Permit ' CITY OF TI MASTER PERMIT
P ERMIT #:4IST2000 -0024
. i
A 1 DEVELOPMENT SERVICES DATE ISSUED: 8/10/00
"L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 11325 SW 90TH AVE PARCEL: 1S135DB -00300
SUBDIVISION: TIGARDVILLE PARK ZONING: R -4.5
BLOCK: LOT: 002 JURISDICTION: TIG
REMARKS: ADDITION AND REMODELING •
• BUILDING
REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 12 FIRST: 729 sf BASEMENT: sf LEFT: 29 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: sf GARAGE: sf FRONT: 20 PARKING SPACES :
TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: 32
VALUE: $ 60,000.00
OCCUPANCY GRP: R3 BDRM: 2 BATH: 2 TOTAL: 729.00 sf REAR: 30
PLUMBING •
SINKS: 1 WATER CLOSETS: 3 WASHING MACH: 1 LAUNDRY TRAYS: 1 RAIN DRAIN: TRAPS:
LAVATORIES: 3 DISHWASHERS: 1 FLOOR DRAINS: 0 SEWER LINES: SF RAIN DRAINS: 1 CATCH BASINS:
TUB /SHOWERS: 3 GARBAGE DISP: 1 WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES:
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: 4 CLOTHES DRYER: 1
GAS FURN > =100K: UNIT HEATERS: HOODS: 1 OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: 4 WOODSTOVES: GAS OUTLETS: 1
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 1 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 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: $ 1,369.80
LE & DOMNICA GHITA OWNER This permit is subject to the regulations contained in the
VASILE Tigard Municipal Code, State of OR. Specialty Codes and
11310 S S W 9 9 0TH H AVE all other applicable laws. 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 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
Rea #: 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.
�g ct — g1 f Lf REQUIRED INSPECTIONS
rosin Underfloor insulation Plumb Top Out Exterior Sheathing Ins[ Electrical Final
Footing Insp Crawl Drain /Backwater Electrical Service Low Voltage Mechanical Final
Foundation Insp Footing /Foundation Dry Electrical Rough In Gas Line Insp Plumb Final
Post/Beam Structural PLM /Underfloor Framing lnsp Insulation Insp Final inspection
Post/Beam Mechanical Mechanical Insp Shear Wall Insp Rain drain lnsp Building Final
�"� n L7/
Issued By : Permittee Signature : - �'/ �� I�
Call (50 639 -4175 by 7:00 p.m)for an inspection needed the next business day
F: 3o - 3, `3c)
2- $i' 2
s '�r Plan Check #
CI " T` ' . Or` �1GARD Residential Building Permit Application
131' SW HALL BLVD. Additions or Alterations Recd By ZE
Date Rec'd -- ` O 7/3%
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E.
V 503 - 639 -4171 Date to DST , - y
F 503 - 684 -7297 Permit # frKi,9 -u o 4
Print or Type Called
Incomplete or illegible applications will not be accepted
71 yarI ui //z p/G --6✓
ame of Project Name
Job m odel c - � ► 41.�v�, � � �- '1:20 ,du 1-eS(z !
Address Site Address � ,� %� , 0 cd 9 I Q. Architect Mailing Address t ay
Ii32S iiiVVV �D- q
U City/State Zip hone c i
Rame A- SiL a OMN►CA- �rH1 "7' 1 rou d t� �� /7(96 n:� -( i - 75"
Name
Owner Mailing Address .fk
9e3 /Cs S'1lJ 9D Ue,
Engineer Mailing Address
Cit /Slate Zip Ph ne g
ri b -RQ q7 U - J-_, —
City /State Zip Phone
General Name
VA - S(LE 6- Hl / t1 �� —
Contractor (�.{� Descr work New 0 Addition 0 Alteration 0 Repair 0
Mailing Address 4� _ e done: A-d o1/ 4-r en. Cyr 0e ( 10 19(IP f,U►4 7
Prior to permit / / 3 1 0 Sul ` 71— Additional Description of Work:
issuance, a copy City /State x,11 Zip ,-Phone
eta
f
of licenses t 6 - Al2.2 , q7 ? j �5fl3) - �0vZ&r
are required if Oregon Const. Cont. Board Exp. Date PROJECT - - 4 00 06
expired in COT Lic.# VALUATION $\ . - -
database
Mechanical Name -� -NEW CONSTRUCTION ONLY:
Sub- MC() CH I 1 EA /f 0 Sq�Ft. House: 11.3 684 Sq. Ft. Garage
Contractor Mailing Address �/
Prior to permit 53 N V' J ,a (--. ,, .r e;"" Indicate the restricted energy installation by the electrical .
