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10318 SW RIVERWOOD LANE S j MCf4 "WW LEVE - toyI& sW 4Z1V oop ---- ----- -- --._ __ -- --. - -__ ..._--_ - _ _ -- �� • S'�� - SSS . 5 i L T FE Nc� Psi Lot e ,z e • g zq A LOT 162 % r- t ST c Lor A ReA - gZYs" } T [f� .. C�_ 'moi 1 1/��T�0� X _ Er i f i l. AMA - I �, _Y_ i C . bYfiI�NA �0 ` 45 Fx�STI � PKWE ` QQ EXIST` - op ► / bq,s9 • E. Ig6 RIVER wG oL LANE . { SITE FIAP� J i CA LE , I " _ zo o I AWRIIMS . 10319 s N! Ktvrwwoov,;� LANA... . STC DESIGIN SERVICE jl�$40 SE Southern I.1tes Dr.. OR. 97,)15 ( 50-1) 698-6669 Project: 6 I O MONO L 60n: 1046 SA)• V911Z WOOF LANE �} i W- 1by )Qbo �T°. Chu Trate: —•�• .w.7�.r..w�.rw•++r.Y�•r.�r��.1�►.�+....�.r..r.__.'�'.�.Y�M�w�M�Mw r1..�.M�_wY��..rw_NV+ YYr.r../I�.A��ri►4�.•�.'..M•.r...+�/W.r��..A+.IrU.Mr.A..��._.-iMM�wY•4•r��.til��tiY�1.IM/�.� a 1 *S X614 ... .. 10" NOTIGE: IFTHEPRINTORTYPEONANY r� � � � ( � � � � I � � i � � � I � � � i � il � � � � � � II � � � � III � I � Iil � ill (T 1TTPI-1 1 � 1 Iir ,lfl 1111I � I � I � I III, Ijl I � r f� l � lii I � I 1-� 11 �1 � � 11.1Ji 11 , 111 ( 11 111 1p III I � ( 1 [ 1 III 1 I lil 111 IIII ► Iil II I I I � I I ( � I IMAGE IS NOT AS CLEAR AS THIS NOTICE 1 2 3 4 5 I 6 7 'q ITIS DUE TO THE QUALITY OF THENo.36 6Z' 8Z � OZ -- — - —1-- - TORIGINAL DOCUMENT �11 EZT (Zi3w ' ,111111 11 111111 11 10318 SW Rivenvoud Lane CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503)639-4175 Uv G d MST INSPEL;riON DIVISION Business Line: (503) 639-4171 BUP _ Received -------- Date Requested � AM _—_PM BUP Location ----��-� f-� �2�� - Suite _ MEC ----- --- Contact Person _ _ /� — Ph(-. --) /aZ `5�7//-5�� PLM -_-_ ------------_ - __ Contractor `� - !� �� _ _ Ph( -) 66'2-- 3_. SWR BUILDING Tenant/OwnerELG Footing 14 - E)' `�� . -�. ELC Foundation Access: Ftg Drain ELR i \� Crawl Drain Slab Inspection Notes: ? SIT t Post& Beam - Shear Anchors Ext Sheath/Shear v V Int Sheath/Shear Framing - - - Insulation l� t Drywall Nailing --- Firewall Fire Sprinkler - �m--- --- ---- --- Fire Alarm Susp'd Ceiling - - - Roof Other: Final PASS PART FAIL PLUMBING - Post&Beam Under Slab Rough-In Water Service Sanitary Sewer Rain Drains Catch Basin/Manhole Storm Drain Shower Pan Other: - - Final --- _PASS PART FAIL - --- - MECHANICAL Post&Beam Rough-In -- — — -- Gas Line Smoke Dampers Final PASS PART FAIL -_®---- �- - ELECTRICAL Service Rough-In - ------- - --- _-- UG/Slab Low Voltage Fire Alarm [] Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. ASS ART FAIL - Please call for reinspection RE: Unable to inspect-no access Fire Supply Line ADA / d Approach/Sidewalk Date } Inspect n Ent -- Other. Final DO NOT REMOVE this Inspection record from th6 Job site. PASS PART FAIL MASTE ERMIT CITY OF TIGARD PERMIT : MST2 PERMIT ft: MST2001-00481 DEVELOPMENT ,SERVICES DATE ISSUED: 9/14/01 13125 SW Hall Blvd.,Tigard, OR 97223 (503' 639-4171 SITE ADDRESS: 10318 SW RIVERWOOD LN PARCEL: 2S114BC-03500 SUBDIVISION: RIVERVIEW ESTATES NO, 2 ZONING: R-7 BLOCK: LOT: 072 JURISDICTION: TIG REMARKS: Addition of breakfast nook, 2 bedrooms on 2nd floor, and covered entry porch. BUILDING _ REISSUE: STORIES: FLOOR AREAS _ REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: FIRST, 195 of BASEMENT: a1 LEFT: SMOKE DETECTORS. v TYPE OF USE: Sr FLOOR LOAD: 40 SECOND: 356 at GARAGE: at FRONT: PARKING SPACES TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT. of RIGHT: VALUE: $57,000 00 OCCUPANCY GRP: R3 BERM. OATH: TOTAL: 55310 of REAR. PLUMBING SINKS: WATER CLOSETS: WASHING MACH: I LAUNDRY TRAYS: ' RAIN DRAIN: TRAPS: LAVATORIES: DISHWASHERS FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS. TUBISHOWERS. GARBAGE DISP: WATER HEATERS: WATER LINES BCKFLW PREVNTR: GREASE TRAPS. OTHER FIXTURES. MECHANICAL FUEL TYPES FURN<100K: BOIL/CMP<.7HP VENT FANS: 1 CLOTHES DRYER 1 FURN>-TOOK: UNIT HEATERS. HOODS. 1 OTHER UNITS: ' MAX INP: btu FLOOR FURNANCL1 VENTS'. 