Permit •
CITY OF T MASTER PERMIT PERMIT #: MST2000 -00069
�, J DEVELOPMENT SERVICES DATE ISSUED: 03/29/2000
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 09425 SW 70TH AVE PARCEL: 1S125DA -10400
SUBDIVISION: PP1994 -061 ZONING: R -4.5
BLOCK: LOT: 001 JURISDICTION: TIG
REMARKS: Construction of 20' x 20' detached carport.( 400sq.ft) Carport is to utilize existing driveway.
BUILDING
REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ACS HEIGHT: 12 FIRST: sf BASEMENT: sf LEFT: 22 SMOKE DETECTORS:
TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: 400 sf FRONT: 23 PARKING SPACES :
TYPE OF CONST: UNK DWELLING UNITS: FINBSMENT: sf RIGHT:
VALUE: $ 5,080.00
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB/SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: 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'LINSPECTIONS
1000 SF OR LESS: 0 • 200 amp: 0 • 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 • 400 amp: 1st W/O SVC /FDR: 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:
>=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY
A. SF RESIDENTIAL 8. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & 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 # SYSTEMS:
Owner: Contractor: TOTAL FEES: $ 326.11
This permit is subjed to the regulations contained in the
WOLLANDER, JON ADAM OWNER Tigard Municipal Code, State of OR. Specialty Codes and
9425 SW 70TH AVE all other applicable laws. All work will be done in
TIGARD, OR 97223 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 taw requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set
Reg #: 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
Footing lnsp
Framing Insp ORIGINAL
Rain drain lnsp
Final inspection
Issued By : 16. KR > � Permtttee Signature : /i ,� . af A
.. -
CaII (503) 639 -4175 by 7:00 p.m. for an inspection neede. the ext business day
I
CITY OP TIGARD Residential Building Permit Application Plan Check # 3 - /3 Z 2
1'3125 SW HALL BLVD. Additions or Alterations Rec'd By eV
Date Recd 6-4 'c=c)
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 3- - CO
V 503- 639 -4171 Date to DST 3 . / ) _ O ( )
F 503 -684 -7297 I I - Permit # M 5TP600 -00067
Print or Type 1 Called 1 / -7 -I - UV
Incomplete or illegible applications will not be accepted
Name of Project ame
Job CAQ.M(LT -- f)rerfk.cANKO
Address Site Address
Architect Mailing .dress
9 41.- SW 7 o City/State • Phone
ame
Op•w W81..a.P`klOVE. Name
Owner Mailing Address
94 Sw 1 O Engineer Mailing Add s
Ci
T i /State Zip Phone (rA( o.oe 91 2 Z, 3$\ Cb1So City/ -te Zip Phone
General Name _
Contractor 6 f.- N //t Describe work New 0 Addition tk Alteration 0 Repair O
Mailing Address to be done:
Prior to A CF�R OICI -- Za x Zo, •
issuance, a copy a copy CitylState Zip Phone
of all licenses So 90. c g.
are required if Oregon Const. Cont. Board Exp. Date PROJECT
expired in COT Lic.# VALUATION $
database
Mechanical Name NEW CONSTRUCTION ONLY: •
Sub- Sq. Ft. House: Sq. Ft. Garage
Contractor Mailing , •dress
Indicate the restricted energy installation by the electrical
Prior to permit
issuance, a copy City/State Zi. Phone s• •contractor in the following areas
of all licenses Rest •• - d Audio /Stereo
are required if Oregon Cons ' .nt. Boar. Exp. Date Energy System . larms
expired in COT ' : Installations Vacuum Irrigation
_ database System System
Plumbing Na•.e (check all that Other:
Sub- apply)
Contractor Mailing Add : - Comer Lot YES 0 Flag Lot YES_ NO
(check one) - (c : k one)
Has the Subdiv' -' • n Plat recorded? • • YES NO
Prior to permit City/State '. Phone
issuance, a copy
of all licenses are Oregon Const. C• . Board Exp. Date
required if Lic.# I hearby acknowledge that I have read this application, that the
expired in COT
database Plumbi ic. # Exp: sate information given is correct, that I a the owner or authorized agent
of the owner, and that plans sub ed are in compliance with
Oregon tate
Name S i t O , nerd; _ D�at�/
Electrical b 00
M ailing Addres Contact s•-/f
W o�.L.P<NJb 2 x381 - $tSo
Contractor
City/State Ph. • - •
Prior to permit H L r 9 Li -0cD C g
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Bo- • Exp. Date Plat 7 ' p 1 'jc required if Lic.# '/ 1 4qy -al e% / goo
expired in COT
database Electrical ' -. # Exp. D. etbacks: Zone: x
it y
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF:
P .� g: .q,,�.� I dl..,t..d,A, f.» r ri r 11-� is \dsts \forms\sfaddalt.doc 11/20/98
Wc"�u^4 W/ o-ttt a- P.^ • 8/p. 449
U M Sr/ '�
•
Permit #: AST 2 — Ce Zio
r 1‘10C •tJ �t
Address :
m ° Issued by. 1.--- Date: J -
1:59
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
i \ l„ El 1. I own, reside in, or will reside in the completed structure.
K W 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
ri 3A. My general contractor (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
ti .
3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that t above • • •, i r 1 ac; is orr :ct and that I have read and do understand the Information
Notice to P ert caner: ab s u /, / o ' esponsibilities on the reverse side of his fo m.
i --1,-t
(Signature of permit applicant) Date)
(White copy to issuing agency permit file,
pink copy to applicant)
Information Notice to Property Owners
About Construction Responsibilities
Note: This Information Notice to Property Owners about Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors .Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people
you hire will be employees. As the employer, you must comply with the following:
Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091.
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources
at 378 -3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may
be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information,,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1- 800 -829 -1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accident.> and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re -done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052,
503/378- 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop- own.pm4
1 /94
CITY OF TIGARD BUILDING INSPECTION DIVISION MST ?,m5_cion o9
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP
Date � R l equested /� 5/2i-4/ co AM PM BLD
Location I L1 2 S 7V j fie► Suite MEC
Contact Person CIGtat- Ph Sgl ' gi SO PLM
Contractor Ph SWR
UILDING Tenant/Owner ELC
all ELR
Footing Access: r, �
Foundation 0 F -F fl3 .) l AS 7'•erry FPS
Ftg Drain SGN
Crawl Drain Inspection Notes: /)„ n p foY Slab .X Jul SIT
Post & Beam ` ,^ ��1� ,� r ^ / ,� fo n /
Ext Sheath /Shear (((GGG 1 ` / L , r -k
a /Shear
ramm
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
c:
.7% S_. • ART FAIL
PL . = ING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
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
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date Z I G Inspector ]/V1 Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.