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Permit { A MASTER PERMIT CITY T I G A R D PERMIT #: MST2005 -00055 �I�� DEVELOPMENT SERVICES DATE ISSUED: 2/23/2005 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 09890 SW RIVERWOOD LN PARCEL: 2S114BD -01100 SUBDIVISION: PICKS LANDING NO.2 ZONING: R -4.5 BLOCK: LOT: 072 JURISDICTION: TIG REMARKS: Interior remodel. BUILDING REISSUE: CUSTOM STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: THRO: sf RIGHT: VALUE: 1, 500.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FOR: PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W /OSVC/FDR: co SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: I co SIGNAL /PANEL: IN PLANT: MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL: 1000+ amp /volt : PLAN REVIEW SECTION Reconnect only: > =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR: HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 145.28 FENSTERMAKER, ROBERT K /LI NDA A OWNER This permit is subject to the regulations contained in the SW RIVERWOOD LANE Tigard Municipal Code, State of OR. Specialty Codes 9890 9890 SW OR 97223 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 the work is suspended for more than 180 days. Phone: Phone: 503 475 - 3180 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through Reg #: 952- 001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503) 246 -6699. REQUIRED ITEMS AND REPORTS /n Issued By : y (_ Permittee Signature : c-41-- Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day " Perm • 0 " , 's° ' •k . t t:, ,.., FOR OFFICE USE ONLY • City of Tigard Date /B y i�3 d 36.--F__. Permit No. : pQ05 - 5 --- 13 125 SW Hall Blvd., Tigard, OR 972i[ 23 2005 Plan Review Phone: 503.639.4171 Fax: 503.598.1t90 4^+ Other Permit: �: � <-, Inspection Line: 503.639.4175 � ! , I C I I Date/By: y: T/ � Date Ready /By: lur,s. 8J See Attached Checklist for . Internet: www.ci.tigard.or.us CITY OF - yam .. Notified /Method: - 7 )( r Supplemental Information • BUILD �T JIV SI N TYP OF WORK REQUIRED DATA: I- AND,2- FAMILY DWELLING ❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all • 1' Addition /alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the CATEGORY OF CONSTRUCTION work indicated on this application. IN I - and 2- family dwelling Ill Commercial /industrial Valuation: $ ©(fi ❑ Accessory building ❑ Multi- family Number of bedrooms: r] Master builder ❑ Other: Number of bathrooms: " JOB SITE INFORMATION AND LOCATION Total number of floors: Job site address: cl 8 ' i 0 5 (A) atv e•.r0 L., y ,i New dwelling area: square feet City /State /ZIP: • 1 elko-0 tom -o- or 7 2214 Garage /carport area: square feet Suite/bldg. /apt. no.: Project name: E rj � D v,' INft ( Covered porch area: square feet r I ' Cross street/directions to job site: 6- .9 Deck area: square feet 0 ..& - ' re I 6 �� — c ..)pc.t .rt,,} --u T( I 0 Other structure area: square feet - i C Tb f2.- WY.YLL.IQ L-- imr- { 6 i As -) ,t"( LiF7 ° REQUIRED DATAi :COMMERCIAL -USE CHECKLIST . Subdivision: pi C. 14 L :ek 4G- Lot no.: Permit fees* are based on the value of the work performed. Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all equipment, materials, labor, overhead, and the profit for the .„ " DESCRIPTION- OF- WORK, work indicated on this application. Valuation: $ 0 i vi (v4� W`"� .,., Existing building area: square feet ll�� New building area: square feet 1X PROPERTY- OWNER' ' -' ❑;T ' " :': Number of stories: Name: ( FtiAl, c V•k 14 3't Type of construction: Address: CiSf e/ o Suj- -- .ke/LCOGG Occupancy groups: City/State /ZIP: T OYL q'7 2, Existing: Phone: (56y 7Q Li 0 3 5 . Fax: ( ) New: . APPLICA'N'T .•a .