1 WOODSTOVES: GAS OUTLETS: _ ELECTRILAL RESIDENTIAL UNIT _ SERVICE FEEDER TEMP SRVCIFEEDFRS BRANCH CIRCUITS _ MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS. 0 200 amp: �0 200 anm: WISVC OR FDR I PIIMPIIRRIGA TION PER INSPECTION. EA ADD'L 5003F: 201 400 amp: 201 400 arnp: tat W/O SVCIFDR. SIGNIOUT I.IN LT: PER HOUR. LIMITED ENERGY: 401 600 amp: 401 600 amp: EA ADDL SR CIR: SIGNALI PANEL. IN PLANT MANU HWSVCIFDR: 601 1000 amp: 601.ampa•1000v: MINOR LABEL 1000.amp/vol/ PLAN REVIEW SECTION Reconnect only: >=4 RES UNITS. SVGFDR>•275 A. >800 V NOMINAL CLS ARFA)SPC OCC. _ ELECTRICAL•RESTRICTED ENERGY - A.SF RESIDEN"IAL _ _ _ B.COMMERCIAL _ AUDIO A STEREO: VALJUM SI STEM, AUDIO 6 STEREO: FIRE ALARM: INTERCOMMAGING: OUTDOOR LNDSC LT. BURGLAR At ARM OT14 BOILER: HVAC. LAt,DSCAPEIIRRIG PROTECTIVE SIGNL. GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL. OTHR. HVAC: DATAfTELE COMM: NURSE CALLS TOTAL.a SYSTEMS TOTAL FEES: $ 1,142.34 Owner: Contractor: This permit is subject to the regulations contained in the LEVEAR,SIMON AND KAREN THOMPSON CONSTRUCTION, MARKTigard Municipal Code,State of OR Specialty Codes and 10318 SW RIVERWOOD LN 8730 SW PINEBROOK all other applicable laws. All work will be done In TIGARD,OR 97224 TIGARD,OR 97224 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. ATTENTION: Phone_ Phone Oregon law requires you to followrules adopted by the Oregon Utility IJotification Center. Those rules are set Rag N: LIC 964." forth in OAR 952-001-0010 through 952.001-0080. You may obtain copies of these rules or direct questions to OUNC by calling(503)246-1987. REQUIRED INSPECTIONS Fooling Insp Crawl Drain/Backwater Electrical Service Gas Line Insp Mechanical Final Foundation Insp Footing/Foundation Dr; Electrical Rough In Gas Fireplace Plumb Final Post/Beam S:-uctural PLM/Underfloor Framing Insp Insulation Insp Final inspection Post/Bearn Mechanica Mechanical Insp Exterior Sheathing Ins[ Rain drain Insp Underfloor insulation Plumb Top Out Low Voltage Electrical Final Issued B � Permittee Signature Call (503) 639-4175 by 7:00 p.m. for an inspection needed the next business day Ci - I - .ti G Building Permit Application —� Datcreceived: Permit no. City of Tigard 16 - Projecl/appl.no.: Expire date: f ,ryn('/i;and Address: 13125 SW liall Blvd,Tigard.OR 97 Phone: (503) 639-4171 Date issued: H -Receipt no.: Fax: (503) 598-1960 Case file no.: Payment type: Land use approval: - 1&2 family:simple Complex: U I &2family dwelling or accessory U Commercial/industrial U Multi-family U New construction U Demolition hi Addition/alteration/replacement U Tenant improvement 'J Fire sprinkle•/alann U Other: Jt,h address: I lo 3 �, JELLY, r--a'' _� .! Bldg. no.: Suite no.: L,ot: Block: Subdivision: - Tax map/tax lot/acawnt no.: (inject name Description and location of work on premises/special conditions:_ h ;M 5AJ7L 4 fv Tr A-01}CTI+J �QEAit FAST �t/e�iE ooi`fs dN rn9 i R�5 �'e t�El1 ESQ /o/ Name: i-,nrt'e),J I&KOJ -,/l t dplain,seliticcapnciti,.solar,etc.) Mailing address Q rJ 1i tl, `)op (-,-, 1 & 2 family drelling: City: Statet� L ZIP: f Valuation of work........................................ $_.5^��00 D Phune: Fax: E-mail: No.of bedrooms/baths................................. Owner's representative: 'Total number of floors........... M i..... .. ........ t Phone: Fax: E-mail: New dwelling area(sq.ft.) L....................MA S S 0 Garage/carport area(sq. ft.)......................... Covered porch area(sq.ft.) ......................... Name: �_ Mailing address: Deck area(sq. ft.)........................................ _ city: _ Stare: I ZIP: Other structure area(sq. ft.)......................... _ Phone: Fax: F'-mail: ('ommercial/industrial/multi-family: Valuation of work........................................ $ Existing bldg.area(sq.ft.) .......................... Business name: t' Sft/Jt':o�4 . I.JC New bldg.area(sq.rt.) ............................... Address: X7 o s0i ` >r11 _ Number of stones City: 1) Statc:0 7.IPc Z t 'Type of construction.................................... Phone: t S Fax: "14 9 E mail: OL'u group(s): Existing: CCB no.: VA ` __ _ _ New: City/metro lic.no.: Notice: All contractors and subcontractors are required to tx. licensed with the Oregon Construction Contractors Board under �. provisions of ORS 701 and may be required to be licensed in the Name: e ` jurisdiction where work is being performed. If the applicant is Address: exempt from licensing,the following reason applies: cit state: zFP: Contact person: Phone. F-mail — Name: lContact person: Fees due upon application ........................... $ Address: Date received: City: State: ZIP: Amount received ......................................... Phone: Fax: E-mail: Please refer to fee schedule. hereby certify I have read and examined this application and the Nd all Jun�dic.i.