Permit A CITY OF T1GARD MASTER PERMIT
DEVELOPMENT SERVICES PERMIT S • MST97 -0551
�j 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE i SUED : 12/26/97
PARCEL: 2S116AD -18800
SITE ADDRESS...:16845 SW RIVERA LN
SUBDIVISION •KING CITY NO. 10 ZONING:
BLOCK 26 LOT -003 JURISDICTION: KIN
Remarks: Remodel - interior den, bath, and laundry
BUILDING
REISSUE: STORIES • 1 FLOOR AREAS BASEMENT...: 8 sf REQUIRED SETBACKS -- REQUIRED -- —
CLASS OF WORK.:ALT HEIGHT • 0 FIRST • 276 sf GARAGE • 0 sf LEFT • 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 0 SECOND...: 0 sf FRONT • 0 PARKINS SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT : 0
OCCUPANCY 6RP.:R3 BORN: 0 BATH: 1 TOTAL : 276 sf VALUE..$: 19740 REAR • 0
PLUMBING
SINKS • 1 WATER CLOSETS.: 1 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 1 DISHWASHERS...: 8 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 8 CATCH BASINS..: 8
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 8 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN ( 108( ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 1 CLOTHES DRYERS: 1
GAS FURN ) =1001( ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 1
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES....: 0 GAS OUTLETS...: 1
ELECTRICAL
— RESIDENTIAL UNIT— — SERVICE /FEEDER— —TEMP SRVC /FEEDERS — — BRANCH CIRCUITS — -- MISCELLANEOUS -- —ADD'L INSPECTIONS -
1' SF OR LESS: 0 8 - 208 alp..: 0 0 - 200 alp..: 0 W /SVC OR FOR..: 0 PUMP/IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 588SF.: 0 281 - 408 alp..: 8 201 - 400 alp..: 0 1st W/D SVC /FDR: 1 SIGN /OUT LIN LT: 8 PER HOUR • 0
LIMITED ENERGY.: 0 401 - 600 alp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 4 SIGNAL /PANEL...: 0 IN PLANT • 0
MANF HM /SVC /FDR: 0 601 - 1.''- amp.: 0 681 +amps -1' '. v: 0 MINOR LABEL -10: 0
1880+ amp /volt.: 0 PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR)=225 A.: ) 608 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:X :: BOILER • HVAC LANDSCAPE /IRRI6: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL • OTHR: ::
HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL 8 SYSTEMS: 0
Owner: Contractor: TOTAL FEES:f 512.46
SID STULLER LET GEORGE DO IT This permit is subject to the regulations contained in the
16845 SW RIVERA PD BOX 513 Tigard Municipal Code, State of Ore. Specialty Codes and all
KING CITY OR 97224 LAKE OSWEGD OR 97034 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone &: 639 -8950 Phone IN: 452 -8120 not started within 188 days of issuance, or if the work is
Reg D..: 088372 suspended for more than 188 days. ATTENTION: Oregon law
requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001 -0810 through OAR 952 -001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987. •
REQUIRED INSPECTIONS
Mechanical Insp Gas Line Insp Mechanical Final
Plumb Top Out Insulation Insp Plumb Final
Electrical Rough Gyp Board Insp Final inspection
Framing Insp Misc. Inspection
Low Voltage Ele r' Fi / ��� //
Issued B / � ✓ / _ _1 - � / Permit Signatt�r
+++++++4+++++++++++++'+++++++++++++++++++++++++++++ + +++++++++-+—÷- + .+
Call 639 -4175 by 7:00 p.m. for an inspection needed th- next business df
•
Plan e
9 Application Recd B CITY OF TIGARD Residential Building Permit A lication 3i
13125 SW HALL BLVD. New Construction Additions or Alterations Date Recd — S
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. z —
V 503 - 639 -4171 Date to DST t2 Zd 11 lee
F 503 -684 -7297 Permit # ild - • I
Print or Type Called I Zr 2 - - q 7
Ktil n I �� Incomplete or illegible applications will not be accepted
(� Name o ro}j ct Name
Job �7/ .'il & 7/J , 6 i ■ilk
Architect Mailing Ad ess
Address Site ys,� f� �f tl
��' 1 City /State Zip Phone
Name r
/ , /!1// jT � /i�
in Addresses Q Name •
Owner Mailing �� Mail A ddr ss ).d,
Ci / tate Zi Phone Engineer
i ' 9 07 "6&9 -Its- City /State Zip Phone
General Name.
