLOOR O RNJACES: I VENTS.........: 2 WDODSTOVEL...: I GAS OUTLETS...: I
—----------—_—__---- -- ---- ---------- ----- -- ELECTRICAL ------_—_-------
--RESIDENTIAL UNIT-- - -SERVi42/rEEDER--- --TEMP SRVC/FEEDERS— --4WM CIRCUITS-- - AISCELLA16118---- --ADD'L IffECTION9-
1111 9F OR LESS: 1 I - 211 amp..: I I - 2111 asp..: 1 N/SVC OR FDR..: 1 PUMP/IRRIGATION: I PER INSPECTIONS I
EA ADD'L 511SF.: I 211 - 411 amp..: 1 211 - 40 amp..: I 1st W/O SVC/FDR: I SIGN/OUT LIN LTs 1 PER HOUR......s
LIMITED ENERGY.: 0 411 - 611 amp..: 1 481 - 680 amp..: 1 EA ADAM. BR CIR: 1 SIM/PANEL...: I IN PLANT......s
MIIF HM/SVC/FDR: I 611 - 1111 amp.: I 611+amps-1111 vt I MINOR LABEL -11f I
1111+ amp/volt.: I ----------------------------- PU1)Mi REVIEW SECTION — ----- -----
Reconnect only.: I )-4 IES UNITS..: SVC/FDR)-M A.. ) 611 V NOMINAI.s CLS IAEA/SPC OCC:
---------------------------------------------- ELECTRICAL -- RESTRICTED ENERGY --------- --- ------—--------------—
A. SF RESIDENTIAL-------------------- B. COMMERCIAL----.—____ ---
AUDIO I STEREO.: VACUUM SYST X.: AUDIO 1 STEREO.: FIRE ALARM.....: INTERCOM/PABINBs OUTDOOR LNOSC LT:
BURGLAR ALARM..: 0TH: :: BOILER.........: HVAC...........s LAND9CAPE/IRR1G: PROTECTIVE SIX:
GAGE OPENER..: CLOCK..........: INSTRIMENTATIONs MEDICAL........: OTHR:
HVAC...........: DATA/TELE COMM.: NUMISE CALLS....: TOTAL i I'VEMSs I
Omer: ---------- ---------------•--------Contractor: ----------------------------- TOTAL FEESO 534.46
JON KVISTAD SKYLINE HOW E DESIGN This permit is subject to the regulations contained in the
11595 SW NORTH DAKOTA ST 5619 SE MILWINMKIE AVE Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 PORTLAND OR 97212 other app'icable law%. All Mork will be done in accordance
with approved plans. Thie permit will expire if Mork is
O. Phone M: Phone is 235-3811 not started within 100 days of issuance, or if the work is
OG RegC.: 117359suspended for more than 180 days. ATTENTION: Oregon law
F" ----------------------- _ M - - requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-181-1111 through OAR 952-111181. You may obtain copies of these rules or
direct questions to OUNC by calling 15131246-1987.
m ----------------------------- ----------- --- REAUIRED 100ECTIaO -------------- -M_. --
5 Errsion 644-8444 Crawl Drain/Back Electrical Rough Elertrical Final _
J Footing Insp PLM/Underfloor Framing Insp Mechanical Final
Foundation Insp Mechanical Insp Low Voltage Plumb Final
Post/Beam Struct Plumb Top Out Insulation Insp Building Final
Post/Beam Meehan Electr' erv' Rain drain Insp
C ! .
