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Permit y CITY O TIGARD MASTER PERMIT PERMIT #: MST2000 -00132 A 4, ,il, DEVELOPMENT SERVICES DATE ISSUED: 2/16/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 09380 SW 74TH AVE PARCEL: 1S125DB-03300 SUBDIVISION: BOULEVARD HEIGHTS ZONING: R -4.5 BLOCK: LOT: 015 JURISDICTION: TIG REMARKS: 461 sq ft addition to home BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 10 FIRST: 461 sf BASEMENT: sf LEFT: 9 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 32 PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: 23 VALUE: $ 32,717.17 OCCUPANCY GRP: R3 BDRM: 2 BATH: 1 TOTAL: 461.00 sf REAR: 73 PLUMBING SINKS: WATER CLOSETS: 1 WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: 1 DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS: TUB /SHOWERS: 1 GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 1 CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: MAX UV: 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: 1 0 - 200 amp: W /SVC OR FDR: ,, Y3 PUMP /IRRIGATION: PER INSPECTION: EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: 1010' SIGN /OUT LIN LT: PER HOUR: LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT: MANU HMISVCIFDR: 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 B. 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: $ 811.59 This permit is subject to the regulations contained in the SETTLE, TERRY + SALLIE A OWNER Tigard Municipal Code, State of OR. Specialty Codes and 9380 SW 74TH AVE SIGNED RESPONSIBILITY all other applicable laws. All work will be done in TIGARD, OR 97223 FORM IN FILE accordance with approved plans. This perm it 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 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 Erosion 844 -8444 Underfloor insulation Plumb Top Out Insulation Insp Final inspection Footing Insp Underfloor insulation Electrical Service Rain drain Insp Building Final Foundation Insp Crawl Drain /Backwater Electrical Rough In Electrical Final Post/Beam Structural PLM /Underfloor Framing Insp Mechanical Final Post/Beam Mechanical Mechanical Insp • Shear Wall Insp Plumb Final . Issued i / - y : l� • 9 D1� �„ Permittee Signature : N_A..∎! / _ Call (503) 6 ' -4175 by 7:00 p.m. for an inspection needed the n: t busi , -s: day ) ��1 7 ' c7 Ikei-14--64 el_i_G-6 i CITY OFINGARD Residential Building Permit Application Plan Check# 0, z 13'125 Sa il HALL BLVD. ? Additions or Alterations Date Rec � .5 -- -v? -©d TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 5 " -a 0° V 503- 639 -4171 Date to DST .5^ 8 .-(;O F 503- 684 -7297 774---- Permit# mSf�uUO -ovl37 Print or Type Called Incomplete or illegible applications will not be accepted • Nampof Project Name Job 5 E 7 E Architect M Address r Address sitTtddress q 380 SW 1y AU E City /State Zip Phone Name TEMy 4 SfiLLXE SETTLE Name Owner Mailing Address 9380 514) "N AVE City /State Zip Phone Engineer Mailing Address PORT Lildt, On e246 -38'!J City /State Zip Phone General Name Contractor TEeRY SETTL E Describe work New 0 Addition Alteration Repair .° Mailing Address to be done: Prior to permit • Additional Description of Work: /1OU E NOtT4 MvlyLC 0 F issuance, a copy City /State Zip Phone LsysNG RDO!1 41- 3' 10 No tTH 4 / 60 ! it of all licenses are required if Oregon Const. Cont. Board Exp. Date PROJECT .q expired in COT Lic.# VALUATION $ 342,117, '',_ database „,,-,,,,=, � - �� . Mechanical Name NEW CONSTRUCTION ONLY: Sub- Sq. Ft. House: /� Sq. Ft. Garage - Contractor Mailing Address 7 "'' • Indicate the restricted energy installation by the electrical Prior to permit issuance, a copy City /State Zip Phone subcontractor in the following areas of all licenses Restricted Audio /Stereo are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms expired in COT Lic.# Installations Vacuum Irrigation database System System Plumbing Name (check all that Other: • Sub - art 6=813$ apply) Contractor Mailing Address Corner Lot YES NO Flag Lot YES NO (check one) (check one) X0 1 5k) C012laGtUS n113S 2A Has the Subdivision Plat recorded? N/A YES NO Prior to permit City /State Zip Phone issuance, a copy taus BMW OR 97iiza 4. 90 - 2 t •$ of all licenses are Oregon Const. Cont. Board Exp. Date , required if Lic.# expired in COT I () �t 31 8 3-.10 x - ,I v I hearby acknowledge that I have read this application, that the database Plumbing Lic. # Exp. Date �$ information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with 5 q/0 6 Oregon State laws. Name 4gnature Owner /Ag t Date Electrical ? 5-Z-06 onntac erson Phone # Sub- _ Mailing Address °LC�� y S.ssT�zE Vii, Contractor 730 - L8 City /State Zip Phone Prior to permit issuance, a copy FOR OFFICE USE ONLY: • of all licenses are Oregon Const. Cont. Board Exp. Date / required if Lic.# {� y i 5 5 � ` ' 3 o (� u r 11 expired in COT database Electrical Lic. # Exp. Date Setbacks: �,/ Zone: 5 Solar: rk I Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF: is \dsts \forms\sfaddalt.doc 11/20/98 • Permit #: '?'O -00 ( -i - DF A. ,A,..--.0 F - �` Address: 93 $(0 S F'/ /91/E `.-._ Issued by: Date: 1859 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 1. I own, reside in, or will reside in the completed structure. 