9690 SW RIVERWOOD LANE-1 yV'D'--"LDING PROCEDI IRE SPECIFICATION (WPS) Yes
_ PREQUALIFIED QUALIFIED BY TESTING _
or PROCEDURE QUALIFICATION RECORDS (ICOR)
Identification # �/
Company Name a9"Mr Revision Date By
Welding Process(es) _—:7
Authorized by �� 1�,9 Cate Qd
Supporting POR No.(s) _-_� TYPe— Manual ❑ Semi-Automatic
Machine ElAutomatic
JOINT DESIGN USED — --
POSITION
Type. F; �' L )-v r Position of Groove:
Single M Double Weld Fillet: lrh kc
a Vertical Progression: Up ❑ Doan ❑
Backing: Yes (� j i Io
Backing Material: ELECTRICAL CHARACTERISTICS
Root Opening &l4 Root Face Dimension AIA
Groove Angle: _ �� Radius (J-U) Transfer Mode GMAW
Back GoL'ging: Yes ❑ No ❑ Method ( ) Shod-Circuiting❑
Globular❑ Spray❑
BASE METALS
Current: AC ❑ DCEP;R DCEN ❑ sed❑PulOthe
Material Spec. � 3 �o O� .S-7� � Tun :.ten Electrode 9 ode (GTAW)
Type or Grade _rAD& � of Size:
Thickness: Groove Fillet
Diameter (Pipe) Type:
FILLER rV1 LS TECHNIQUE
AWS Specification /9
A S Stringer or Weave Bead:
AWS Classification �= / ]""'_ / Multi-pass or Single Pass (per side)
Number of Electrodes 6JVAr
Electrode Spacing Longitudinal
SHIELDING Lateral
Flux � Gas .4q .-eo � Angle
Composition ` �•
Electrodw-Flux Chas Contact Tube to Work Distanc 1
( s)__.____ Flow Rate • d �N Peening
Gas Cup Size Interpass Clean?ng: 6,#\llr
PREHEAT
Preheat Temp., Min POSTWELD HEAT T EATMENT
Interpass Temp., MinTomp. /Q
Max Time /1
WELDING PROCEDURE
Pass or Filler Metals Current rpm
Weld Type & mp r Wire Travel
Layers) Process Class Diam. Polarity eed Speed Volts Speed d Joint Details
00
2 o
A
O�
Form E-I (Front)
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ORIGINAL DOCUMENT - -- - MMMMM
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WELDER CERTIFICATION
Cert. No.C-1680
Welder: LONNIE EDWARDS
SS#: ` 1-13-2147
City of Portland Expiration Date: 04-08-03
4Wde2rS' nature5,. Date
CTI Authorized Signature 0-0V 002
Carlson, Testing, Inc.
Tigard, Oregon (503) 684-3460
See Reverse Side for Qualification Data
Qual. Spec: AVMS D1. 1-00
Process: FCAW Position: 3G
Weld Desc: VEE-GROOVE
Material: A--36
Filler: E71T-1 Thickness: 1/8" TO 3/4"
RemarkQ: BACKING REQUIRED
Civail. Spec: AWS D1.1-00
F'rOcm: SMAW Position: 3G
Weld Desc: VEE-GROOVE
Material: A-36
Filler: E7018 Thickness: 1/8" TO 3/401
Remarks: BACKING REQUIRED
WELDER CERTIFICATION
Cert . No - C-1680
Welder : LONNIE EDWARDS
SS# : 541 -13 -2147
City of Portland Expiration Date : 09-11 - 02
Welder Signature
Date
CTI Authorized Signature 09/14i2001
♦r
Carlson Testing, Ine.
