Permit 7,
q ®Y �' � ® MASTER PERMIT
PERMIT #: MST2008 00151
COMMUNITY DEVELOPMENT DATE ISSUED: 10/27/2008
4 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DD
SITE ADDRESS: 09660 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 LOT: 101 JURISDICTION: TIG •
PROJECT: STEVENS
Project Description: 256 sf. covered porch.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ALT HEIGHT: FIRST: sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: N
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: DWELLING UNITS: THIRD: sf RIGHT: 5
VALUE:
OCCUPANCY GRP: BERM: BATH: TOTAL: 0 sf 4,828.16 REAR: 15
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 <100K1 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 FDR: PUMP /IRRIGATION: PER INSPECTION: CO
ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 151 W/O SVC /FDR: 1 SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: N e . _ 4441 k
MANU HM /SVC /FDR: ' 601 - 1000 amp: 601.amps-1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
OCti Reconnect only:
> =4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY O •
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT: q'
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL: V I
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL M SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR Specialty Codes and all other applicable
JOEL STEVENS OWNER laws. All work will be done in accordance with approved plans. This
9660 VENTURA CT permit will expire if work is not started within 180 days of issuance. or
TIGARD, OR 97223 if the work is suspended for more than 180 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 -0010
through 952- 001 -0080. You may obtain copies of these rules or direct
Phone: 503- 293 -6896 Contact #: questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Reg #:
TOTAL FEES: $ 272.60 .
REQUIRED ITEMS AND REPORTS
•
O P ....dab
Issued By . j`' - _ Permittee Signature : �',
Call 503.6 ��
5 by 7:00 a.m. for an inspection that • • -ss day.
This permit card shall be kept in a conspicuous place on the job sit= completion of the project. •
Approved plans are required on the job site at the time • each inspection.
•
a -CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2008 -00151
COMMUNITY DEVELOPMENT DATE ISSUED: 10/27/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DD-09300
SITE ADDRESS: 09660 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 LOT: 101 JURISDICTION: TIG
PROJECT: STEVENS
Project Description: 256 sf. covered porch.
BUILDING
REISSUE STORIES• FLOOR AREAS REQUIRED SETBACKS REQUIRED
of
CLASS OF WORK. B� HEIGHT. FIRST sf BASEMENT. sf LEFT: 5 SMOKE DETECTORS: N
TYPE OF USE. SF FLOOR LOAD. SECOND sf GARAGE. sf FRONT 20 PARKING SPACES .
TYPE OF CONST• DWELLING UNITS. THIRD sf RIGHT. 5
VALUE q 626 16
OCCUPANCY GRP• BDRM. BATH. TOTAL. 0 sf REAR 15
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: BOIUCMP < 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 FDR: PUMP /IRRIGATION PER INSPECTION
EA ADD'L 500SF 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT. PER HOUR
LIMITED ENERGY 401 - 600 amp: 401 - 600 amp. EA ADDL BR CIR: SIGNAL/PANEL. IN PLANT.
MANU HM /SVC /FDR• 601 - 1000 amp: 601+amps- 1000v: MINOR LABEL.
1000+ amp /volt •
PLAN REVIEW SECTION
Reconnect only:
0=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 8 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 6 SYSTEMS.
This permit Is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR Specialty Codes and all other applicable
JOEL STEVENS OWNER laws All work will be done in accordance with approved plans This
9660 VENTURA CT permit will expire if work is not started within 180 days of issuance, or
TIGARD, OR 97223 if the work is suspended for more than 180 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 -0010
through 952- 001 -0080 You may obtain copies of these rules or direct
Phone: 503 293 - 6896 Contact #: questions to OUNC by calling 503 246 6699 or 1 800 332 2344
Reg #:
TOTAL FEES: $ 272.60
REQUIRED ITEMS AND REPORTS
Issued By . ___;-_,, - / Permittee Signature :
,40
Call 503.6 • .4 5 by 7:00 a.m. for an inspection that usi ss day.