-rcept credit cards,please call jurisdiction fm mote information. attached checklist. All provisions of laws and ordinances governing this Uvisa U MasterCard work will be .complied with,whether •cified herein or notcredit cera nan,t+er _— Eipiret Authorized signs m: ate: f f Name o(cudholder u shown on,rcdn cert S Print name: VVV Cardholder stRnetnre Amount Notice:This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. 440-4614 ItAXWOM) One- and Two-Family Dwelling Building Permit Application Checklist Reference no.: Associated permits: Cit of Tigard City g U farctncal U Plumbing U Mechanical Address: 1 3125 SW I lull Blvd,"Tigard,OR 97223 U(liber Phone.: (501) 639-4171 -- Fax: (503) 598-1Onfl THE FOLLOWING 1 1 FOR PLAN REVWW Vet, dNo N/A I land use actions completed.Scc_)utr(ltLtioncrtteria I'll cunruu� mt reviews. 2loning.Flood plain,solar balance points,seismic sells designation,historic district,etc. 3 Veriitcation of approved plat/lot. 4 Fire district- -_approval required. 5 Septic system permit or authorization for remodel. Existing syster- apacity 6 Sewer permit. 7 Water district approval. 9 .oils report. Mast carry original applicable stamp and signature on file or with a, ticalion. 9 Erosion control U plan U permit required. Include drainage-wary protection,silt It oke design and location of catch-hasin protection,etc. 10 -�L. Complete sets of legible plans.Must he drawn to scale,showing conformance to applicable local and state codes. Lateral design details and connections must be incorporated into the plans or on a separate full-size sheet attached to the plans with cross references between plat location and details. Plan review cannot he completed if copyright violations exist. _ 1 I Site/plot;,Ian drawn to scale.The plan must show lot and huilding setback dimensions;pniperty corner elevations 01 - there is mire 1111111 a 4-111.elevation L;,'ferential,plan mast show contour lines at 2-11.intervals);location ofeasemenv.and driveway;footprint of structure(including decks).loci uion of weII%/septic systems:utility locations;direction indicator;lot area;huilding,coverage area;percentage of coverage;impervious area;existing structures on site;and surface drainage. 1.3 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads••connection details, vent ^ tier and location. I I Floor plans.Shoes all dirttensions,room identification,window`ve,location of smoke detectors.water heater. furnace,ventilation lams,plumbing fixtures,halconies and deck: 10 inches above grade,etc. _ 14 Cross section(s)and details.Show all framing-member sizes and spacing such as floor beams,headers,joists,suh-floor, wall construction,roof con.structioa. More than one cross section may be required to clearly portray cowtructio.t.Show details of all wall and roof sheathing,roofing,roof slope,ceiling height,siding material,footings and loundation,stain, fireplace construction, thermal insulation,etc. _ 15 Elevation views. Provide elevations for new construction;minimum of two elevations for additions and remodels. Iixterior elevations must reflect the actual grade if the change in grade is greater than four foot at building envelope. Full-size sheet addendums showing foundation elevations with Lross references are acceptable. I o Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and fixations;for non-prescriptive path analysis provide specifications and calculations to engineering standards. _ 17 Floor/roof framing.Provide plans for all flours/roof assemblies,indicating member siring,spacing,and hearing locations.Show a0ic ventilation. 18 Basement and retaining walls. Providr croti`wvfons and details showing placemen:of rehar. For engineered systems,see iter» 22,•'1?ngineer's calculations." 19 Begin calculations, Provide two se(s til calculations using current code design values for all heanls and multiple joists over 10 feet long and/or any hewn/joist carrying a non-un_ifornl load. 20 Manufactured noon/roof truss design details. 21 Energy Code compliance. Identify the prescriptive path or provide calculations.A gas-piping schematic is required for four or more;appliances. 