issuance, a copy City /State Zip Phone subcontractor in the following areas
of all licenses 7 rY' 7 /O ( 1 7,2.21 531- 7 gg?, Restricted Audio /Stereo
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms
expired in COT Lic.# cip, 8 q,a q,0 Installations Vacuum Irrigation
database "„--- - System System
Plumbing Name ' 1 ) (check all that Other:
Sub- OW ry . i apply)
Contractor Mailing Add— Corner Lot YES NO Flag Lot YES NO
(check one) (check one)
Has the Subdivision Plat recorded? N/A YES NO
Prior to permit City /State Zip Phone
issuance, a copy .
of all licenses are Oregon Const. Cont. Board Exp. Date
required if Lic.# I hearby acknowledge that I have read this application, that the
expired in COT
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
' Oregon State laws.,,
Name j C� • na
Siture o f O /Agent ► ' / / Date
Electrical \/L tek, fl c z/ i 1 1 i tro
Sub- Mailing Address V - ,q �a '�,/ Contact Person Name� �/� Ph ne #
Contractor I3 10 WE 'tic? t-t. ( R� Q- ' �Oa�O
City /State CA-AM-5 Zip'qn p Vhone 3 ( 0 — 33 - .20e9 1
Prior to permit D V - 1 x'1 1 9 7 c, 3 0
issuance, a copy I ` d 3 3- FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: Map/T
required if Lic.# DH JEL'�v1A - / - 6030 C
expired in COT fit'c, a) ((80 7 3 i0 ffri / 35 ' !/
database Electrical Lic. #1 d80 7 3 Exp. Date Setbacks: Zone 7
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF:
` jr t.PPL , aq , 3g j ( i:\dsts\forms\sfaddalt.doc 11/20/98
\I
7
Permit #: RSrAD - d 006,
A/ .
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� . �_F�'.,. Address: / /3v� � Sc) l 0 ..49-1/--- F •: Irv. o
'
Issued by: Date:
I 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:
1. I own, reside in, or will reside in the completed structure.
ICI 2. I understand that I must register anstruction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is
I (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
N . 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 onstr ction Responsibilities on the reverse side of this form.
—
i I/ ' - 8 111 pO
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
linfoRmeAorn Hefts to Pvoperty Ownevs
• About ConstrucUon ResponslibMas
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 acing 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.
EEPLOY ER RESPON3PBCUT5ES:
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 structute, you will, in most instances, be ruled to he an employer and the people
you hire will be employees. As the employer, you rniist comply with the following:
Oirepn's cy;'.;ils'Llok.:Ing 'sax llav As an employer, you must withhold income taxes from employee wages at the time employees
are paij. 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.
Unempktyment in.surarce lax; 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.
DirkeIrs° czciper.S01151E if2a2Tance: As an employer, you are subject o the Oregon Workers' Compensation Law, and must
obtain workers' compensat:on insurance for you employees. If you fail to obtain workers' compensation insurance, you may
be subject to penalties aid 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.
lInternaii Revenue Sr: Ar 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.
017, ClEspomelaiduTHES /AND ARE/, OF CONCERN:
Cee'!e 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 proc,erty 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.