Iss,-ted By : Permittee Signatures
++++++++ ++++++++++ ++-++++ -+++4 + 1 +++++++++++++-t`+ ++•+++++++++++++++++
Call 639--4175 by 7:00.1 p. m. for an inspection needed 'khe next business day
n
CITY OF TIGARD Residential Building Permit Application Plan
Rec'd
C
1310 SW HALL BLVD. Additions or Alterations .c
Date Recd
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. _
V 503-639-4171 Date to DST
F 503-6$4-7297 Permit
Print or Type Called_j-10-fi? _;t r*f
Incomplete or illegible applications will not be accepted -,& °'41 Tie')
Name of Probed Name
Job
Address Site Address Architect Mailing Addresu
City/State Zip Phcne
Nth -
J %LM -— Name
Owner Mailing Address
City/State Zip Phone Engineor Mailing Adu�.rss
�e•• � �� City/State Zip Phone
General Name 1
Contractor t,�u�. �S a� 1 ILL_ Ciescribe work New O Addit AReration O Repair O
Mailing Address to be done:
Prior to permit Additional Description of Work:
Issuance,a copy City/State Zip Phone
of all licenses
are required If regon Const.Cont.Board Exp.Date PROJECT
expired In COT Lic.#
database i , V 4LUATION $
II ' -��"`�•--
Mechanical Name NEW CONSTRUCTION ONLY:
Sub- -M _ j p; Sq. Ft. Hou Sq. Ft.Garage
Contractor Mailing Address
Indicate the restricted energy installation by the electrical
Prio. s perTnit I eA subcontractor in the followareas
issue ice,a copy City/State Zip Phone
rf all i,censes / &SS--•311S Restricted Audio/Stereo
are required if Oregon Const.'Cont.Board Exp.Date Energy S stem Alarms _
expired in COT Lic.# Installations Vacuum Irrigation
database -1Uf.Z System System
Plumbing Name (check all that Other-
Sub-
ther
Sub- -�`dlliw l�tyntapply)
Contractor Maillnq Address Comer Lot YES NO Flag Lot YES NO
(check one) (chedc one
e• &' (� Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City/State ZIP Phone
Issuance,a copy OIL 7'P2 I- �—
of all lice:.nes are Oregon Const Cont.Board Exp.Date
if Lic#r I heap u ed a that I have read this application,that the
expired In COT 101419-Iq y g pp
database Plumbing Lic # Exp.Date inf n n is correct,that I am the owner or authorized agent
I L othat plans submitted are in compliance with
NName a Owner/Agent Dg e
Electrical (stdGtE Qrr.G�tZ�� 1
Sub- Mailing Address — Contact erson Name Phon #
m Contractor •�r_ Z, � � — i
W 040
City/State Zip Phone
J Prior to permit
issuance,a copy G 1Dl FOR OFFICE USE ONLY:
of all licenses are ^-^gon Const.Cont.Board Exp.Date
required if Lic.# Mep/TL�,C
expired in COT "3 4 c'4^�'" -•2 -
'!I IJ _4-001K
database Electrical Lic.# Exp.Date t a Zone: Solar:
-z,- q _ k--4-s- �)
Electrical Supervisor Lic.# Exp.Date Approval: Plan in Approval: TIF:
-- �- /y� \
l r it� �/�o .d8 I:bat.NOm»badd.lt.doc,,,20�
K Y L I N E
JOB : 1008
LOT: 2
DATE: 03-05-1999
HOWICS & DUION PROPERTY: KVISTAD
Gm mliv SAIV. CITY: TIGARD
PsWcmd� Wrm
SCALE: 1"=20'-0"
PLAN No.: #1008
16.60,
--------------------------------------------------------------
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MAP: 655 G-3
mom' ;i�' ::6 ,: TAX LOT. 105 LOT 2
BARTON 5U5PIVISION
115 5 SW NORTH DAKOTA
LOT 2
1,359 80. FT.
CITY OF T I G A R DELECTRICAL PERMIT
PERMIT#: ELC1999-00329
DEVELOPMENT SERVICES DATE ISSUED: 6/2/99
13125 SW Hall Blvc1..Tinard.OR 97223 (5031639-4171 PARCEL: 1S134CA-00105
SITE ADDRESS: 11595 SW NORTH DAKOTA ST
SUBDIVISION: BARTON ZONING: R-4.5
BLOCK: LOT : 002 JURISDICTION: TIG
Prolect Description: Install a 200 AMP service/feeder and 20 branch circuits to an existing dwelling unit.