This permit card shall be kept in a conspicuous place on the job sit u completion of the project.
Approved plans are required on the job site at the time each inspection.
, Building �it Applicatio>h 4 " C
Residential �o FOR OFFICE USE ONLY
Received r — Permit N o '
IN q City of Tigard D ate/B (� .��
13125 SW Hall Blvd., Tigard, 0,0 , �`\ )) Plan Review _
O Phone 503 639 4171 Fax 503. ' :1 .1 1 Q l Date/By 10. 2 -2. 0 Other Permit
TI G n R D Inspection Line 503 639 4175 C� w�V Date Ready/By Ions ® See Page 2 for
Internet www tigard -or gov O � VW "�`0 Notified/Method idp—� / , Supplemental Information
.V0 ` ��� s ,� T nl;(
TYPE OF ��N V REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑' molition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
IN Addition/alteration /replacement ❑ Other: equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ _ I , , r
Kl- and 2- family dwelling ❑ Commercial /industrial
❑ Accessory building ❑ Multi - family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 9 &C 0 sw V eiv, -t Lt" 4.„ c. .1- New dwelling area: square feet
City /State /ZIP: Tt Q u�d Q R / �9 '} 7-7- 3 l Garage /carport area: square feet
Suite/bldg. /apt. no.: J Project name: p . Po ht /-l�.fl ew Covered porch area: 2-5,6 square feet
Cross street/directions to job site: Deck area: square feet
V ern ! Lan ci. CA- . 3 o►A to u L. A., Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: 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.
/I I 1 G 4.A /_ I f� 0A) / P fr d Valuation: $
/'1 o C� �C T Y �'1 Existing building area: square feet
New building area: square feet
V( PROPERTY OWNER ❑ TENANT Number of stories:
Name: Jo e_ ( 5t o env, S Type of construction:
Address: 96,4 O stk.; 0 c.41+u a.— ci Occupancy groups:
City /State /ZIP: 'r. C �d O1 9,7 2.2 3 Existing:
Phone: (So3) 2 0 3 . 6 89 G Fax: (.9:03) z9 3 - L Z. $ New:
®. APPLICANT ❑ CONTACT PERSON NOTICE
Business name: sa„,,, e __ All contractors and subcontractors are required to be
Contact name: J c f eV Wl S. licensed with the Oregon Construction Contractors Board
` 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: O u) N CA — Joel stet./ en, ,S' BUILDING PERMIT FEES*
(Please refer to fee schedule)
Address: O I l 7
Structural plan review fee (or deposit):
City /State /ZIP:
Phone: ( ) Fax: ( ) FLS plan review fee (if applicable):
CCB lic.:
Total fees due upon application: alb 714
Amount received: c /- 7t
Authorized signatur This permit application expires if a permit is not obtained
within 180 days after it has been accepted as complete.
Print name: JO e . 5 tee1 e!M r Date: * Fee methodology set by Tri -County Building Industry
Service Board
I:\Building \Permits\BUP -RES PermitApp.doc 11/6/07 440- 4613T(I1 /02 /COM/WEB)
Building Permit Application Checklist ..
One- and Two - Family Dwelling FOR OFFICE USE ONLY
IN City of Tigard Received
DateBy Permit No
V 1 3125 SW Hall Blvd , Tigard, OR 9 7223 Associated permits
C Phone 503 639 4171 Fax 503 598 1960
24- Hour Inspection Line. 503 639 4175 0 Electrical 0 Plumbing ❑ Mechanical
T I G A R D Internet www ugard -or gov ❑ Other
THE FOLLOWING ITEMS ARE REQUIRED FOR PLAN REVIEW Yes No N/A
1 Land use actions completed. See jurisdiction criteria for concurrent reviews. ❑ ❑ ❑
2 Zoning. Flood plain, solar balance points, seismic soils designation, historic district, etc. ❑ ❑ ❑
3 Verification of approved plat/lot. ❑ ❑ ❑
4 Fire district approval required. Name of district: . ❑ ❑ ❑
5 Septic system permit or authorization for remodel. Existing system capacity ❑ ❑ ❑
6 Sewer permit. ❑ ❑ ❑
7 Water district approval. ❑ ❑ ❑
8 Soils report. Must carry original applicable stamp and signature on file or with application. ❑ ❑ ❑
9 Erosion control ❑ plan ❑ permit required. Include drainage -way protection, silt fence design and location of catch- ❑ ❑ ❑
basin protection, etc.