• / = , IN CONTACT` PERSON .; `` , NOTICE • Business name: All contractors and subcontractors are required to be Contact name: S j -v-`. :A 0 co -v4 licensed with the Oregon Construction Contractors Board J under ORS 701 and may be required to be licensed in the Address: jurisdiction in which work is being performed. If the City/State /ZIP: applicant is exempt from licensing, the following reasons apply: Phone: ( ) Fax::( ) E -mail: CONTRACTOR Business name: BUILDING PERMIT FEES* Address: Please refer to fee schedule. City /State /ZIP: Fees due upon application Phone: ( ) Fax: ( ) i CCB lic.: Amount received j /�{J Date received: ) L/ Authorized signature: i This permit application expires if a permit is not obtained "`��'"'''" ��1 within 180 days after it has been accepted as complete. Print name: - ez F 5 xj„ r Date: 2 f 2_,-2../ 0 5 * Fee methodology set by Tri- County Building Industry Service Board. i:\ Building \Permits \BUP- PermitApp.doc 12/03 440- 4613T( I I /02/COM/WEB) • • Electrical Permit Applic . ? - ' ,FOR OFFICE USE ONLY -- 4 Aq a -acs ' City of Tigard Received Permit S Tga 5 ag 5 Date 13125 SW Hall Blvd., Ti g Plan Rev ard, OR 97223 Plan Re : iew Other Permit: Phone: 503.639.4171 Fax: 503.598.1960 FEB q � ��stl + Date/B Inspection Line: 503.639.4175 C® (� ' !I Date Ready/By: Juris: 0 See Page 2 for . Internet: www.ci.tigard.or.us �y {p� 4 yt�� Notified/Method: Supplemental Information - a� - ;r -� .• �: ,:T, €; - �;� :tom; 'ia�;,;,�;± >�;;�.w S; " >`: `�yY 1 „: + 1 "?�. .�cx` ; § a: .s . .. ..�. � � ¢;z - YuP�E; �R „ ,.F � =' t I;�E.z.� ,3 � :z -, r�P7„' , ,. I•� ._ ... ;1...: "v- .d�� ei. .....��iYl :.n M`F .'zw rv fiS:l� ; ���3+� - 1 � °' r`,� �t;•'nw5- fit..- 'Lt'� < •v�,.P _... °'c ..: - r� - ._•.s�.�u�.. , • ❑ New construction lg. Addi'��, 7/�1 o ireplacement Please check all that apply: El Demolition ❑Other: ❑ Service over 225 amps, comm'l ❑ Hazardous location y£ : „ ,.. _. ¢ _ r y „ $:h _ e ,, ❑ over 320 amps - rating ❑ Buildng over 10,000 sq. ft., . s ; -EGO. ' .. -_-,;,.:., _,:, =. l ,.. - •; W_ 1'k R ' °®' OI R GTIQa �. ,,. of 1- and 2-family dwellings 4 or more new residential cam;" � -, z- �•;� - �:��.:�.�, T � �?�� �-�, , .,.- , ..::z�� °:.', - =: =. y g u.- .>�ics,. -..��� ::.�= ;�.+,'P; -�,�s �;a� :t�s5..xrz:: � v, _, n °s.;,_ ''� "s�a�%�x:3:u; 2 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ Multi - family ❑ Mastr budder El Other: ❑Building over three stories ❑Feeders, 400 amps or more u „.. ; M r , {y e ,, , r ; „ , y $<<, ,, m; ❑Occupant load over 99 persons Manufactured structures or },r r _ ifl :, OB -� 62c 0 1 T _, ,2 : 1- 4 3 1rail : _rr ❑E /lighting plan RV park Job no.: Job site address: G� r,�j ❑Health -care facility ❑Other: 1 3 G p l W Submit 2 sets of plans with any of the above. City/State /ZIP: ri, 6.k/L9 OAP The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: C `a p( 4 / I^1 G f10 l P Description Qty. Fee. Total Cross street/directions to job site: tits i, ClRW19 New residential single- or multi - family dwelling unit. {� Includes attached garage. v r>/Z -N�h "fro / ©T ' - (j 3 1m Iv11lo/ttr LFT 1,000 sq. ft. or less 145.15 4 Subdivision: OW flaTtvl.N,-P©tt9. Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 a ;' : _t«,= „.� wzu' mow,.:» :_ : {,__: ,x - -. Limited energy, non - residential 75.00 2 ' i ?y ,;%ti ) ° c ', UESC PT q S R O O,2K r � , ,, Each manufactured or modular (314 dwelling, service and /or feeder 90.90 2 Z Kb es L_ U.l' 01 ce C '$ f2 Services or feeders installation, alteration, and /or relocation PI ( A (.46 12.®© ,,-A-- 200 amps or less 80.30 2 1;1;; = , , .„..,„ , .;. ,E_,r.Ai w -` a ` kr ss `:mw =. - .; :r a s 201 amps to 400 amps 106.85 2 ;,.s.`" (f b E ""r 4 r�� - v,. ..;' `' .. " f.'''''"' -.' ... 