22 Engineer's calculations. When required or pro ided,(i.e,,sheat tall,rclof truss)shall he stantlwd by an engineer nt architect liven>rd in Oregon and shall he shamm w hr apphcahl, t„flit-prnjr t umdrt re\ic%k 23 rive(5)site plans are required Int hent I 1 atho\c. SUr Marl/ 111111 h" 1'.' 1 1 n 1 1 1 24 'Two(2)sets each are required flit Items 10, 19.20 K 22 ahoy c �- 25 Building plans shall not contain red lines or tape-ons. _ 26 No rolled,reversed or tnirror•d building plans will he accepted 27 28 — Checklist must be completed before plan review start date. Minor changes or notes on submitted plans may, he in blue or black ink. Red ink is reserved for department use only. W-41614(600WOM) Electrical Permit Application )a1c recceed Permit no.""1172p Cit ' of Tigard Project/appl.no.: — Expire date: Cityof'figard Address: 13125 SW Nall Blvd,Tigard,OR 97223 Date issued: By: Receipt no.: Phone: (5011 639-4171 -- -- Fax: (503) 598-1960 Case file no.: Payment type: Land us(• approval. r � U 1 &2 family dwelling or accessory U Commeru,l/industrial U Multi-family U Tenant improvement U New construction 'tD Addition/alteralicm/rt•placl arra! J Other: U Partial INFORMATION Job address n /. 11llg nti.: \uilc no.: Tax map/tax lot/account ri,, . Lot: Block: Su division: Project name: - C'Y�i Q(jy;ti Description and location of work on premises:NoI�?I 11,7/. we3r ?tiLc�, Estimated Gale of eOrt1PlC1 ill/IIISPCc IJ,,n f 0 11-1 0VI-OR APPLICATION FEE SCHEDULE Job no: Pec non. Business name: - L(-c-M. Description ^, cfl�. tr31.1 1 iitAl nnll .iu� - New rawidenliAl-sinRk or mldti-fnmilr per Address: _ awcumk11111�hle)Udr ti A1tafIMYI KNrilf e City: Stale: ZIP: Service Included: Phone: Fax: E-mail: 1000stl It orlcsti -_ T 4 Each ullduum;d.5(q s .rt.or ane n thereof CCB no.: El cc.bus. lie.no: Limited energy,residential _ 2 city/metro lie.no.: Limited energy,non-resideraird _ 2 Each manufactured hnme or modular dwelling Signature of su rvisin electrician(required) lute Service and/or feeder _' _ Sup.elect.name(print) Licence iu, Serrationvices r e loca ti nslallallon, alteration or relocation: 200 amps or less 2 Neale(print): l-MeJ LL)J �,�A`z 201 amps to 400 amps 2 401 amps in 600 ams 2 Mailing address: 1731�� SL,) t�%63 _�nl (101 amps to IWosnips - 2 lily: T_C.0KW Stall: ZIP: 7 I'Lki Over 101K)amps or volts 2 Pllone!21_0 SI`, Fax: E-mail: Reumnectonl - I Owner installation:The installation ,s .xing made on property I own Temporary services or feeder,- which is not intended for sale,least:,rent,or exchange according to Instolintion.alteration,orrelocation: 2W amps or less 2 211011 ORS 447,455,479,670,701. amps ul 4(xl amps 2 ON ner'ti ,itnature: Date: 40 I to Mal an s 2 Branch circuits-new,ellerallon. or extension per panel: Name. v A. Fee for hranch circuits with purchase of Address: service or feeder fee,each branch circuit 2 City: —state: ZIP: H. Fee for branch circuits without purchase of service or feeder fee,first branch circuit: '- Phone: Fax: F-mail: Each additional branch circuit — Misc.(Service or feeder not Included): U Service over 225 amps-commercial U Hcalth-care facility Each pump or irrigation circle 2 U Service over 320 amps-rating of 1&2 U Hazardous hxation Each sign or outline lighting 2 family dwellings U Building over 10A X)square feet four of Signal circuit(e)or a limited energy panel, C.1 System over 600 volts nominal more residential units in one structure alteration,or extension• 2 U Building over three stories U Feeders,4W amps or more •DeNcn tion _ _ U Occupant load over 99 persons U Manufactured structures or RV pn-k FAch addlllonal Inspection over the allowable In any of the alcove: U Pgressllightinpplun U Other: Perulspection sobrclit seh of pians with ani of the above. Investigation fee 7he above are not applicable to iemporari construction service. Other --- - Peanut fee.....................$ — Not all lunutictions ecrept credit cants,please call inrialiction 6x mote information Notice:This permit application U Visa U MasterCard expires if a permit is not obtained Plan review(at —_ 9h) $ credit card number: —_--_ __ within IRO days after it has been State surcharge(8%,)....$ Fixpires accepted as complete. TOTAL .......................$ _. Now d c of r o shown on credit card S —_._.