Contractor ,Ze7 O / »a a Z Describe work New 0 Addition 0 Alteration 0 Repair 0
Mailing Add ss to be done:
Prior to permit ,47i 57 9 Addition pi Description o Work: �� / /
issuance, a copy City/S� a Zip 770 P h /on /ems p 1_2 ) 1� /P/' / d/` e iii 6 ' ,r. 4 cae // y
of all licenses . .o E. �i.�ie , 5 (3 2 (/
are required if Oregon Const. Co Board Exp. Date PROJECT
expired in COT Lic.# 7 / 7
VALUATION
database �f� 0 9 /9 Mechanical Name / NEW CONSTRUCTION ONLY:
Sub- f Sq t- +lease:> A Sq. Ft. Garage
Contractor Mai in Address 2'1 I•
Prior to permit Comer Lot YES NO Flag Lot YES NO
issuance, a copy City/State Zip Phone _ (check one) (check one)
of all licenses `= 7 Restricted Audio /Stereo Burglar
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarm
expir in Lic.# ba e Installation Garage Door HVAC
Plumbing Name Opener _ Systems
Sub- /.0 �/ O �� �� , (check all that Other:
Contractor Mailing Address apply)
Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit City/.$tate , ` / l _ ��C
Zip, Ph,onr�e Has the Subdivision Plat recorded? N/A YES NO
issuance, a copy - p, p9 J --
re14,)
of all licenses are Oregon Const. Cont. Board Exp. Date -
required if Lic.# Reissue of MST #: Solar Compliance
expired in COT (Calculation Attached)
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized
Name agent of the owner, and that plans submitted are in compliance
f with Oregon State laws. _
Electrical � ,� i ��G . Signa :4 .f Owner/ Date
Sub- Mailing A• • - ss / v �- _ h o �1 Z
Contractor • ►'
C• a -r on Name Phone ne #
City/St-te ,�'.■—' P one --�_r� P l � 2 ./°
-7e
Prior to permit � /ly��,j OR 0 '� ICE USE ONLY:
issuance, a copy di � �O Pat #: Map/TL #:
of all licenses are 0 'i on Cow ont. Board \ Exp. Date KA/� �a , I �$ 116Ab _ iggQ v
rd in if Lic Setl�ad � ! d Z�ne: Solar:,
ex pire fired in COT r N 1
database ctr - Lic. # Exp. a En ring Appro I: , PI i g Ap rov . TIF :
1 v M fC e.
I:SFREM.DOC (DST) 4/97
,c
..
)1ill KING CITY
15300 S.W. 116th Avenue, King City, Oregon 97224 -2693
Phone: (503) 639 -4082 • FAX (503) 639 -3771
Notice To Contractors Working In King City
Due to an intergovernmental agreement with the City of Tigard, many building related permits
for projects in King City are issued and inspected by the City of Tigard.
If your permit application DOES NOT REQUIRE PLAN REVIEW, simply complete the
appropriate application legibly and submit it to the King City staff. The King City staff will
collect all fees and fax the application to the City of Tigard. City of Tigard staff will then create
the permit, issue the permit, and perform inspections. Please indicate on the permit application
whether you would like the Tigard staff to call you when the permit is ready for issuance or
whether you prefer it to be mailed without any notification. Any incomplete or illegible
application will be returned to King City staff for correction and no processing will occur until a
complete, legible application is received.
If your permit application DOES REQUIRE PLAN REVIEW, this form must be signed by a
King City staff person. King City staff will simply sign this form indicating land use approval.
Take this signed form to the City of Tigard Development Services Counter located at 13125 SW
Hall Blvd, Tigard, to submit applications and plans. Development Services Technicians are
available at 639 -4171 Ext. 304 should you have any questions concerning submittal
requirements. All permit fees will be assessed and collected at the City of Tigard.
The City of King City hereby authorizes applicant to pursue permits at the City of Tigard
Building Department for the following project: `9-�i4 h4,, )z vvctdc-d
located at: /(0,ti3 �4,) ie , ,,,,st,
leoc,,,, 0_,..,,..
King. City Representative (
I DSTS',KCtNST.DOC
5/23/00 Activities for Case #: MST97 -00551
2:22:58 PM
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA005 Application received 12/15/97 DRA RECD BON 12/15/97
MSTA008 Permit Created 12/15/97 B DONE BON 12/15/97
MSTA010 Check for prcl. restrict. 12/15/97 B . MEMO BON 12/15/97 King City.
MSTA012. Plans routed to Plans Examiner 12/15/97 B SENT BON 12/15/97
MSTA030 Reviewed plans routed to DSTS 12/24/97 RDP APPR RDP 12/24/97
MSTA032 DST Post - Review Completed 12/24/97 B DONE BON 12/24/97
MSTA720 Mechanical Insp 12/24/97 2/12/98 RB FAIL RB . 2/13/98 concealed already w/ gypsum.
unknown if already approved.