10 3 Complete sets of legible plans. Must be drawn to scale, showing conformance to applicable local and state ❑ ❑ ❑
building 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 plan location and details. Plan review cannot be completed if .
copyright violations exist.
11 Site /plot plan drawn to scale. The plan must show lot and building setback dimensions; property corner elevations (if ❑ ❑ ❑
there is more than a 4 -ft. elevation differential, plan must show contour lines at 2 -ft. intervals); location of easements
and driveway; footprint of structure (including decks); location of wells /septic systems; utility locations: direction
indicator; lot area; building coverage area; percentage of coverage; impervious area; existing 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, location of smoke detectors, water heater, ❑ ❑ ❑
furnace, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.
14 Cross section(s) and details. Show all framing- member sizes and spacing such as floor beams, headers, joists, sub- ❑ ❑ ❑
floor, wall construction, roof construction. More than one cross section may be required to clearly portray
construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings
and foundation, stairs, fireplace construction, thermal insulation, etc.
15 Elevation views. Provide elevations for new construction; 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 engineering standards:
17 Floor /roof framing. Provide plans for all floors /roof assemblies, indicating member sizing, spacing, and bearing ❑ ❑ ❑
locations. Show attic ventilation.
18 Basement and retaining walls. Provide cross sections and details showing placement of rebar. For engineered ❑ ❑ ❑
systems, see item 22, "Engineer's calculations."
19 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple joists ❑ ❑ ❑
over 10 feet long and/or any beam/joist carrying a non - uniform load.
20 Manufactured floor /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 provided, (i.e., shear wall, roof truss) shall be stamped by an engineer or ❑ ❑ ❑
architect licensed in Oregon and shall be shown to be ap to the .roject under review.
,TURISDICTIONAL SPECIFICS
23 Three (3) site plans are required for Item 11 above. Site plans must be 8 -1/2" x 11" or 11" x 17 ". ❑ ❑ ❑
24 Two (2) sets each are required for Items 16, 19, 20 and 22 above. ❑ ❑ ❑
25 Building plans shall not contain red lines or tape -ons. "Mirrored" building plans will not be accepted. ❑ ❑ ❑
26 "Reversed" building plans must meet criteria outlined in the Permit & System Development Fees document. ❑ ❑ ❑
27 "Drawn to scale" indicates standard architect or engineer scale. ❑ ❑ ❑
28 Site plan to include tree size, type and location per approved project street tree plan (if applicable), and City of Tigard ❑ ❑ ❑
Street Tree List.
29 Site plan to include trees and tree protection measures as required by conditions of approval. Tree locations, driplines, ❑ ❑ ❑
and protection measures must be drawn to scale and must include the project arborist's signature of approval.
30 A Clean Water Services' Sensitive Area Pre - Screening Site Assessment form is required for all building additions, ❑ ❑ ❑
including decks, patio covers (over non - impervious surface) and accessory structures to existing residential dwellings
on a lot of record approved prior to September 9, 1995.