^— Cardholder dRnemrc ---�- —Amnuni 4404613( AIWOM) Electrical Permit Fees: Limited Energy Fees: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY _ Cot,;,ilete Fee Schedule Below: Restricted Energy Fee...................................................... $75.00 Number of Inspections per permit allowed (FOR ALL SYSTEMS) Service included: Items Cost Total Check Type of Work Involved: P,esidential-per unit 1000 sq it.or less _ $145 15 _ 4 Audio and Stereo Systems Each additi,,nal 500 sq it or portion thereof $33.40 1 Burglar Alarm Limited Energy $75.00 Each Manufd Home or Modular Garage Door Opener' Dwelling Service or F ioder $90.90 _ 2 El Services or Feeders Healing,Ventilation and Air Conditioning System' Installation,alteration,or relocation 200 amps or less $8030 2 Vacuum Systems' 201 amps to 400 amps _ $10685 _ 2 El 401 amps to 600 amps $16060 2 nlhel 601 amps to 1000 amps $24060 2 Over 1000 amps or volts $45465 2 Reconnect only $66.85� 7 TYPE OF WORK INVOLVED -COMMERCIAL ONLY Temporary Services or Feeders $75 00 Installation,alteration,or relocation Fee for each system........................................ 200 amps or less $68.85 2 (SEE OAR 918-260-260) 201 amps to 400 amps _ $100.30 2 Check Type of Work Involved: 401 amps to 600 amps "_ $133.75 2 Over 600 amps to 1000 volts, ❑ Audio and Stereo Systems see"b"above. Branch Circuits Boller Controls New,alteration or extension per panel a)The fee for branch circuits u Clock Systems with purchase of service or feeder lea. O Each branch circuit $665 Data Telecommunication Installation b)The fee for branch circuits without purchase of service Fire Alar Installation or feeder fee. First branch circuit _L— $46.85 F_� HVAC Each additional branch circuit $6.65 Miscellaneous E nstrumentation (Service or feedar not Included) Each pump or mgation circle $53.40 F-1 Intercom and Paging Systems Each sign or outline lighting $53.40 Signal circui(s)or a limited eme qyLandscape Irrigation Control' panel,alte,ation or extension $73.00 Minor Labels 110) $125.00 I ❑ Medical Each additional inspection over the allowable In any of the above Nurse Calls Per Inspection - $62.50 ------ Per hour __ $62.50 —. In Plant ___ $73.75 ❑ Outdoor Landscape Lighting' Fees: Protective Signaling Enter total of above fees $ Other 80,:State Surcharge $ .. - _..__ Number of Systems 25%Plan Review Fee ' No licenses are required Licenses are required for all other installations See"Plan Review'sechin on _ front of application -- Fees: Total Balance nue --- - -- - Enter total of above fees $ Tr ist Account# __ 81,, btate Surcharge $ Total Balance Due -- i:Ndsts\forsklc-fees.doc 10/09/00 Mechanical Permit Application -- — Datereceived: Permit no.: '66 1� City of Tigard Project/appl.no.: Expire dale: City of Tigard i Address: 13125 SW Hall Blvd,Tigard,OR 97223 —� Date issued:Phone: (503) 639-4171 — By: Keceipt nr.. Fax: (503) 598-1960 Case file no.: _ f ayment type: Land use approval: ---_--_ Building permit no TYPE OF PERMFI U I & 2 family dwelling or accessory U Commercial/ordusirctl U Multi•ramily U Tenant improvement U New construction XAddition/alteration/replacement U Other: 1 ' SFI FINVORMATION1SCHEDbLE Joh address: 1031g Si.J2 h10(rt) Indicate equipment quantilies in boxes below. Indicate the dollar Bldg.ne.: _ Suite no.: value of all mechunical materials,equipment,labor,overhead, 'rax map/tax Iet/account no.: profit. Value$ I,ot: IBlock: Subdivision: 'See checklist 1'or important application information and Project name: ` F A4- - jurisdiction's fee schedule litr rr;idcntii l permit fcc City/county: FAMILY DWELLING PE9MIT FEE SCHEDULE Dcscriplion and locatio of work on premises: *,,J,' 1 1 Est.date of completion/inspection; p -- — 7 I►c ss riprion (1t}. Res.ouly Res.only Tenant improvement or change of use: AU- Is ( Is existing space heated or conditioned'?U Yes A No An handling unit -__ __—CFM Is existings roc insulated'?U Yes U Nt, Air conditioning(siteplan requirc )_ - S I Alteration o existing system MECHANICAL CON1*KACTOR oiler•compressors '4, \J-t-- State boiler permit no.: Business name: AA --- (\1S- 141) Tons _B1,11/1I Address: r _1 1 i t r._ L fl _ 'ir�o a dampers/duct smo a detectors City: /(fleftj Slatc:q ZIP: ZL I cat pump(site plan require ) — Phone: j 2 1 ax: E-mail: nstall/rep acr turnac T N CCB no,; 7 '7 Z Z, — Including ductwork/vent liner U Yes U No nsta /rrplacc/re orate rale•% suspended, City/metro lic.no.: �A? wall,or floor mounted Name(please ting: Vent forappliance of irr than furnace 1 1e gest un: Absorption units BTU/H _ Name: Chillers_—.