MSTA722 Plumb Top Out 12/24/97 1/30/98 MS PASS MRS 1/30/98
MSTA725 Framing lnsp 12/24/97 1/23/98 TLP PART J'H 1/23/98 underfloor
MSTA740 Insulation Insp 12/24/97 2/10/98 RC PASS J'H 2/10/98 This is a garage that is being
. turned into habitable space.
The wall facing the existing
house will have R -21, the
garage floor will have pressured
treated 2 X 6's, with high
density 25 insulation. The attic
space is trussed, and has
probably 4 inches of existing
insulation. The contractor will
be required to placed 6" batts
• over existing. Windows shall be ,
• low E valu. ?'s see Bob P
MSTA745 Gyp Board Insp 12/24/97 2/12/98 RB • FAIL RB 2/13/98 no cards left on site to identify
• prior approvals re: mechanical
& electrical (electrical panel not
signed off).
MSTA790 Electrical Final 12/24/97 JT NOTE J *H 3/17/98 King City - we do not inspect
sent a request to DSTs to
refund monies collected for
electrical and inform the
• contractor he must go through
WACO. Jeanne T. 2/12/98
. 2/25/98 money refunded, owner
& contractor informed
MSTA795 Mechanical Final 12/24/97 3/17/98 RB NOTE J *H 3/17/98 check mechanical rough
issues... exhaust fans, return air
& heat duct above ceiling.
Approved at final.
MSTA797 Plumb Final 12/24/97 3/11/98 TN PASS J *H 3/12/98
MSTA798 Final inspection 12/24/97 3/17/98 RB PASS J *H 3/17/98
MSTA080 (F) Ready to issue 12/24/97 B MEMO BON 12/24/97 Needs current CCB
MSTA092 (F) Issue combination permit • 12/26/97 GEO PASS DST 12/26/97
Page 1 of 2
5/23/00 - Activities for Case #: MST97 -00551
2:22:58 PM
. Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MSTA715 Plm/undslab Imp 1/5/98 GS PASS GES 1/5/98 straighten and wrap closet
flange
MSTA725 Framing lnsp 2/9/98 RC PASS J*H 2/9/98
MSTA745 Gyp Board Insp 2/12/98 RB PASS RB 2/13/98 pending- mechanical rough to
be viewed at final- above
ceiling
MSTA720 Mechanical lnsp 2/12/98 RB FAIL RB 2/13/98 to be viewed at final
MSTA970 Case Fineled 3/23/98 JT 3/23/98
Page 2 of 2
1 2_ 35 160.,"L.- CA V-
3 CITY OF TIGARD BUILDING INSPECTION DIVISION
24-Hour Inspection Line: 639 -4175 Business Phone: 63 -4171
Date Requested: 3-17- - q r P.M. .M K F MST: q7-055I
/- G
Location: l t0 o Li 5 £(.0 e GL_ C BUP:
Tenant: Suite: Bldg: MEC:
Contractor: c Phone: PLM:
Owner: Si.� S
-- tk i iQJ Phone: 4 6D- D a t oO ELC:
ELR:
SIT:
BUILDING / : LDG t I n't) PLUMBING MECHANICAL ELECTRICAL SITE
Site ' os I :earn Post/Beam ' os v ; y Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line - Rough -hi UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Crawl/Found Dr Heat Pump Low Volt
pprov Approved Approved Approved Approved
Appr /Sdwlk roved Not Approved Not Approved Not Approved
IN FINAL FINAL FINAL
•
O Call for reinspection O Reinspection fee of $ required before next ' tion O Unable to inspect
Inspector: I Date: 3/') / Page of
3-10,
CITY OF TIGARD BUILIG INS ECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
Date Requested: 3 -) / 9.? A .M. P.M. MST: 7 D�J 5 I
Location: J(/ I /5 r{,{f e�.(,LJ BUP:
Tenant: / Suite: Bldg: MEC:
Contractor. / ` J • ! .0 - ,• Phone: ' , 52 — fl I 2 0 PLM:
Owner: � / , Phoe: CL ��G
,t,P e 7 ELC:
z-o , 6 - 19 - 5 D ELR:
SIT:
BUILDING BLDG (con't) LUMBING) MECHANICAL ELECTRICAL SITE
Site Post/Beam / _ Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved v Approved Approved Approved
Appr /Sdwlk Not Approved Not Approved Not Approved Not Approved
FINAL M 1 2 1321 5 6I- L FINAL FINAL FINAL
O Call for reinspection O Reinspection fee of $ required before next inspection O Unable to inspect
—
Inspector: j , /. , - Date: 3 //// ,6 Page of
O