Permit CIIYOFTUG 411k
COMMUNITY DEVELOPMENT DEPARTMENT OREGON MASTER PERMIT
`nmsawlid Blvd. P.O. Box n3397.n*mm Oregon m7223(503)a39-41/a PERMIT # ^ MST92-0238
639-4171 DATE ISSUED: 10/20/92
EXPIRED SITE ADDRESS...: 09640 SW 74TH AVE ������W������ PARCEL: 1S125DB-03805
SUBDIVISION....: BOULEVARD HEIGHTS ZONING: R-4.5
BLOCK..... ^ LOT ^26
BUILDING --- - --
REISSUE: DWELLING UNITS:1 BASEMENT ^0 sf
CLASS OF WORK.:ADD BEDRMS:1 BATHS:2 GARAGE ^484 sf
TYPE OF USE...:SF FLOOR AREAS---- REQUIRED SETBACKS
TYPE OF CONST.:5N FIRST....:242 sf LEFT..:5 ft RIGHT.:20 ft
OCCUPANCY GRP.:R3 SECOND...:748 sf FRONT.:40 ft REAR..:30 ft
STORIES ...... .:2 THIRD :0 sf REQUIRED -
HEIGHT ^24 ft TOTAL :990 sf SMOKE DETECTORS.:Y
FLOOR LOAD ^40 psf VALUE $^ 54252 PARKING SPACES..:1
Remarks: ADDITION OF 990 SO FT LIVING AREA AND 484 SO FT ATTACHED GARAGE
- PLUMBING -
SINKS.. ..... :0 FLOOR DRAINS....:0 BACKFLOW PREVNTRS..:0
LAVATORIES ^2 WATER HEATERS. .1 TRAPS ^0
TUB/SHOWERS ^1 LAUNDRY TRAYS...:1 CATCH BASINS... .... :0
WATER CLOSETS,.:2 SEWER LINE (ft).:0 GREASE TRAPS :@
DISHWASHERS ^0 .WATER LINE (ft) .0 OTHER FIXTURES :0
GARBAGE DISP...:0 RAIN DRAIN (ft).:0
WASHING MACH...:1 SF RAIN DRAINS..:1
MECHANICAL -- FEES - ---
FUEL TYPES -- UNIT HTRS..:0 type amount by date recpt
/GAS/ / / VENTS :6 BPRT $ 298.00 JH 10/20/92 -
MAX INPUT:0 BTU VENT FANS :2 BPLC $ 193.70 JLH 10/13/92 232618
FURN < 100K ..:0 HOODS ~0 B5PC $ 14.90 JH 10/20792 -
FURN >=100K ..:0 WOODSTOVES. : 0 MPRT $ . 43.00 JH 10/20/92 —
FLOOR FURN..... :0 CLO DRYERS. : 1 MPLC $ 10.75 JH 10/20/92 —
BOIL/CMP < � HP:0 OTHER UNITS:1 M5PC $ 2.15 JH 10/20/92 -
GAS OUTLETS:0 PPRT $ 75.00 JH 10/20/92 -
Owner: P5PC $ 3.75 JH 10/20/92 -
PETER DE GROFF
9640 SW 74TH AVENUE
•
TI8ARD 97223
Phone #: 246-3811
Contractor:
OWNER
'
•
Phone #:
Reg #..: 00000
$ 641.25 TOTAL
This permit is issued subject to the regulations contained in the REQUIRED INSPECTIONS
Tigard Municipal Code, State of Ore. Specialty Codes and all other Foot/found Insp Insulation Insp
applicable laws. AD work will be done in accordance with approved Post/Beam Struct Gyp Board Insp
plans. This permit will expire if work is not started within 180 Post/Beam Meehan Rain drain Insp
days of issuance, or if work is sus mdy? more than 180 days, Plm/undslab Insp Mechanical Final
PLM/Underfloor Plumb Final
Permittee Signature: / � 0 4 � Mechanical Insp Building Final
/ Plumb Top Out Erosion Control
Issued By: ' Framing Insp Crawl Drain
. /� Call for inspection G30 4175
Review of our records indicate that you are the applicant
for permit number — co Z 3 R
at 9 Q S�J 7� �4 -tom
and that inspection activities have not been completed.
Due to the age of the project and lack of activity, the
permit is hereby expired by limitation as provided by
Oregon Specialty Codes. If you wish to continue activity
on this permit a new application and fees will be required.
If you have questions please call Hap Watkins, Inspection
Supervisor at 639 -4171 ext. 416.
`G A •R\'"' ''W— : ,
"� *
City of Tigard I'
Building Division APR I3'00 + = .. 0 :-. a t
13125 SW Hall Blvd. < i 1
Tigard, OR 97 OR J ? ; U.S. „R” POSTAGIw w
,,....,,, \lf1 q
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, , 6 Lynn T.. s
,, q �® 2123 , . melot Ct.