- _.. _ HP Address: Compressors_ . — _ HP nvrronmrnta rxhaust and vent Iat nn ('.fly: --- State: 7,IP:_—_ Apphamevenl Phne:oI . -- _ E-mail: )ryerex gust ooc s, 'ypr / res.kitcherilhazinal hood fire suppression system Name: "' 1,.J Fxhaust fan with single duct(bath fans) Mailing address: CC ?xhaust.system apart from healing or AC 1�— F ell p p ng and distribution(up to 4 out cls) City: c.4#1 slate{) ZIP: 1722Hr x LI'(3 NG oil Phone: - YI --- - J - I.tx: — F.-mail: Fuel piping each additional over 4 out ets rocess flflngcschernaticrequired) Number 4011110S 7city: i tier st app ance or equ pment: Wcorativefire lace _—— State: ZIP: nsett-•ty e_ Phone Fax: E-mail' Woodstove/pcl let stove Other: Applicant's sl);nnturc: Datc• Name (pant): -_�--- --- — --J- Nnt all jurisdiclions accept ctedit card+,please call judsdictinn lot mote infrnnntitet Permit fee.....................$ U Visa U Mastercard Notice:if Thi ern t i not obtain Minimum fee.... ...........$ expires if a permit is not obtained Plan review(at — %) $ t'redit cud number' I:,sp;rc, within 180 days after it has been State surcharge(9%)....$ --- accepted as Irtc ame of c . ted com 1<kr a+s own on c it card P P $ TOTAL .......................$ Cardholder signature —v AnI 440.4617(6100R'OM) MECHANICAL PERMIT FEES COMMERCIAL FEE SCHEDULE: 1 & 2 FAMILY DWELLING FEE SCHEDULE: TOTAL VALUATION: PERMIT FEE: D9scription: Price Total $1.00 to$5,000.00 Minimum fee$72.50 Table 1A Mechanical Code Oty (Ea) Amt $5,001.00 to 810,000.00 $72.50 for the firs'$5,000.00 and 1) Furnace tis& 0 BTU $1.52 for each additional$100.00 or including ducts vents 14 00 fraction thereof,to and including 2) Furnace 100,000 BTU+ $10,000.00. including ducts&vents 17.40 $10,001.00 to$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 14.00 fraction thereof,to and including 4) Suspended heater,wall heater- _ _ _ $25,000.00. or floor mounted heater 14.00 $25,001,00 to$50,000.00 $379.50 for tho first$25,000.00 and 5) Vent not included in appliance permit $1.45 for each additional$100.00 or 6.80 fraction thereu to and Including 6) Repair units $50,000.00. 12 15 $50,001.00 and up $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. Comp* 7)<3HP;absorb unit Minimum Permit Fee$72.80 SUBTOTAL: $ to 100K BTU 14.00 8)3-15 HP;absorb 8%State Surcharge $ unit 100k to 500k BTU 25.60 9)15-30 HP;absorb 25%Plan Review Fee(of subtotal) $ unit.5-1 mil BTU 35.00 _Required for ALL commercial permits only _ 10)30-50 HP;absorb TOTAL COMMERCIAL PERMIT FEE: $ unit 1.1.75 mil BTU _ 5220 11)>50HP:absorb unit>1.75 mil BTU 87.20 12)Air handling unit to 10,000 CFM ASSUMED VALUATIONS PER APPLIANCE: 10.00 Value Total 13)Air handling unit 10,900 CFM+ Description: Ut (Ea) Amount 17.20 Furnace to 100,000 BTU,Including 955 14)Non-portable evaporate cooler ducts_&vents 10.00 Furnace>100,000 BTU including 1,170 15)Vent fan connected to a single duct ducts&vents 6.30 Floor furnace Including vent 955 16)Ventilation system not included In Suspended heater,wall heater or 955 appliance permit 1000 floor mounted heater17)Hood served by mechanical exhaust Vent not included In applicance - 445 10.00 permit _ 18)Domestic incinerators Repair units 805 1740 <3 hp;absorb,unit, 955 19)Commercial or industrial type incinerator to 100k BTU69 95 - 3-15 hp;absorb.unit, _ 1,700 20)Other units,including wood stoves 101k to 500k BTU_ _ 10.00 15-30 hp;absorb.unit,501k to 1 2,310 21)Gas piping one to four outlets mil.BTU - 5.40 30.50 hp;absorb.unit, 3,400 22)More than 4-per outlet(each) .1-1.75 mil.BTU 1.00 >50 hp;absorb.unit, 5,725 Minimum Permit Fee$72.50 SUBTOTAL: $ >1.75 mil.BTU Air handling unit to 10,000 cfm 656 8%State Surcharge $ Air handling unit>10,000 cfm 1,170 Non- orlable evaporate cooler 656 TOTAL RESIDENTIAL PERMIT FEE: $ Vent fan connected to a single duct 446 Vent system riot included in 656 - appliance permit Other Inspections snd Fees: Hood served by mechanleal exhaust 656 1 Inspections outside of normal business hours(minimum charge-two hours) Domestic incinerator _ 1 170 $72 50 per hour Commercial or Industrial Incinerator 4 590 2 Inspections for which no fee is specifically Indicated (minimum charge-hall hour) Other unit,Including wood stoves, 858 $72.50 per hour Inserts,etc. 3 Additional plan review required by changes,additions or revisions to plans(minirnur charge-one-half hour)$72 50 per hour Gas piping 1-4 outlets 360 Each additional outlet _ 63 Slate Contractor Boller Certification required for units>200k BTU. 