3 .. .... , _ ,''. '' ':�,a 1' °x`14 ! ,v'' a T '''W'',- 401 amps to 600 amps 160.60 2 Name: 1--ce Z,fl-rt-S A(n 1`2 601 amps to 1,000 amps 240.60 2 Address: CI ri p So 12-t-V- woo -4, Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: rt 0 9 7 2:2-4 Temporary services or feeders installation, alteration, and /or relocation Phone:,(rj 63) E 78 tI p 35 2 Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, e , or exchan ac rding to ORS 447, 449, 670, d 70 . 401 amps to 600 amps 133.75 2 Owner signature: , Date: 2 Z - 3 CLY Branch circuits - new, alteration, or extension, per panel E ,r / S � '`` � t , � ' r tr -. ';< A. Fee for branch circuits with tl , 14 '" k 1g01 5 ,. �� i y � i..vm .. OJ 2� � $ir L fr 3,u�tn Xvf a"• k € � 4 as`+d� "a4 #� .�F F � 'e ':i XsL%1Y'+ service or feeder fee, each 6.65 2 Business name: 5 y`^._ branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, • 46.85 2 Address: each branch circuit Each add'1 branch circuit 1 1 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2 Sign or outline lighting 53.40 2 E - mail: Signal circuit(s) or limited- • a t 5 ,`° , zm ,xx. energy ��' � ���`l�is _ �"�;, y �'Qi R�= TOO�2�I ,;.��, --� �i ��. .�.�,�':� °� k H�`.:� has `� P anel, alteration, or :.fir ,mss :�s. iM < ,_ �._ -_'t extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr min) 62.50 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 t ritik ;t C T � C A L VIII )uat7:' ".,... " P , ; CCB Lie.: Electrical Lic.: Suprv. Lie.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per permit allowed. i :\Building\Pemuts\ELC- PermitApp doc 12/03 440- 4615T(10 /02 /COM/WEB Electrical Permit Application - City of Tigard t • Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* n Burglar Alarm n Garage Door Opener* Fl Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* n Other: Fee for each commercial system $75.00 (SEE OAR 918- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is\ Budding \Permits\ELC- PermitApp.doc 04/03 CITY OF TIGARD , i BUILDING DIVISION -' '" PERMIT #: MST2005 -00055 13125 SW Hall Blvd., Tigard, OR 97223 A � DATE ISSUED: 2/23/2005 Phone: (503) 639 -4171 i /�� Inspection Requests (24 Hrs.): (503) 639 -4175 ... INSPECTION WORKSHEET FOR DATE: 4/15/. 15 TIME: 7:08AM PAGE: 28 SITE ADDRESS: 09890 SW RIVERWOOD LN CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 072 TYPE OF USE: PROJECT NAME: FENSTERMAKER DESCRIPTION: Interior remodel. OWNER: FENSTERMAKER, ROBERT K/LINDA A, PHONE #: CONTRACTOR: OWNER PHONE #: 503- 475 -3180 rjuk ci-4 , 22c t Inspection Request Scheduled For: Date: 4/15/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 299 Final inspection 004650.01 503-784 -0352 V Corrections /Comments /Instructions: L1 M rc agim .____ . • Allni Ii 1 i 411.. r ■■■•••---- I -ASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL % ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED c Inspector: Date: Phone #: 503 718 - p /I ( ) T - 924 - i- a^..l&A - Z Gu-/Z. -R 1 Vz / CITY OF TIGARD BUILDING DIVISION PERMIT #: MST2005-00055 1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/23/2005 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 __II.. INSPECTION WORKSHEET FOR DATE: 3/31/2005 TIME: 7 :05AM PAGE: 16 SITE ADDRESS: 09890 SW RIVERWOOD LN CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.2 LOT #: 072 TYPE OF USE: PROJECT NAME: FENSTERMAKER DESCRIPTION: Interior remodel. OWNER: FENSTERMAKER, ROBERT K/LINDA A, PHONE #: CONTRACTOR: OWNER PHONE #: 503- 475 -3180 Inspection Request Scheduled For: Date: 3/31/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message ' / 120 Electrical rough-in 003378 -01 503. 784 -0352 N �/ l q q gL rf i /Aeh f4 OU 3 4/0q- 0 ( l� Corrections /Comments /Instructions: i l/ri PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N ' ' Date: > r- l ® � Phone #: (503) 718- ■