I \ Budding \Permits\BUP- RES- PennrtApp doe 03/21/06 4404613T(11/02 /COM/WEB)
Electrical Permit Application FOR OFFICE USE ONLY
r � 1.i1 y of Tigard � Date Received By l i(� (f ermis No � rj �� r;—j 13125 SW all Blvd., Tigard, OR ' - Plan Review J f
C ' Phone. 503.639 4171 Fax: 503 5"131 o et(01 Date/By Other Permit
TI G A R D Inspection Line 503 639 4175 ‘ Q , ,Date Ready /By lure ® See Page 2 for Lv Internet. www tigard -or gov OC q \ ��, V fied/Method f Supplemental Information
TYPE OF WORK 0 `�` ` PLAN REVIEW
❑ New construction 0C Addition/alteratiole r ' • . / O P lease check all that apply (submit 2 sets of plans w /items checked below)
1 ❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: 9 1 where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
g 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ",
Job no.: I Job site address: 964 p 5 W Ve4,, tu".a o more R c r eatioy
❑ Six ix o or r moo more
residential units ❑eceational vehicle parks
City/State /ZIP:
Q 0 Health-care facilities Supply voltage for more than
�� 1 6-4 Q l� 1 / 7 Z Z 3 - ❑ Hazardous locations 600 volts nominal ,?'
Suite/bldg. /apt. no.: " Project name: ft, Oy 7 Ho M ci, ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description
qty. I Fee. I Total I •
e i New residential single- or multi- family dwelling unit.
Ve+1fu C•C ►n. I`., Q,/1 6 II A- L Al Includes attached garage.
Subdivision: Lot no.: 1,000 sq ft or less 145 15 4
Ea add'l 500 sq. ft or portion 33 40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq ft )
AI / Al mited energy, multi - family 75 00 2
/7 G0. Q� t° d �� O v �� residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
g. PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: J 0e) -I-
. 401 amps to 600 amps 160 60 2
`e'V e� r 601 amps to 1,000 amps 240 60 2
Address: '66 0 S 10 UQ_' j-L.tit,a a Over 1,000 amps or volts 454 65 2
City/State /ZIP: 17' ch QRN ci 7 Z Z 3 Temporary services or feeders installation, alteration, and/or
• relocation
P hone: ($p3) Z 13 . 6 g 114 Fax: ( 50)) 2 q 3 - t Z S1- 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 , or exchaneaccording to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: /A / 0 1 or A. Fee for branch circuits with
LICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6 65 2
Business name: B Fee for branch circuits
/ without service or feeder fee, r
Contact name: J O�1 S tec,e „, J first branch circuit 46 85 it ,
Address: Each add'I branch circuit 6 65 D/ 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90 90 2
Phone: dwelling, service and/or feeder
( ) Fax: ( ) Reconnect only 66 85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: C1
/e' Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension Describe. Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Phone: ( ) I Fax: Per inspection 62.50
( ) Investigation per hour (1 hr min) 62.50
CCB Lic.: I Electrical Lic.: 1 Suprv. Lic.: lndustnal plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal.
Plan review (25% of permit fee)
Print name: J ry G etJe4e) f Date: a
State surcharge (12% of permit fee)
Authorized signatur TOTAL PERMIT FEE —
- This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Building\Permits\ELC- PermitApp doe 05/23/06 440-4615T(I I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Buildmg\Permrts\ELC- PermitApp doc 03/23/06
Information Notice to Property Owners About
Construction Responsibilities Statement
Oregon Law requires residential construction permit applicants who are not licensed
with the Construction Contractors Board to sign the following statement before a
building permit can be issued. [ORS 701.055 (4)]
This statement is required for residential building, electrical, mechanical and plumbing permits.
Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need
not submit this statement. This statement will be filed with the permit.
Please check the appropriate box and complete the following statement:
X I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
FX I will be performing work on property I own, a residence that I reside in or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will contract with a
contractor who is licensed with the CCB and will immediately notify the office issuing this building
permit of the name of the contractor.
I have read and understand the Information Notice to Property Owners about Construction
Responsibilities contained on these two pages and I hereby certify that the information checked and
completed above is correct and accurate.