'Residential A/C requires site plan showing placement of unit TOTAL COMMERCIAL $ VALUAI ION: is\dsls\forms\meth-fees+doc 08/06/01 Plumbing Permit Application Datereceived: Permit no.Jt/�T,204 - City of Tigard Sewer permit no.: Building permit no.: Address: 13125 SW Ifall Blvd,Tihard.OR 97223 Cityrrji7gurA Phone: (503) 639-4171 :.3ject/app1.ra,: Expire date: Fax: (503) 598-1960 Dale issued: By Receipt no.: Ladd use approval: Case file no,: Payment type: OF PERMIT U I &2 family dwelling or accessory U Conuurrcial/induwlal U Multi-family U Tenant improvement U New construction M Addition/alteration/replacencent U Food service U Other: JOB SITE INFORMA`Iflldfi�- 1ULE(foripecial Informatiou Jot)addre,ti j/h jG,.� -yl�gp( Descriplion Qty. hee(ea.) 'folal —�� New I-and 2-fancily(IHellings only: Bldg.no.: -' — I Suite no.: (includes 100 ft.foreach utilily connection) Tax map/tax lot/accont SFR(1)bath -------------------- Lot: Block: Subdivision: - --- - - - `- _ R Shft(2)bath Project name:_ (6;-L( �2 4 _ SFR(3)bath City/county: IIP: Each additional bath/kitchen Description ano to ition 01'kvork on premises: I Slteuti ilies: L -� Catch basin/arca drain fist.date of completion/in l,rt t ni: Drywells/leach line/trench drainPLUMBING _ 1 1 Footing drain(no.lin.ft.) Manufactured home utilities Business name: Cult',' JYI�!?l�l _ Manholes Address: Rain drair connector City: TState: ZIP: ^ Sanitary sewer(no. lin. ft.) — - Phone: ( S Fax: E-mail: Storm sewer(no. lin f(.) CCreg.no: Water service(no. lin.Il.) City/metro lie.no.: Fixture r Item: Contractor's represenlat�% .ignaturc; Absorption valve _— _ -- Back flow preventer Print name Date: Backwater valve _ Basins/lavatory — Name: Clothes washer -- - - - - - Dishwasher _ Address: _ _- Drinking fountain(~) City: ZIP:Mate:I _-_ - Ejectors/sump Phone: Fax. I m:IsI:Y Expansion tank Fixture/sewer cap Name(print): �- e,J �(�/�(L Moor drains/Iloor sinks/hub P- - � � - Garbage disposal Mailing address: "r)two Hose Bibb City: C State ZIP: f 7 22,qIce maker Phone: Fax: E-mail: Interceptor/grease trap Owner installation/residential maintenance only: The actual installation Primer(s) _ will be made by me or the maintenance and repair made by my regular Roof drain(commercial) employee on the prof ehy I own m per ORS Chapter 447. Sink(s),basin(s),lays(s) Owner's si mature: Date: _ Sump Tubs/shower/shower pan Urinal _ Name: Water closet Address: Water heater City: Sate: ZIP: Other: - - ---- Phone: Total Not all jurisdictions accept credit cants,please call jurisdiction for trxxe information. Notice:This permit application Minimum fee............ ... Plan review lal — 191 $ U Visa U MasterCard expires if a permit is not obtained Credit card number:_ --�—L-- within I80 days after it has been State surcharge(8%) ....$ — xpircs — -- accepted as complete. TOTAL .......................$ Name of carabolder as shown on credit card Cardholder signature Amotmi 440.4616(ISMCOM) PLUMBING PERMIT FEES: — PRICE TOTAL New 1 and 2-family dwellings only: — FIXTURES individual —_ _ QTY _(ea) AMOUNT (includes all plumbing fixtures in PRICE TOTAL Sink 1660 the dwelling and the first100 ft. QTY (ea) AMOUNT 16.60 for each utilit connection)__ Lavatory One 1 bath $249.20 1 ub or Tub/Shower Comb. 16.F0 Two 2 bath _ $350.00 _ Shower Only —�� 1E.60 Three(3)bath $399.00 Water Closet 16.60 _ SUBTOTAL Urinal 16.60 8%STATE SURCHARGE Dishwasher - 16.60 PLAN REVIEW 25%OF SUBTOTAL -- TOTAL Garbage Disposal 16.60 -- _ _ — Laundry Tray 16 60 Washing Machine y_ 16.60 Floor Drain/Floor Sink r' 1660 PLEASE COMPLETE: 3" 16..60 4" 16.60 - Water Healer O conversion O like kind 16.60 Quantity b I Work Performed Gas piping requires a separate mechanical Fixture Type: New Moved Replaced Removed/ permit. _ Capped MFG Home New Water Service 46.40 Sink _ MFG Home Now San/Storm Sewer 46.40 LavatoDL ._V _ Tub or Tub/Shower Hose Bibs 16.60 _ Combination Roof Drains 16.60 Shower Only Drinking Fountain 16.60 _Water Closet Urinal _ Other Fixtures(Specify) 16.60 _-T Dishwasher Garbage Disposal Laundry Roorn Tray Washing Machine _ Floor Drain/Sink: 2" Sewer-1 st 100' 