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DEPARTMENT OF LAND USE&TRANSPORTATION
WASHINGTON LAND DEVELOPWNT SERVICES DIVISION
Aaft 15";NORTH FIRST, HILLSBORO, OR 97124
2 I INSPECTION REQUESTS: 503/640-3561/693.4415
COIJN
f PHONE 503/648-8761
OREGON Page 1 of 1
Date 09/02/93
Time 14 : 25
Permit Type Residential Electrical Permit Permit # : 05044218
Permit Status APPROVED Applied 08/27/93
Situs Address 10251 SW RIVERWOOD LN TI Issued (19/02/93
Permit Title SFR - ALL INCLUSIVE LV Completed
Permit Descr. To Expire 03/01/94
Project Title SFR - ALL INCLUSIVE LV Project # P003419U
Project Descr . * EROSION k
Parcel Number 2SiTI - Land Use District
Valuatior, 0
Legal Descr ,
owner INSPECTION - TIGARD Construction OTH
Applicant Name GARY 'S VACUFLO Classification 900
Applicant Addr. : P. O. BOX 3583 Occupancy
PORTLAND, OR 97208 Validated by PH
Applicant Phone : 775-2042 Inspector Area
CONTRACTOR : GARY ' S VACUFLO Lic , C 26-728C 775-2042
Fee description Units Fee/Unit Ext fee Data
---------------------------------------- ---------- ----------------------------
Limited Entegy/Alter./Extension 1 40 . 00 40 . 0u
Subtotal Electrical Fees : 0 40 . 00
State Surcharge of 5% 0 2 . 00
Total Electrical Fees : a 42 . 00
*** Fees Required *** * k* Fees Collected & Credits ***
Receipt No . Date Payment
09/02/93 42 , 00
TOTAL 'CHIS DATE ********* 42 . 00
Fees : 42 . 00
Adjustments : . 00 Total Credits : , 00
Total Fees : 42 . 00 Total Payments : 42 . 00
Balance Due : , 00
NO1ICE, This per,nit becomes null and void If the work or construction for which If Is Issued Is not commenced within 100 days Once conslruc.Ion has started.
the permit becomes null and void II construction Is Interrupted for a period of 180 days 1 certify that the Information prosented by the Applicant and
his ager' or agents In oupport of this permit Is true and correct to the best of our kncwrledge 1 acknowledge that the Building Department's relianre
upon farce And misleading Information may Invalidate title permit All provisions of Applicable laws and oreinances governing the construction and use
of this budding or structure will be complied with whether or not specified on the plans or noted nn the plans correction sheets. I acknowledge that
the granting of a permit does not grant authority to access privAte property or In use assements 1 further acknowledge that the use or occupancy of
the structure or building permitted depends upon my calling for Inspections at variou-i times during the process of construction and the building
Inspection staff verifying compliance with the verlmu codes. Jse or occupancy of the building or structure permitted prior to approval by the
Building Department Is solely at the risk o'the applicant and such use or occupancy Is revocable until All Inspection requirements are satisfied and
approval Is given by the Building Official. I further acknowledge that a Ilan may be placed on the title or the property upon which the permit Is issued
specifying that the use or occupancy of the building or structure Is provisional and revocable until the satisfaction of all Inspection requirements
APPLICANT'S SIGNATURE —
WASHINGTON COUNTY RESTRICTED Department of Land Use & Transportation
F►pt-Nord Inspection Section ELECTRICAL ENERGY
155 North First Avenue, #350.12
HiI'a) (oro, Oregon 97124APPLICATION
In/ormatlon: `.:t13 640-3470 Fax: 503)693-4412
PRINTPLEASO
Please complete all sections, 1 through 5. Project No__ Permit No.
Label No. Uate
-
1. Location of installation - --
Address /l)v2 l .3L,1J Irfl'L t)C ael Or Issued By__ _ __- _ Office
City_ zip Code 2 4, Type of work:
Tax Map Map No.
