Permit •
,� CITY OF TIGARD MASTER PERMIT
.' 'i'- COMMUNITY DEVELOPMENT Permit #: MST2011 -00080
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/02/2011
'TIGARD Parcel: 2S114BCO3500
Jurisdiction: Tigard
Site address: 10318 SW RIVERWOOD LN
Subdivision: RIVERVIEW ESTATES NO.2 Lot: 72
Project: Levear
Project Description: Foundation repair
BUILDING
Floor Areas Required Setbacks Required
Stories: 0 Bedrooms: 0 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0
Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke
Dwelling Units: 0 Third: 0 sf Right: 0 Detectors:
Total: 0 sf Value: $7,500.00 Rear: 0
PLUMBING
Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0
Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0
Drains: 0
Tubs /Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: ' 0 Ice Maker: 0 Hose Bib. 0 Backwater Value: 0
Other Fixtures: 0
Drywell- Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0
Heat Pump: N Hoods: 0 Other Units: 0
Furn <100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0
Furn > =100K 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less: 0 0 -200 amp: 0 0 -200 amp: 0 W/ Svc or Fdr: 0
Ea add9 500 sf: 0 201 -400 amp: 0 201 -400 amp: 0 W/O Svc /Fdr: 0
Mfd Home /Feeder /Svc: 0 401 -600 amp: 0 401 -600 amp: 0
601 -1000 amp: 0 601 +amp- 1000v: 0
10004-amp/volt: 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio & Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ALT SF VB R -3 0
Owner: Contractor:
LEVEAR, SIMON AND KAREN CONCRETE LIFTING SOLUTIONS LLC Required Items and Reports (Conditions)
10318 SW RIVERWOOD LN PO BOX 4614 1 Structural Observation
TIGARD, OR 97224 TUALATIN, OR 161279
PHONE: 503 - 330 -5101 PHONE: 503 -595 -5110
FAX:
Total Fees: $352.83
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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through 01.: 952- 001 -0090. You may obta' a . •r e rules • direct questions to OUNC by calling 50 2 .1987 or 1.800.332.2344.
Issued By: / / /�L_ «._ «/ -'
Permittee Signature:
. _
C. •.4175 by 7:00 a.m. for the next available inspection date.
This permit card s a be kept in a conspicuous place on the job site until completion of the project.
. Approved plans are required on the job site at the time of each inspection.
Building Permit Application — e PED
Residential i -- FOR OFFICE USE ONLY
City of Tigard MAY 1 2 2411 RDeceorved , ffir :/�/ permitNo.: g t I — OV
Er
13125 SW Ilan B Tigard, OR 97223 Plan Review t
Phone: 503.718.2439 Fax: 503.598.19 i ���'� Other Permit:
CITY QF TIUA'� Date/B
T 1 GAKD Inspection Line: 503.639.4175 �' G �, r D ate Read : Jur s: ® See Page 2 for
Internet: www.tigard-or.gov
BUILDING DIVISION Notified/Method: I ( / — Supplemental Information
v. , PE OF WORK ^. % t t.
0 New construction ❑Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
❑ Addition /alteration /replacement ® Other: Repair equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRE {CTIO\ work indicated on this application.
Ell- and 2- family dwelling ❑ Commercialiindustrial Valuat $7,500
❑ Accessory building ❑ Multi- family Number of bedrooms: nc
El Master builder ❑ Other
: Number of bathrooms: nc
JOB SITE INFORMATION AND LOCATION Total number of floors: 1
Job site address: 10318 SW Riverwood Lane New dwelling area: 0 square feet
City/State /ZIP: Tigard, OR 97224 Garage/carport area: N/A square feet
Suite/bldg. /apt. no.: Project name: Covered porch area: N/A square feet
Cross street/directions to job site: On SW Riverwood between SW 103" and SW Deck area: N/A square feet
Bonanza Other structure area: N/A square feet
Subdivision: Rverview Estates No. 2 Lot no.: 72 Permit fees* are based on the value of the work performed.
Tax map /parcel no.: 2S114BCO3500 Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and,the profit for the
DESCRIPTION OF IA ORk work indicated on this application.
Add 6 piers to support an existing single story addition to a single family Valuation: $
dwelling to correct past settlement. Lot is flat with no slope issues. Existing building area: square feet
New building area: square feet
G7' '' Z a '. � 4
1.� ❑ TENANT Number of stories:
Name: S 1 M•0 P44 Leo 6 Avt- Type of construction:
Address: 10318 SW Riverwood Ln Occupancy groups:
Y >� s: P
City/State/ZIP: Tigard, OR 97224 Existing:
Phone: ( 503) 330 S i 0 1 r-ay:( ) New:
' ' ' ' �� ® CONTACT PERSON 1 BUILDING PERM! F FEES"
'. (Please refer u fee schedule),
Business name: Zarosinski Engineering & Design, Inc.
Structural plan review fee (or deposit):
Contact name: Dean P. Zarosinski PE
Address: 1400 NW 155 Circle FLS plan review fee (if applicable):
City/State/ZIP: Vancouver, WA 98685 Total fees due upon application:
Phone: (360) 513 -2746 Fax: : ( ) Amount received 1 0 7 Pd
E -mail: dzaro@zaroenv.com � �`�� t � w � l� s z � -
Commercta . d residential CON TRACTOR ial prescriptive installation of
roof - top moon PhotoVoltaic Solar Panel S s em.
mess name: Concrete Lifting Solutions Submit two (2) se f roof plan with co on details
�(j , and fire department ac _ alon: : i the 2010 Oregon
1C Address: 7110 SW Fir Loop Suite 120 Solar Installation Specialty . a e checklist.
� City/State /ZIP: Portland, OR 97223 Permit Fee (incl • .c plan r w $180.00
+ and • • strative fees .
\ f� J fj Phone: (503) 595 -5110 Fax: ( ) State su .. ge (12% of permit fee): $21.60
CCB 1k.: 161279 W3
otal fee due upon application: $201.60
Authorized signature: " r/ f This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: Dean P. Zarosin • PE Date: 5/12/11 * Fee methodology set by Tri- County Building Industry
Service Board.
I: \ Building \Permits\BUP- RESPermitApp.doc 02/ 24/2011 440- 4613T(11/02/COM /WEB)