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 „2 000. UCH 51(
24 -Hour Inspection Line: 6Z 175 Business Line: 639-1 1
BUP
Date Requested % D — ' 9 T AM PM BLD
Location / J 3 1-," ?o ' ` Suite MEC
Contact Person J rc 4 c -h U'f C� Ph , 2_c 9 q PLM
Contractor � ' , 44, Vea e_,LJ Ph SWR
BUILDING Tenant/Owner r1. ELC
Retaining Wall ELR
Footing
Foundation / `'�1 FPS
Ftg Drain \�(
Crawl Drain Inspection es: / . n SGN
Slab ot I �J �� �� /Ch's' ► SIT
Post & Beam
7
Ext Sheath /Shear
Int Sheath /Shear .
Framing
Insulation
Drywall Nailing -AIL 1 .—
- - ` .. , . . V` G c, r
Firewall __ /r�
Fire Sprinkler %�•f Ind - 1 APP, ,-s) A (4 C / .•,,� ;4-) - /.1 7e9,('s t;14,
Fire Alarm
Susp'd Ceiling `�-�-1L 5 i , V
t ° s'7 0 cP.P r;6- , G /- C. /)O,/
Roof / f C pv y� C , it % te,
Misc: L ( f ' I � �-C� � �G a
Final
PASS PART FAIL (6`))- I 7Ee7 r 1 ,, r) / • �2 /C &CFp P'E
PLUMBING
Post &Beam _ , t
Under Slab 0�n r rdow Sa �- 11'Sc9_ e- A 6 ( C?
Top Out L./ e
Water Service ,( tr1,1 e l f0 r% rV-e �ir
Sanitary Sewer
Rain Drains cs9 _ A, Air e_ r1 ^ -7 I ,-,,= 1rr_
Final - •
PASS PART FAIL - ,N Jur ile - , - d .4."''' rT9
MECHANICAL
Post & Beam ra 7 '/' 4 1 =7Y r `,, S ; kl. I.. r5 ('
Rough In
cv
Gas Line _ -LA C - L= [_.
Smoke Dampers I ) C .? 7y :A 4 r �
Final 1/4.--- r s
PASS PART FAIL n ( ^ . c ( �t C-�,,, .G C - - cr� -�-,,�
ELECTRICAL J ' J
Service 7-(-- t n/- .,,
Rough In
UG /Slab '0" /]/ ,1 � 7 - ) r/7 L , ' •� e-iP JS . S /r /p r",� �74-
Low Voltage
Fire Alarm IF c'' jO 4 d2 L C / F `/ L cD c�7 7 in c"_
(Fin. P. j ?
S > ► PART FAIL //'I SIrlE ,/ �"f�7 S/c_<<°- 2 rwz /' ZR.2(:/' R
Backfill /Grading - — C. �� ., fr-.
Sanitary Sewer
Storm Drain [ I 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 ()r6. , / 0/ Inspector 4,N c e p a Ext
Final V ,/ t�
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
•
CITY OF TIGARD BUP DING INSPECTION DIVISION ,
MST ; •
24 -Hour Inspection Line: 64, ,75 Business Line: 639 -41
• BUP
Date Requested AM PM BLD
Location 7/ 3 j-5 ?(- 01_ A-0-e.- Suite MEC
Contact Person Ph f ZQ PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain 6 w r 9 'RP v >� SGN
Crawl Drain Inspection 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
Rain Drains
ART 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 [ I 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 / J //0 / �)1 / J Ze -fv-L.
Other Date Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
■
CITY OF TIGARD BUILDINGANSPECTION DIVISION c T �/
D
24 - Hour Inspection Line: 639 - 4175 Business Line: 639 - 4171 MST g
BUP
Date Requested AM PM BLD
Location f 1 3 Z � 12 Suite MEC
Contact Person Ph w 1-0 86 9 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access: •
Foundation b � FPS
• Ftg Drain 1m
VV SGN
Slab
Crawl Drain Inspection Notes: /1 3/ 0 Fo SIT
Post & Beam c.��11[/1Lf
Ext Sheath /Shear
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm I
Susp'd Ceiling �
Roof /f
Misc:
iii
PAS PART FAIL
PLUMBING
Post & Beam -
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS —PART FAIL
IffECHANJ At
- Post & Beam
Rough In
Gas Line
Smoke Dampers
CFin�
BASS' 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 12---5 i Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.