RESIDENTIAL Fentrlcted Energy Fes $4000
Thomas Map Book: P,.ge Section (lot all systems)
Directions v-e-r L_ i`Gc, `is 6'`.!�-LC Check type of work involved:
-- - /i dio and Stereo Systems*
Commercial [] Residential � ' Zrglar Alarm
Tenant Name elephone Systems*
(if commercial) _--- ----- --------------- - - -- -- Garage Door Opener*
This permit becomes null and void If the work authorized by the ef're Alarm
permit Is not commenced within 180 days from date of Issuance eating,Ventilation and Air Conditioning Sybtems•
of such permit or if the work authorizei Is suspended or abandoned
at any tine after work is commenced fur a perloa of 180 days. cuum Systems*
Electrical Permits are non-refundable and non-transferable. Other
2. Contractor application;
Ll
7 COMMERCIAL Fee for each system $40.00
Electrical C9ntractor C�� r :Lt,.s rose OAR 918-260-260)
Address ' Jai $3 t e.r
Date i Job N ember Check type 0 work involved:
Property Owner I'j e i..* { ,Ps► D MM,I I
Contractor's License No, -,tea:Z,2k C C. I Bauer controls
Contractor's Board Reg. No. (tz-1 U'/-7_ Clock Systems
Phone No._._. - - • 05L_d- Data mmunicaUonn InelalleUons
Fire Alarm Alarm Installation
3. Owner appllcation: HVAC
Instrumentation
Intercom and Paging System
Print Owner's Name i Phone No,
Landscape Irrigation Control*
ddb dross .. - Medical
Nurse Calls
p—- Outdoor Landscape Lighting*
This permit Is Issued under OAR 916-320-370. The applicant agrees Pr'9ctive Signaling
to make only restricted energy Instsllarlons(100 volt amps or loss) ocher
under this l.,rmlt and to do the following:
1 Only use eleetrlral licensed persons to do Installatlone where
required. (Cardin resldsntlel and other tronssctOns are exempt `! Number of Systems
horn Ncensing. Thi—o have asterisks I"). All othoro need llcens-
tng.) !No licenses are required. Licenses are required for all other installotwns.
2 Call fr.�r an Ittsnectlon when all the Installations under this permit
are reedy for Inapertion
3 Purchase soparote permira fo, rilllnstalleflons that ars not reedy 5. Fee11//9/ „
for Ins;w..tlon when the Inspoi-tor b out to Inspect under this L
pormIt Enter fees $
4 Assume responsibility for orsunttng that all cortectlons tequired
by the inspector are done •nd
5
5. Assume responalbllity lot ceiling Mrs final Inspection when all of Surcharge (.05 X total above) $
the c.nrrarNnne are co repleted
The personsrrrmIt r ia9t ho the epplkrarrf or a parson Total $
authorlred d e rt dlcatit.
Space below reserved for validation.
?uthority if other than npplicont
For inspections call
646-3561 for 693-4415
2.4-hour recorder, one worxing day In advance of need
111'92
CITY OF TiGARDI 24-Hour
BUILDING Inspection Li%e: (503) 639-4175
INSPECTION DIVISION Susiness Line: (503)639-4171 MST
BUIP
Received — Date Requested �r� �/ _ AM___ PM __- BLIP
Location .� ,� �� ar_-� Suite___ MEC
Contact Person
--- - - Ph ( -) - PLM
Contractor Ph( ) — SWR _
- - - / ---
BUILDING _ Tenar*0 er �l -�JL`'''� ' - ELC
Footing---- - 6 C'— c "
Foundation Access: ELC
Ftg Drain ELiR
Crawl Drain -
Slab Inspection Ncitev
- SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear l - - -
Framing
Insulation --""�--
Drywall Nailing - -- - -
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:_
Final
PASS PART FAIL
PLUMBING
Post& Beam
Under Slab
Rough-In
Water Serv;ce
Sanitary Sswer
Rain Drains
Catch Basin/Manhole
Storm Drain
Shower Pan I
Other:_
Final
PASS PART FAIL
MECHANICAL��
Post&Beam
Rough-in
Gas Line
Smoke Dampers
n 1 -.._.
PASS PART FAIL
E�LECTPP'AL -
Serviso —
Rough-In
UG/Slab --
Low Voltage
Fire Alarm --- _---� �.--- ---- - --
Final n Reinspection fee of$_ _._ required before next inspection. Pay at City Hall, 13125 SW Hal!Blvd.
PASS PART FAIL
SITE u Please call for reinspection RE: -- Unable to inspect-no ac:ess
Fire Supply Line
ADA Data !Hsps aor '
�'�—/<_+ d t,
Approach/Sidewalk
Other'
Firal DO NOT REMOVE this: Inspection record from the Job site.
PASS PART FAIL
A CITY OF TIGARD -_ MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT#: MEC2002.00549
13125 SW Hall Bivd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 12/5/02
PARCEL: 2S 114BC-02400
SITE ADDRESS: 10251 SW RIVERWOOD LN
SUBDIVISION: RWERVIEW ESTATES NO. 2 ZONING: R-7
BLOCK: LOT: 061 JURISDICTION: TIG
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APDL: VENT SYSTEMS:
STORILS: _BOILERS/COMPRESSORS _ HOODS:
_ FUEL TYPES 0 3 HP: 1 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: CLO PRYERS:
FURN < 100K BTU: i__AIR HANDLING UN_ITS OTHER UNITS:
FURN >=100K BTU: <= 10000 cfm
GAS OUTLETS:
> 10000 Cir!!:
Remarks: Installation of exterior AC unit. Cannot be planed in the required setbacks
Owner: FEES
KATHARINE NYHUS De:;cription Uate Amount
10251 SW RIVERWOOD LN Y12/1/02 $72.50
TIGARD, OR 97224 1 X11 t i l� I,rrmit Err
I AX I X Star.lax 12/5/02 $5.80
Total $78.30
Phone: 50;-039-3993 — —
Contractor:
SPECIALT`( HEATING & COOLING
9528 SW TIGARD ST
TIGARD, OR 97223 REQUIRED INSPECTIONS___
Phone: 020-5043 Final
Unt Insp
Final Inspection
Reg #: LIC 66578
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 adr:pted in the Oregon
Utility Notification Center. Thee reales are set forth in OAR 952-001-0010 through OAR
952-001-0100. You may obtain copies of these rules or direct questions to OUNC by calling
(503)246-6699.