RESIDENTIAL UNIT _ TEMP SRVC/FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP/IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN/OU7 LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/SVC/FDR: 601+amps- 1000 volts: MINOR LABEL (10):
SERVICE/FEEDER BRANCH CIRCUITS
_ _ ADD'L INSPECTIONS
0 - 200 amp: 1 WISERVICE OR FEEDER: 20 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+amp/volt: >=4 RES UNITS: >600 VOLT NOMINAL:
Reconnect only: SVCIFDR>=225 AMPS: CLASS AREA/SPEC OCC.,
Owner: Contractor:
JON KVISTAD BEAR ELECTRIC
11595 SW NORTH DAKOTA ST PO BOX 389
TIGARD, OR 97223 28085 BUTTEVILLE RD NE
DONALD, OR 97020
Phone: Phone: 678-1355
Ree#: LIC 000209
SUP 3162S
ELE 24-107C
FEES _ Required Inspections
Type By Date Amount Receipt Rough-in
PRMT GEO 6/2/99 $160.00 99-315838 I Elect'I Service
Elec','t Final
5PC"f GCO 6/2/99 $8.00 99-315838 ORIGINAL
Total W8.00
This Permit is issued subject to the regulations contained in the Tigard Municipal Code,State of OR. Specialty Codos 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 Nwork is
a. suspended for more than 180 days. ATTENTION: Oregon taw requires you to follow rules adopted by the Oregon Utility Notification Center. Those
R rules are set forth in OAR 952-001-0010 through OAP,952-001-0080. You may obtain copies of these rules or direct questions to OUNC at(503)
t•- 246-1987.
N
Permit Signature: Issued By:
J —
m
OWNER INSTALLATION ONLY
.i The installation is being made on property I own which is not Intended for sale, lease,or rent.
OWNER'S SIGNATURE: _ DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: _ DATE%
LICENSE NO:
Call 6394175 by 7:00pm for an inspection the next business day
RE& l unity Development ELECTRICAL PERMIT APPLICATION
13125 SW Hall Blvd. � Q d03z9
JUN ( 1 l9i0ard, OR 97223 Permit #
p Date Issued
UNITY DINFLO n( (503) 639-4171
(503) 684-7297
CITY OF TIIGARD TDD No. (503) 684-2772
Inspection (503) 6394175
1. Job Address: 4. Complete Fee Schedule Below:
Name of Development -�0A.) A1)/9��D V Number of InspocOwn per permit allowed
Address__1/5 95 5LAJ _NOAVV� Service included Items Cost(es) Sum
City/State/Zip T7CGAAA,_�L� _ � 4a. Residential -per unit
1 1000 sq. ft or legs —_ $11000 ,
Name (or name of business)___ Esch additlonel 500 sq.It.or
portion thereof $2500 Energy $2500 1
14NEachMa
Commercial ❑ Residential _--
Each nurd Horne or Modular
Dwelling Service or Feeder $66.00 — 2
2a. Contractor installation only:
ib. Services or Feeders
installation,alteration,or relocation
Electrical Contractor &A& ELE Gtr G. ZNG 200.:rips or less / sw 00 6,0,oa 2
Address P, v, f o X 3 EI _ 201.n,ps to 400"a 111180 2
401 amps to eimps $120.00
City_VQAZ.+/[.p State OR Zip o2p 601 amps to loon amps $180.00 2
Phone No. is 7 S' /3SS —_ Over 1000 snips or Vons $3111.00 2
reconnect only $50.00 2
Job NO. N 123-1 — ----
contractor's license NO., ,Zy-/071 4c.Temporary Services or Feeders
Contractor's Board Reg. NO. p 10 9/f Instanetlon,eneratlon,or relocation
Signature of Supr. Elec'nX 200 amps a less 2
m S Phone No. G78-/�S.S 201 snips to amps $55.00 2
License No 316 - 401 snips to sa05 amps $7500
over eoo amps to IOno Vohs $100.00
2b. For owner installations: see"b"ab01e
4d. Branch Circuits
Print Owner's Name Now,alteration or extension ps,pane
Address _ a)The fee for branch circults with 2
purcheso of service or feeder M.