��^ 9 Po r . nd, OR 97225
■
7 .2 IIII3 IUIIftltl!!I!II!1I!I!!Ilt1 III)ll ItI!!iI!!iI
o F (: Permit No: M6T 4. 2— 02_35—
1 4. R* 4)tt` Address: q4 Ail) ) 7 .
tee_ - ..o
a . * '' -' a Issued by G �fiu Date: /a -2 2
1; 5g FOR OFFICE USE ONLY
• STATEMENT: ` .a
INFORMATION NOTICE TO PROPERTY OWNEIM :
.. ABOUT CONSTRUCTION RESPONSIBILITIES
- " Note: Oregon Law, ORS 701.055(4) , requires residential construction permit .
applicants who are not registered with the Construction Contractors Board to
sign thafollowing statement before the building permit can be issued. This state-
ment 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-applicable blanks,.and initial boxes 1 and. 2, .and .either•box 3A or 3B:
1. F771/4C . I own, reside in, or will reside in the completed structure.
. 2. 1 1. . understand that l must register as a construction contractor if the structure is sold
- or offered for sale before or upon completion. .
• 3. A.1 • I My .general .contractor is
Contractor registration number • .
I will instruct my general contractor that all subcontractors who work on the struc-
. ture must be registered with the Construction Contractors Board.
OR
1,
3. B. rfF� I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construc-
tion Contractors Board. If I change my mind and do hire a general contractor, I will .
contract with a contractor who is registered with the Construction Contractors Board
- and I 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 understand
the Information Notice to Property Owners about Construction. Responsibilities on the
reverse side o this form.
A P , ` / # -�k -9�
Signatur- of 'ermit Applicant,, , Date
.CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT .
INFORMATION NOTICE TO PROPERTY OWNERS •n
•
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);
passed . by the_ 1.989 Oregon Legislature.
•
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 Department of Revenue at 378 -3390.
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 DHR
at 378 - 3224.
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 DIF at 373 -7434.
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 221 -3960.
•
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 accidents and omissions such as falling tools, paint overspray, water damage from pipe punc-
tures, fire, or work that must be re -done.
Time 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 to: Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310 -0151 -
Phone 503- 378 -4621
0244J 10/24/89
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131 25 SW Hall Bwa. PLNCK /RECT # / � ^ � ag- 0?
CITY OF TAG 1'OBos23397 PERMIT # n15/92- 0.238
COMMUNITY DEVELOPMENT DEPARTMENT Tigard, Oregon 97213
(503) 6394171 DATE ISSUED
JOB ADDRESS: q640 .5 tk) 74 TAX MAP /LOT /51 25 D 8 - a 3Rd S
aU
SUB: R /P d �G+� �.o, y h �/ " LOT: LAND USE:
VALUATION: 5 , / 075c • z y„
OWNER �. _. SPECIAL NOTES
NAME: tPe +e Melani ( ° roif REISSUE OF:
ADDRESS: 9(a40 5 A) 7`\`W Avg LAST REISSUE:
ckarcc, q12:Z3 - 1116 FLOOD PLAIN/
PHONE: (5o3) 2.4(0 _ 3g I 1 SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: S T- PLANNING: 0/e9./e
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: OTHER: ?VG' 77F - `WC--
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS : - PLUMB: LIST /SUBCONTRACTORS: !�
MECH:? BUS TAX:
iOr ARCH /ENGINEER CALCULATIONS:
NAME: ReGL aec - niir911De t. ASSoC',--V tcl TRUSS DETAILS:
ADDRESS: PO. e7ox I S H.E"ri r)3t°n . OTHER:
PHONE: ( 2 46-=2.0qD
PROPOSED BLDG. USE: - se5i .eh��
COMMENTS: 'AAc i 6Y) = ci9D Ike (i>c s act fi ' g S=f 4/.5 5-3/47
APPLICANT SIGNATUR �1
Received By: � Date Received: /0 -
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
7)7st97-O 3 ' 10 -432 00 Building Permit Fees a t,$). v) .a
10 -431 00 Plumbing Permit Fees 7},' 7S;
10 -431 01 Mechanical Permit Fees �3. % � 413, Lv
10 -230 01 State Building Tax (5 %) -
Building I4/.90
Plumbing . :15
Mechanical AI;
7�
10 -433 00 Plans Check Fee aa4, y5 / q 3 `` /0. 7
Building /y3•7O
Plumbing
Mechanical jo.7,
10 -230 06 Fire
30 -202 00 Sewer Connection
30 -444 00 Sewer Inspection
25- 448 -02 Commercial TIF Fees
25- 448 -04 Industrial TIF Fees
25- 448 -06 Institutional TIF Fees
25- 448 -03 Office TIF Fees
25- 448 -01 Residential Traffic Fees
25- 448 -05 Mass Transit TIF Fees
52 -449 00 Parks System Dev Charge (PDC)
31 -450 00 Storm Drainage Syst Dev Chrg
(SSOC)
24- 445 -01 Water. Quality (Fee°in lieu of)
24- 445 -02 Water Quantity (Fee in lieu of)
TOTAL
nm /3587P.WPf