;sst.ced By: , �� 'f - --- Permittee Signature:
Call (503) 639.4175 by 7:00 P.M. for inspections needed the next business day
DEC-4-2002 07:37A FROM:HILLSBORO OFFICE 5036610793 TO:5035981960 P:2/3
Mechanical Permit Application
Date received:/a' Permitno.:rn-
City of Tigard Project/appl.no.: Expire date:
City ofTigard Address: 13125 SW Hall Blvd,Tigard
Phone: (503) 639-417, (` Date issued: ey't7 Receipt no.:
Fax: (503) 593-1960 '"'G � Can efilenu.: Payment type.
'1 Building Land use approval: )I —T BlB Permit no
• a'
I &2 family dwelling or accessory U
al'Indusmal CI Multi-family 0 Tenant improvement
0 New constnrcuon Vt7dl!d!,n�/al teration/replacement ❑Other.
_,J10101 ShK900MUTION
Job address: f O<3a;/ ':alt) QIndicate 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 S
Lett: Block: _ I Subdivision: 'See checklist for important application information and
Project name: fl Y^44 S _ W jurisdiction's fee schedule for residential permit fee.
City/county: ZIP; 11 7 X.. - 7woningoitephinrequired)
t �t 1 t
Description and to anon of worst on premises: �-- Fee(ca.) Tuta1
Est.date of nipleu inspection: /off- Cf 02 escription Qty. Res.onl Res,onlTenant improv ment or change of use:is existing space heated orconditioned7,VYes UNo AAstte anrequueIs existing space insulated') 'Yes 0 No Ating VACsystemrs
Business nam �j (� �, ,* n 'f State boiler permit no.:
HP Tons--BTU/Ii
Address- c5W :/::� a-i Sr I Fir smoker ampers/ uctsmoke detectois
City: r "r '14 1 State:r,4 7-IF':47 7,:9 a-7 Heat pump site plan require ) -e__
Phone�3L.�pr,EiilFaxSq� p�/ E ma[l: nst rep ace mac urner
CCB no.: G(�S _ Including ductwork/vent liner O Yes 0 No
nstal replace/relocateheaters--suspen ed,
City/m.cru lic.no_ !� , ,- _ wall,or floor mounted
Name(please pnat): rt!14. / ZIS vent fora tante other than furnace
CON-UACY PERSON Refrigeration:
Absorption units STU/i _ —
i�a^te: Lze /Y h 17l lE: Chillers
Address: S 3- $' .S LCom ressors HP
aviron teutail e. haat ao van ation:
City: cl _ S e:p' ZL": y 11A�4-2 Appliancevent
Phone 3 (rip- Erx:59s1o?/S E-mail: )ryerexhaust
fill 0o s,Type res. tc en/ alma:
hood tie suppression system
Name: _q,�. Exhaust fan with single duct(bath farts)
Mailing address: (p $/ 5W avif taust systema awn n m ea n or At.
City: rfralqf IState: Q "LIP: 4'71 .2- :J tie piping maddistribution(up to 4 oudets)
Type: 1_110 NG Oil
Phone:
3 ?} Fax: Email: tie pipineachadditional over out ets -
tocesspiping(schematic required)
Dumber of ou
Name: :lets
Address: � �faTier appliance or equipme�—
Decorative fireplace
City: state: ZIP: tuert-type —'—�
Phone: ax: E-mail: oo rovdpcl astr,ve
Other*
Applicant's signature, Dare: u er:
Natne (print): I&t&L('I ty , r,V,VC�'' --
t vewknntu• Permit fee.....................S ..
nyid t en+L'a ord+.plea.e calf jun�dteuon for mere mtamuaon. No Lice-This pe.mit application
(visa ❑MnaterCvd Minimum fee.............. .$
,44 Lib nti _!iR �� ex?irt il'a permit is not obtained Plan review(at
Credit eye number. s - --� within 180 days after it has been
xpua
-' State surcharge(896) ....3
T an enetill Card accepted as complete.
TOTAL .......................S
Cards dei fi uta Amount 44)4617(dlCnrCtlA!1
DEC-9-7 °92 07:37A FROM:HILLSBORO OFFICE 5036810793 TO:5035981960 P:3/3
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