Tigard, Oregon (503 ) 684 -3460
See Reverse tide for Qualiticaticn Data
Qual - Spect AWS D1.1-00
Process: FcAw position: 30
Wald Desc: VIM-GROOVZ
Material: A-3`
Piller: 871?-1 Thicjmoss: 1/S' TO 3/4"
Remarks: BACKING RX=R=
Qual. Spec:
Process: PoMition:
Meld Desc:
Material:
Piller: T'hic)mess:
Remarks:
r
wo
•r
NOTICE: IF THE PRINT OR TYPE ON ANY -rl-! rlr 1 ( � � I � � I � � I � � I � ill � I � ! li tli Il ! � ! ll ill II ! ! I � rl ! ! l ! ! � ! 1� ! ! � I rl ! ell Ili ill � ! `il ! r-�l III ! 1 ► I � ! ! � ! ! r ! ! I I i I T-1 1 111 I I ISI I .II �11
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WELDER CERTIFICATION
�-, Cert. No.C-689
:3NOHa _ -.kjOSI/12J3dns i
Welder: CHRISTOPHER LEDBURY
SSM 541-62-0990
7i9qumeo-JOCIOPO City of Portland Expiration Date: 03-30. 13
:3NOHd : jqqujqjdeS-AInr
:kIOS1Ab3dns
:rime Welder Signa Date
:3�lOF-:�'
:aOSIAN3dnS '
+� CTI Authorized Signature k 04104/2002
eunI'ip&vf Carlson Testing, Inc.
3NOHd :8OSIA213dnS Yigard, Oregon (503) 684-34M j
WN1.4 See Reverse Side for Qualdcation I
4wew-kenuer
1N3yUO 1dW3 ,O ON003H Sb'3U-0nn Gkwl. Spm: AWS 01.4-92
Proems: SMAW Potion: 2G
Weld Desc: FLARE BEVEL
s :s tyl :�II!d Material: A706 TO A.36
:161�ie11V s Filler: E7018 Thickness: 05 AND LARGER �
F :0900 PPM Rema*s:
of Wo. :990=d
:oWS 'Zeno I
Qual. Spec: AWS D1.1-98
03HIfl 2i JN1N0� :s�euua
Process: FCAVN Poeition: 3G, 4G
a311W1�Nn Cl „8/L : au40!q ML3 'JIl!� Weld Desc: VEE-GROOVE
9£-d :1e1owY�I i Material: A-36
3A00 33A :off Pl3M Filler: E71T-1 Thickness: 1/8" ' O UNLIMITED
Off' BOE :uosod yWS :ssaooJd Remarks: BACKING REQUIRED
86-L.La S V :oWS 'IenO
eu.
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9690 SW Riverwood Lane
CITYOF TIGARD _ BUILDING PERMIT
PERMIT#: BUP2002-00485
DEVELOPMENT SERVICES DATE ISSUED: 11/27/02
13125 SW Hall Blvd., Tigard. OR 97223 (503) 639-4171 PARCEL: 2S114BD-02200
SITE ADDRESS: 09690 SW RIVERWOOD LN
SUBDIVISION: COPPER CREEK STAGE 2 ZONING: R-4.5
BLOCK: LOT: 037 JURISDICTION: TIG
REISSUE: _ FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: OTR FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT? MEZZ?: _ REQP 'LACTSACKS _ REQUIRED _
FLOOR LOAD: psf LEFT: ft RGHT ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 6,500.00
Remarks: Post replacement
Owner: Contractor:
HARGER, LORN S AND KAREN J KUSHNER STRUCTURES
9690 SW RIVERWOOD L.N 8616 N SWANSON STREET
TIGARD, OR 97224 F-)RTLAND, OR 97203
Phone: 503-283-8337
Phone: 503-283-8337
Reg #. LIC 109369
FEES REQUIRED INSPECTIONS
Description Date Amount Footing Insp
lit 1'I'I ti 1,111 Its 11/4/02 $71 83 Framing Insp
II3UII DI I'rrnw I�cc 11/27/02 $11050 Final Inspection
Final Inspection
IT'AXI h Suite Fax 11/27/02 $884
DC I31d Re 11/27/02 $20.00
Total $211.17
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. 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 the rules adopted by the Oregon Utility Notification Center. Those Hiles are set forth in OAR
952-001-0010 through OAR 952-001-0100. You may obtain a copy of these rules or direct questions tc OUNC by
calling (503) 246-6699 or 1-800-332-2344.