. rint . ame of permit aa,ppplicant : - ature of permit applicant
.Joel 5 TeuWt./
Date
Permit #: - Cr1 -�
This form is supplied to building .r G//,',/ /'�,
permit offices by the Oregon '-:=14-.51--N Address: ( °�6�� •�A /• / (..447-4 «4 O
Construction Contractors Board,
as required by ORS 701.055 (6) ' ` yy
Issued by: /3./ Date: /a //we
This copy to issuing permit office
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CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO.: i te - P7STAA)s - ' )tS /_.... 67
PLANNING DIVISION:
Required Setbacks: ❑ ❑ Not Appro e
Side: S Street Side: i
Front. G age: 30 Renr: _.« .
Visual
. l I r n : Approved No t A )ti
sua Clearance: a ce � pp ❑ r
pl
Maximum Building Height. 3 feet
CWS Service Provider Letter Required: ❑ Yes ? No
❑ Receivec
B): /914A. tfl-Ge Date: ia/io
ENGINEERIN 1" DEPARTMENT:
Actual Slope: 12. % Approved ❑ Not Approved
Site Pla .Approved ❑ of proved
By: Date: /D / 0S
Notes: cr1..c.4
CITY OF TIGARD - SITE PLAN REVIEW
BUILDING PERMIT NO: Lj , A At if
Street Trees: Approved ❑ Not Approved
Protected Trees: ( I Approved ❑ Not Approved
By: `4` ,,� 1 Date: y / y 0
•
v
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: M ST'2008 -Oa 61
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .�• 1I1.
INSPECTION WORKSHEET FOR DATE: 1/2770009 TIME: 7 :O0AM PAGE: .i
SITE ADDRESS: 09680 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: -10-1 TYPE OF USE:
PROJECT NAME: SrEVENS
DESCRIPTION: : s{ covered porch.
OWNER: STEVENS, JOEL PHONE #: 503 - 293.6096
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/27/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 080063 -01 9/1 -207 -4799 N
Corrections /Comments /Instructions:
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ADDITIONAL FEES ASSESSED
Inspector: 1 1 Date: Phone #: (503) 718 - 2436
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CITY OF TIGARD
. BUILDING DIVISION PERMIT #: MST2008-00161
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/20
Phone: (503) 639 -4171 .�i1
Inspection Requests (24 Hrs.): (503) 639 -4175 ' -_
INSPECTION WORKSHEET FOR DATE: 1/20/7009 TIME: 7:00AM PAGE: 1
SITE ADDRESS: 09660 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUAW' ESTATES NO LOT #: 101 TYPE OF USE:
PROJECT NAME: STEVENS
DESCRIPTION: 2"f. < covered porch.
OWNER: STEVENS, JOEL PHONE #: 603_293_6896
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/20/ ?009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
275 Framing 079BBF1/i -01 971.207 -4799 N
Corrections /Comments /Instructions:
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❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL r CALL FO INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: / Date: l / f/ Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: MST20013 -0Crl a
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/27/2008
Phone: (503) 639 -4171 AglidiA
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Inspection Requests (24 Hrs.): (503) 639 -4175 6__:.
INSPECTION WORKSHEET FOR DATE: 12/31/2006 TIME: 7:00AM PAGE: 6
SITE ADDRESS: 09660 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASI T ON SQUARE ESTATES NO LOT #: 101 TYPE OF USE:
PROJECT NAME: STEVENS
DESCRIPTION: 256 sf_ covered porch.
OWNER: STEVENS, JOEL PHONE #: 503 - 293 -6096 I
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12/31/2008 Pour Time: 2:00
Code # Inspection Description Confirm # Contact # Message
X05 Footing 079314 -01 971- 20741799 Y
Corrections /Comments /Instructions: CALL, 41 ikt■ �
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Ti FAIL ❑ CALL FOR INSPECTION ❑ AD DITIO AL ( '. ES ASSESSED
b. ti ) 1 Ins e ctor Date: ( Phone #: (503) 718- 2 A
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