55.00 3" Sewer-each additional 100' 46.40 4" Water Service-1s1 100' 55 00 Water Heater Other Fixtures Water Service-each additional 200' 46,40 (Specify) Storm&Rain Drain-list 100' 5500 _ Storm&Rain Drain-each additional 100' 46.40 Commercial Back Flow Prevention Device 46.40 Residential Backflow Prevention Device' 27.55 Catch Basin 16.60 Inspection of Existing Plumbing or Specially 72.50 Requested Inspectionsper/hr COMMENTS REGARDING ABOVE: Rain Drain,single family dwelling 6525 - Grease Traps 16.60 - -- ---- - - —� QUANTITY TOTAL Isometric or riser diagram Is required It Quantity Total Is >9 _ *SUBTOTAL 8%STATE SURCHARGE - -- — -- "•PLAN REVIEW 25%OF SUBTOTAL Ra uired only it fixture qty total Is>9 TOI AL $ *Minimum permit fee is$72 50•BN state surcharge,except Residential Backflow Prevention Device,which Is$36 25 4 B%state surcharge "All New Commercial Buildings require plans with Isometric or riser diagram a� plan review is\dsts\forms\plm-fees.doc 10110/00 SEE 35MM ROLL # 20 FOR. OVERSIZED DOCUMENT CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE CLASSIC PLUMBING 521 S BLAINE ST NEWBERG,, OR 97132 Plumbing Signature Form Permit #: MST2001-00481 Date Issued: 9114101 Parcel: 2S114BC-03500 Site Address: 10318 SW RIVERWOOD LN Subdivision: RIVFRVIEW ESTATES NO. 2 Block: Lot* 072 Jurisdiction: TIG Zoning: R-7 Remarks: Additir i of breakfast nook, 2 bedrooms on 2nd floor, and covered entry porch. Your company has been indicated as the plumbing contractor for the permit indicated above. In order for the plumbing permit to be valid, please have the appropriate individual from your company sign below and return this Plumbing Signature Forin prior to the start of the work to the address above, ,17-TN: Building Dept. No plumbing inspections will be authorized until this completed form is received OWNER: PLUMBING CONTRACTOR: LEVEAR, SIMON AND KAREN CLASSIC PLUMBING 10318 SW R;VERWOOD LN 521 S BLAINE ST TIGARD. OR 97224 NEWBERG. OR 97132 Phone #: Phone #: 503-554-1605 Reg #: I Ir 00072323 PI M 36-81 PB AN INK SIGNATURE IS REQUIRED ON THIS FORM Signature of Author ed Plumber t If you have any questions, please call (503) 639-+171, ext. # 310 CITY OF TIGARD 24-Hour BUILDING Inspection Line: (503) 63n-4175 2 P INSPECTION DIVISION Business Line: (503)63y4471-, MST BUP - ---- Received - Date Requested_- ��AM BUP Location Yv ,1�'�14.4-) Suite MEC Contact Person 12 ) - f�' 57 157 PLRI Contractor __ Ph( ) SWR BUILDING Tenant/Owner ---__�____ ELC Footing ELC FoundationAcc Drain Cr awl Drain j�(�Q � �• ELR - - Cr __ Slab Inspection Notes: SIT Post& Beam Shear Anchors Ext Sheath/Shear �L Int Sheat,/Shear Framing -- -- ----- - _ - Insulation Drywall Nailing -- - --- Firewall Fire Sprinkler - -- Fire Alarm Susp'd Ceiling - _--- Roof Other: ----- -- — rn S PART FAIL P BING__ Post&Bean, Under Slab Rough-In _ Water Service Sanitary Sewer Rain Drains - -_—_ .•-� __ Catch Basin/Manhole / Storm Drain Shower Pan O r: n PART FAIL ----------- HANICAL Post&Beam riough-In -- ----- ------ ryas Line Smoke Dampers - -- - -- -— - ----- --— �I r� S PART_ FAIL --- CTRICAL Service Rough-In _ UG/Slab Low Voltage ...._. -- Fire Alarm Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW HEJI Blvd. PASS PART FAIL SITE F] Please call for reinspection RE: — u Unable to inspect-no access Fire Supply Line ADA Z Approach/Sidewalk Date�' `"' ___..._.__ -_ Inspector A Other:_ Final -� DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE WILLAMETTE ELECTRIC INC PO BOX 230547 TIGARD, OR 97281 Eiec�rical Signature Form Permit #: MST2001-00481 Date Issued: 9114101 Parcell: 2S1140C-03500 Site 'Adress: 10318 SW RIVERWOOD LN Subdivision: RIVERVIEW ESTATES NO. 2 Block: Lot: 072 Jurisdiction: TIG Zoning: R-7 Remarks: Addition of breakfast nook, 2 bedrooms on 2nd floor, and covered entry porch. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valk , the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Dept. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL LONTRACTOR: LEVEAR, SIMON AND KAREN WILLAMETTE ELECTRIC INC 10318 SW RIVERWOOD LN PO BOX 230547 TIGARD. OR 97224 TIGARD, OR 97281 Phone #: Phone #: 624-3631 REQ #: LIC 75059 SUP 1965S ELE 34-283C AN INK SIGNATURE IS REQUIRED ON THIS FO M / 7 Signu'ure of S411ervising Electrician If you have any questions, please call (503) 639-4171, ext. # 310