Issued By: ---
F'ennittee 1
Signature: --
Call 639-4175 by 7 p.m. for an inspection the next business day
Building Permit Application
�i Date received: J-t4-G 1- Permitno..a - i_�S
City Of Tigard
City of Tigard
Address: 13125 SW Hall lllvd,Tigard,OR 97223 Prolect/appl.no.: Expire date:
Phone: (503) 639-4171 Date issued: By: Receipt no..
Fax: (503) 598-1960 Case file no.: Payment type:
Land use approval: _ 1&2 family:Simple Complex:
1
LL'] I &2 family dwdinf,or accessory U Commercial/industrial J Multi-laniily U New construction U Demolition
U Additioi:/alteratiotVr Olacement U Tenant improvement U Fire sprinkler/alarm Other.
INFORMATIONJOB SITF
IBldg. no.: Suiteno.:
I t _ Block: Subdivision: J Tax map/tax lot/account no.:
Project name: —
1iltuon and location of work on premises/special conditions:
OJJr N111 FOR SPECIAL INFORNIA-1 ION, USE CHUCKLINT
_/ solar,
Name: 77 ?tid r7 rC",'�7";f-�C�'
Mail ingaddress: ,C�.�'c" '�v '' !V ��.� �! I & 2 family dnellinq:
City: i< ! v Sit":/''F -VP! g ,2� Valuation of work........................................ $_ �i�car:�
Phone:5 , b 4 Fax: ;'�' E-mail: No.of bedrooms/baths.................................
Owner's representative: kvs N1✓r Total number of floors.................................
Phone: r" r''• • I F_mail:r,,44)&N"•rf'/ Vew dwelling arca(sq.ft.) ..........................
APPUCANT Garage/carport area(sq.ft.)
Name: Covered porch area(sq.ft.) ......................... —
MailinE address: --- Deck area(sq.fl.) ....................................... --
('itv: Slate: I - — Other structure area(s t.).........................
r,ix 1.-maFil C
phone: 1otnmerclaUlndustriallmul(I-family:
CONTRACTORValuation of work........................................ $
Business name: Existing bldg.area(sq. ft.) ..........................
---- -- ---- — New bldg.area(sq, ft.) -
- Number of stories........................................
City: 9ttit0:a'o
Type of construction
Phone: r �: 1 Fax: E-mail:
J .y Occupancy group(s): Existing:
CCB no.:_
New:
City/mesio lir.no. Notice:All contractors and subcontractors are required to I><
CUIDUSIGNER licensed with the Oregon Construction Contractors Board under
Nano•. provisions of ORS 701 and may be required to be licensed in the
-_ - jurisdiction where work is being performed. If the applicant is
Adrlress:
- -- exempt from licensing,the following reason applies:
City: `Mate: IZI1':
Contact person: flan no.:
Phone: Fax: I E-mail: --
Name: Contact person: fees due upon application $
Address: _ Date received: .
City: State: 7T7 Amount received ......................................... $_
Phone: I E-mail: Please refer to fee schedule ~
hereby certify I have read and examined this application and the Not an Jurisdictions accept credit('ards,pleaw call iurisdi(ti(n fot tuore infottnaiiol
attached checklist. All provisions of laws and ordinances governing this U Visa U Mastercard
work will he complied%Athywhether specified herein or not. ,,ht cord numter
Expires
Authorized signature: 1r Name of cucarolder u shown on credit crd
Print name: Y--4.x &,z_%/1 Cardholder signature S _Anuxmt
Notice.phis permit application expires if a permit is not uhtained within 190 days after it has been accepted as complete. 4.0 14611 ttowd't in)
One- and Two-Family Dwelling -�
Building Permit Application Checklist Reference no.
Associated permits:
Cityuj7➢gard city of l fgard J Electrical U Plumbing U Mechanical
Address: 13125 SW I fall Blvd, Ilgard,OR 9722 J Other
Phone: (503) 639-4171
Fax: (503) 59R-1960
1 111111A IOL12
I land use actions completed.Sec jurisdiction criteria for concurrent reviews. ____
2 Zoning.Cloud plaits,solar balance points,seismic soils designation,historic district,etc. —
3 Verification of approved plat/lot.
4 Fire district approval required.
5 Septic system permit or authorization for remodel. Existing system capacity
6 Sewer permit.
7 Water district approval. —
R Soils report.Must carry original applicable stamp and signature on file or with application.
q Erosion control U plan ❑permit required.Include drainage-way protection,silt fence design and location of
catch-biv,m protection,ctc.