4 1 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. I 3A. My general contractor is (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 F4] 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 the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. • S -f - 6 - 6 (S •.' •;' 't applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) , linforme.Nora Hadca to Property Owa_rs About Coco[ nesponsfibralas Note: This ;nfortnation 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 i construct a new home or rnake a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLUVER If you hire persons not registered with the Construction Contractors Board to do labor in constntcting or assisting in the constn.iction or improvemen t. of a residential structure, you will, in iTIOSi instances, be ruled to be an employer and the people you hire will be employees. As the employer, you most cornply with the following: Oregon's riiii:IY - POrleRig hay As an employer, you must withhold income taxes from employee wages at the time employees are paid. YOU will be liable for he tax payments evn if you dc.)n't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenue at 945-8091. Unemployment insurasicela;,.: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. Fo- .■ information, call the Oregon Employment Division at the Department of Human Resources at 378-3524. Workers compensation innurance: 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' Compensa■lon Division at the Department of Consumer and Business Services at 945-7888. U.S. Jin term]; Revenue Senrke.: As an employer, you mu-st withhold federal income tax from employees' wages. You will be liable for the tax payment ever: if yo didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040. 011-.F.ER RESPONSE .71ES 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 k mention through inspections. Liability and pro5;arty damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. Throe 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 I /94 Cr r .6 AD 24 -Hour BUILDING Inspection Line: (503)639-4175 0 06 INSPECTION DIVISION Business Line: (503) 639 -4171 ►1ST BUP Received Date Requested �1���,� AM PM BUP Location 3D 7 I�w �-- Suite MEC / r Contact Person � Ph ( ) `t' ' 3 ?1,5 PLM Contractor Ph ( ) SWR . ,, BUILDING Tenant/Owner ELC Footing Foundation ELC A ccess: • V Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear S Framing Insulation F ri P Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL D fl& `W / _ T `�� v\/ S bCCir PLUMBING S � � � L.l� 1 (•0 1 T-i V , I �17 I Post & S labm Under ab (� m 1\ ° nder l lr ``��/i 1 �C�1'� � ��Q,�,V 1,5 p► ,�,�1 ,\ ��J t�D Water C�06a YJ Ifi 04 CPQR, lU� )N s 1�� L i`" 1t Water Service Sanitary Sewer lc i? I _ G \10 & g - C A t1� �� A �/ Rain Drains JJ 9J la 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 A S PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. SITE E Please call for reinspection RE: E Unable to inspect — no access Fire Supply Line ADA l Approach /Sidewalk Date � J ✓ a 2 — Inspect - Ext Other: Final DO NOT REMOVE this inspection record fro the job site. PASS PART FAIL CITY OF TIGARD 24 - Hour BUILDING Inspection Line: (503) 639 -4 <lSPECTION DIVISION Business Line: (503)_639 -4171 M S _��)o - nom t �i� - 4-7 BUP Received Date Requested (" AM PM BUP Location 9 3 3D 7 '7 4 Suite MEC Contact Person Ph ( ) PLM • i Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing _ Foundation ELC Access: Ftg Drain - ELR - Crawl Drain _ Slab Inspection Notes: SIT Post & Beam • Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing _ s 1 Firewall Fire Sprinkler Fire Alarm ' i; i _� ®► - , Susp'd Ceiling ` - Roof Other: # 1 Final - It�y���'r�.d (9 / .. / / 1® PASS PART FAIL PLUMBING • Post & Beam Under Slab Rough -In - - - j` o Water Service ' Sanitary Sewer Rain Drains Pr Czae Catch Basin n /Manhole Storm Drain Shower Pan Other: _ Final PASS PART FAIL MECHANICAL Post & Beam Rough -In Gas Line Smoke Dampers Final - PASS PART FAIL ELECTRICAL - Rough -In UG /Slab Low Voltage // .z' -- "` (j0 .4-'( Fire Alarm • El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. A PART FAIL SI E El Please call for reinspection RE: ❑ Unable to inspect - no access Fire Supply Line � ADA i-- ,yd lY Ext �'- Approach /Sidewalk Date / / 0 ? _Ins pec t o r � G Other: ` � � Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL hi\ CITY OF TIGARD IILDING INSPECTION DIVISI ^N MST 00e oa /3 Z 24 -Hour Inspection Line: ''' -4175 Business Line: 63_ 0171 a / c� BUP Date Requested / — / AM PM BLD Location 93 D o 7g ` (i -ti`2 Suite MEC Contact Person -77--/AA8 tegt_Ph —3 S /c5 PLM r r Cont acto Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation 7 �J FPS Ftg Drain /6 y lo F er. - 7 SGN Crawl Drain Inspecti6n Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling . Roof Misc: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rai Drains i id Ogr PART FAIL ANICAL 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 Dat �' Ins 7 � Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 MST 2600 4.3g INSPECTION DIVISION Business Line: (503) 639 -4171 //' BUP Received Date Requested � / AM PM BUP Location FD 7 Suite � MEC ` Contact Person Ph ( ) A - 3 873 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing Foundation ELC Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler 420 Fire Alarm Susp'd Ceiling C Roof Other: ma ASS___MPART FAIL P L Post & Beam Under Slab AiD ikita ePiEf-2 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 Hall PASS PART FAIL SITE Please call for reinspection RE: Unable to inspect — no access Fire Supply Line ADA /1—/ � _ Approach /Sidewalk Date Insp ®ctor ' Ext Other: Final DO NOT REMOVE this inspection record from the job site. PASS PART FAIL