City__ State Zip Each branch ckcult 10_ $5.00
Phone No. b)The fee for branch circuit$wf hotrt
The installation is being made on property I own which is purchave of service or der . 2
feeder
not intended for sale, lease Or rent. Each
Manch circuit $3500
Each addNlonel branch circuit _ $5.00
Owner's Signature 4e. Miscellaneous
(Service or feeder not Included) 2
3. Plan Review section (if required): Each pump or Irrigation ehcle $40.00 2
Each sign or out'ne Ilghtbng _ $4000
Signal clrcult(s)or a Ihnited energy 2
IL Please check appropriate Item and enter fee In section 68. penal,alteration or extension _•_ $4000
4 or more residential units in one structure Minor L+hels(10) 3107.00
IL
N Service and feeder 225 amos or more 4f. Esch additional Inspection over
System over 600 volts nominal
—_Classified area or structure containing special occupancy the allowable In arty o}the above
Per Inspection SWOO
as described in N E.0 Chapter 5
Per hour $55.00
In Plant
Submit 2 sets of plans with application where any of the above
W apply. Not required for temporary construction services. 5. Fees:
J 6a. Enter total of above fees /Ga.oO
NOTICE 5%Surcharge (.05 X total fees) s — •po
PERMITS BECOME VOID IF WORK OR CONSTRUCTION Subtotal $ em?
AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR IF Plan6b. Enter Review
w if e A for
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR Sub Review H required (Sec 3) $
A PERIOD OF 180 DAYS AT ANY TIME AFTER WORK IS Srru��btohrl
COMMENCED. Trust Accourri A X
$ —
Mm�Pp
Balance Due : /(�
CITY OF TIGARD BUILDING INSPECTION DIVISION MST
24-Hour Inspection Line: 639-4175 Business Line: 639.4171
BUP
Date Requested �� 2"�AM PM BLD
Location 11 S ! n - OaX� Su//it--e MEC
Contact Person 6C Ph PLM
Contractor Ph SWR .
BUILDING Tenant/Owner ELC _`�
Retaining Wall ELR _
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Motes:
Slab SIT
Post&Beam
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation —
Drywall Nailing —�
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post&Beam
Under Slab
Top Out
Water Service
Sanitary Sewer -�
Rain Drains
Final
PASS PART FAIL _
MECHANICAL
Post&Beam —
Rough In
Gas Line — — —
Smoke Dampers
Final
PASS PART FAIL
29=22&: '*' A
a Service _
Ix Rough In _
N UG/Slab _
Low Voltage — — —
Fire Alarm
PASS-1- ART FAIL
W MIT
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 [ )Please call for reinspection RE- _ [ I Unable to inspect-no access
ADA / —L
Approach/Sidewalk Date ` _` OF Inspector —Ext
Other
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job alto. .
CITY OF TIGARD BUILDING INSPECTION DIVISION MST 9?-
24-Hour Inspection Line: 639-4176 Business Line: 639-4171 --
p BUP
_Date Re uested� — 1 '' ( AM PM BLD
LocationSuite MEC `t
Contact Person Ph PLM
Contractor _ Ph SWR
Yenant/Owner ELC
e a ning Wall ELR
Footing Access:
Foundation FPS
Ftg Drain !J1d �� BGM
Crawl Drain Inspection Nates: --
Slab � SIT
Post 8 Beam --�-
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
4AS" PART FAIL —JWUMBING
Post& Beam --
Under Slab
Top Out -- —'
Water Service
Sanitary Sewer —
Rain Drains _
Final � —!
PASS PART FAIL
Post&Beam — - —
Rough In
Gas Line — -- — — --
Smoke Dampers
S PART FAIL
ILWIRICAL -
Service
Rough In
UG/Slab
Low Voltage
Fire Alarm
Fi.,al
PASS PART FAIL y +
SITE
Backfill/Grading
Sanitary Sewer
Storm Drain [ J Reinspec -)n fee of$ _ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ J Please call fcr reinspection RE: ( J Unable to inspect-no access
ADA
Approach/Sidewalk
Other Date 7/�� LI Inspector
Final
PASS PART FAIL DO NOT REMOVE this Inspection record from the job site.