10 _ Complete sets of legible plans.Mttst he drawn to scale,showing conformance to applicable local and state
building,codes. I,atersl dcaEn details void connections must he inc Lirated into the plans or on a separate full-size
sheet attached to the plans with cross references between plan' -,11 .n and details. Plan review cannot he completed
if copyright violations exist. _
I I sifelplol plan drawn to scale.The plan must show lot and building sethack dimensions:property comer elevations(.I
there is more than a 441.elevation differential,plan rumor show contour Imes at 24t.intyrnols);lavation of easement,%and
driveway;footprint of structure(including decks);location of well"t'sepuc systems;utility It direction indicator;Int
area;building coverage arra;percentage of coverage;impervious:uya;yxisLing structures on site;and surface drainage,
12 Foundation plan.Show dimensions,anchor bolts,any hold-downs and reinforcing pads,connection details,vent
size and location. --
13 Floor plans.Show all dimensions,room identification,window size,loriuon of'smoke defectors,water heater,
furnace,ventilation fans,plumbing fixtures,balconies and decks 30 inch -,above grade,etc.
14 Cross scclion(s)and details.Show all framing-member sizes and spaciity-,u�h a%Ilo or beams,healers,joists,sub-floor,
wall construction,root construction.More than one cross section nlay hr m-quued to clearly portray construction.Show
details of all wall and roof sheathing,roofing,rool'slope,ceiling height,siding material,footings and foundation,stairs,
fireplace construction, thermal insulation,etc.
15 Elevation views.Provide elevations for new constnrc•tion;minimum of two elevations for additions and remodels.
Exterior 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 cross references are acceptable.
16 Wall bracing(prescriptive path)and/or lateral analysis plans.Must indicate details and locations;for
non-prescriptive path analysis provide specifications and calculations to enginccring standards.
17 Floor/roof fronting.Provide plans for all floors/roof assymhlics,indicating member sizing,spacing,and bearing
locations.Show attic.ventilation. _
IR Basement and retaining walls. Provide cross sections and details showing Placement of rehar. Fur engineered
sysicins,ser,item 22,"Engineer's calculations."
1) Beam calculations.Provide two sets of calculations using current code design vtdues for all beams and multiply joists
over Irl feet lung and/or any beam/joist carrying it non-uniform load.
20 Manufactured floor/roof truss design details. _
21 Energy Cole compliance.Identify the prescriptive path or provide calcul tions. A gas-piping schematic IS required
for four or more appliances.
22 Engineer's calculations.When required or provided,1 ,bear•vall,roof truss)shall ho tamped by an engineer or
architect licensed in Oregon and shall he shown to hr,ily lu,illy to the projrrt under res w\k
23 Five(5)site plans are required for Item I I above Site plans mist he 8 112' x I I .a I I" x I _
24 Two(2)scIs each are required for Items 16, 19,20 K 22 above.
25 Building pill's shail not contain red lines or tape-ons. "Mirrored"building plans will he not accepted.
26 "Reversed"building plans must meet criteria outlined in the fem'it&c System Ue\elopmcnt Fees document.
27 "Drown to scale" indicates standard architect or engineer scale.
28 Site plan to include tree size,type&d location per approved project street tree plan(if applictible),and COT Strect Tree List.
Checklist must be completed before plan review start date, Minor changes or notes on submitted plans mai be in hluc or black ink.
Red ink is reserved for department use only. '"14h14( A10WOMI
CITY OF TIGARD 24-Hoar
BUILDING Inspection Line: (503) 639-4175
MST
INSPECTION DIVISION Business Line: (503) 639-4171 _
_
BLIP
Received -- _-- _ _ _ -- Date Requested -"7_,!i_ AM--- -- PM --__-_ SUP
Location —_—�_` � --r' --__. Suite _-_- -- MEC
Contact Person _ _-_ _-_ -�- Ph PLM
Contractor _ Ph(—__ —) _--_ SWR -
BUILDING Tenant/Owner -- ELC
Footing ELC _
Foundation Access:
Ftg Drain AV- /l e _ `" ELR
Crawl Dain —
Slab Inspection Notes:/' QYL SIT
Post&Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/ShearFraming
Insulation
Insulation
Drywall Nailing - - _—
Firewall
Fire Sprinkler -------. - ---_-�
Fire Alarm
Susp'd Ceiling ----------- -
Roof
Other:
i
APARTFAIL
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
Final Reinspection fee of$ required before next inspection. Pay at City Hall, 13125 SW Hail Blvd.
PASS PART FAIL
SITE Please call for reinspection RE: — A E] Unable to inspect-no access
Fire Supply Line
ADA
Approach/Sidewalk Data -_.-._ Inspector
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL
SEE 35MM
ROLL # 20
FOR
OVERSIZED
DOCUMENT
41 no
Qua[ Spic:''
Process: Peron: _
Weld Desc: * - --
moi. - • .... •' M
Material: - - - – . . t•�- - . .
Filler: Thickness: WELDER CERTIFICATION -
Remarks: Cert. No.0-1785
Qual. Spec:
Welder: ADELBERT BAILEY Process: Position: SS#: 544-04-4798City of Portland Expiration Weld Desc: P n Date. 04-08-03
Material:
Filler: Thickness !
Weld r Sig ature Date
Remarks: •
CTI Authorized Signature 04/1 002
WELDERS RECORD OF EMPLOYMENT Carlson Testing, Inc.
FIRM: � , • - Tigard, Oregon (503) 684-3460•
SUPERVISOR: See Reverse Side for Qualification Data
Apri�oine
---__. PHONE:_ _ • ,
FIRM: ; Ckiel. s'poc. AWS Dt.t-vo ' _ •�. "' v
SUPERVISOR: Process: FCAW Position- G
July-SeptemPHONE: Weld Desc: VEE:-GROOVE
FIRM:
Material: A-36 SUPERVISOR: Filler: E71T-1 Thi s: 1/8 TO 3/4
October-Decemb,or PHONE: Remarks: BACK NG REQUI
FIRM:
SUPERVISOR:
PHONE: Qual. Spec:
Process: Position: '
Weld Desc:
Material: ,
Filler Thickness:
- - •-- ,�...... �_ �.�, �,� ;� Remarks. i
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STEEL COLUMN AND BOLTING DETAILS
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Specifications
t Spread Footings
��' • base footings on approved firm, compacted, inorganic soil
N v extend footings 1 '0" minimum into the soil
Wood footing forms shall be removed after use.
Expanded metal footing forms shall remain in ground .
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bars No. 5 and larger. ASTM A615, grade 60
bars No. 4 and smaller: ASTM A615, grade 40
Concreteprotective over or reinforcement:
r concrete cast against earth: 3"
concrete exposed to earth of weather: 2 "
LIABILITY
The City of Tigard and its Minimum compressive g days: � p
9 �� ess�ve siren th F'c at 28 da � �. 2,. 00 psi
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employees shall n Use of fly ash or other pozzolans shall be permitted
_�..��_�._ ._.... _._ r_._........,..,_.._ _... . .. .�.... of be
responsible for discrepancies Use no calcium chloride in any concrete
which may appeal- herein. Steel
Steel to conform to AISC Manual of Steel Construction
Furnish steel with rust inhibiting coating .
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PERMIT NO. C/f`
it scope of work.
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1 . remove 4 existing wood columns supporting 2�� floor
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All , / 0V),! �lo�� t•� ,t Gate ��_L..• .".�..aZG
sy. 3. install new spread footing under each steel columns
VOLUNTARY REPLACEMENT OF WOOD COLUMNS
► 9690 SW RIVERWOOD LANE, TIGARD, OR 97224
OCTOBER 2002 scale as noted
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