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Permit , _ ' • L.------- / MASTER PERMIT CITY OF TIQARD / �� ` ~�� K �� PRIM. PERMIT #. : MST90-0103 , COMMUNITY DEVELOPMENT K� E0�' DATE ISSUED: 10/01/90 13125 SW Hall Blvd. P.O. Box oouor. Tigard, Oregon oru23poo 639-4175 bi|L oDDKLbb...: 1��.516 yw 100tH PARCEL: 2S102CD-03700 SUBDIVISION....: SHILO ZONING: R-4 5 � .... . BLOCK..........: LOT.............:6 ---------------7---------------- BUILDING -------------------_--_---_ REISSUE: DWELLING UNITS:0 BASEMENT.... . .'. . . . :0 sf CLASS OF WORK.:ALT BEDRMS:0 BATHS:0 GARAGE..........:0 sf � TYPE OF USE...:COM FLOOR AREAS---------- REQUIRED SETBACKS---------- TYPE OF CONST. :5N FIRST,,.. . . : 144 sf LEFT,... :5 ft RIGHT. :48 ft - OCCUPANCY GRP.:B2 SECOND...:0 sf FRONT.:7 ft REAR..:23 ft STORIES.......:1 THIRD....:0 sf REQUIRED------------------- HEIGHT........:12 ft TOTAL------:144 sf SMOKE DETECTORS.: FLOOR LOAD....:40 psf VALUE.....$: 900 PARKING SPACES..:0 . Remarks: --------------------------------- PLUMBING ------------------------------------ SINKS..........:3 FLOOR DRAINS....:1 BACKFLOW PREVNTRS..:0 LAVATORIES.....:0 WATER HEATERS...:0 TRAPS..^...........:0 TUB/SHOWERS....:0 LAUNDRY TRAYS...:0 CATCH BASINS.......:0 WATER CLOSETS..:0 SEWER LINE <ft).:0 GREASE TRAPS.......:0 DISHWASHERS...0:0 WATER LINE (ft).:0 OTHER FIXTURES.....:0 GARBAGE DISP...:0 RAIN DRAIN (ft).:0 WASHING MACH...:0 SF RAIN DRAINS..:0 --------------- MECHANICAL -------------- ---------------- FEES -------------- FUEL TYPES----------- UNIT HTRS..:0 type amount by date recpt /ELE/ / / VENTS .....:0 PAYM $ 16.80 JLH 03/18/90 204890 MAX INPUT:0 BTU VENT FANS..:1 BPRT $ 16.00 / / FURN < 100K ..:0 HOODS......:1 BPLC $ 10.40 / / FURN >=100K ..:0 WOODSTOVES.:0 B5PC $ 0.80 / / FLOOR FURN....:0 CLO DRYERS.: 0 MPRT $ 17.50 /. / BOIL/CMP < 3HP:0 OTHER UNITS:0 MPLC $ 4.38 / / GAS OUTLETS:0 M5PC $ 0.88 / / Owner: ---------------------------------- PPRT $ 30.00 / / RONALD BROWN P5PC $ 1.50 / / 13930 SW 100TH AVE PAYM $ 64.66 JLH 10/01/90 TI8ARD OR 97224-0000 Phone #: 503-620-4365 Contractor: -------------- --------- OWNER/CONTRACTOR Phone #: Reg #..: OWNER ------------ ------------------ $ 81.46 TOTAL This permit is issued subject to ihe regulations contained in the ------- REQUIRED INSPECTIONS ------- Tigard Municipal Code, State of Ore. Specialty Codes and all other Underfloor insul Plumb Final applicable laws. All work will be done in accordance with approved PLM/Underfloor Building Final plans. This permit will expire if work is not started within 180 Mechanical Insp Erosion Control days of issuance, or if work is pen Plumb Top Out Insulation Insp ___________________ Permittee Signature: Gyp Board Insp _________ ..... _______ Water Line Insp _____ I ssued By _______ �__.________________ Mechanical Final _____________._____ Call for inspection - 639-4175 . � . o F O Permit No: � . �s< �1; 0 Address: � ','�1.'e`�a:: ` Z Issued by Date: �85g FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. 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 box 1 and either box 2A or 2B: 1. 15.�/A I own, reside in, or will reside. in the completed structure. 2. A. I I. My. '.general contractor is _ , Contractor registration number . I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. .(1 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 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 of this form. , Al Alt 01 4.i1X Sig -ture of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 \ WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT . ©s • - 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 15 :,1 with ORS 701.055(5), passed by the 1989 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' Compensa- tion Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, 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, calf 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 informa- tion, 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 b.rought,.to your :attention through inspections. Liability and Property Damage - insurance: Contact your insurance 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 to: Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310 -0151 Phone 503- 378 -4621' 0244J 10/24189 /t1 r -ore /G 3 C fl OF TI EA RD z t PINCK �_ � ��x'r # % ' ^ ..-4171 PEST 1 COMMUNITY DEVELOPMENT DEPARTME • 11 DATE ISSUED JOB ADDRESS: /�- 9� ,5 /00 TAX MAP /tar .2.S /- .3loa SUB: . _____ A. LAND USE: VALUATION: OwNER / sP�L NOTES NAME: OVA /d I/ ' 4V dr N c, RE�7E OF: ADDRESS: �-? qc ,__5 G.. • /OO ' /1 - ?.9" 1(>1,E''d - HOOD PLAIN / SENSTr1VE LAND: PHONE: r-,2 a -?r.' APPROVALS REQUIRED CONTRACTOR PIANNING: Cr — g(9 V NAME _ - IItfJG: ADDRESS FIRE DEPT OME R . PHONE: WENS RD ED BUILDERS BOARD I: EXP DATE: LIST/ • BUS TALC. ARCH /ENGINEER CATCL TATI(]S: NAME' TRUSS DE AILS: ADDRESS: . OIL: PHONE: STS: / /-2 ` l — fi iOo 90 -0o /R PIy: - Maw: P.E T I AO= I DESCRIPTION /1 5JQo. ct 10-432 00 T Armor PD. BAL. DOE Building Permit Fees / ao G,.-/t 9.60 10 -431 00 Plumbing Permit Fees 3U, av 30 . c 6' 10- 431.01 Mechanical Permit Fees / ? • f' 10 -230 01 State Building Tax (mss) ,� - Building o, t C Plumbing /.So Meth 8i 10-433 00 Plans (iiedC Fee /44 8 /0 . at Building /a. (ill Plumbing Meth 1/ .3 Y 30-202 00 Sewer Connection 30-444 00 Sewer Inspection 51-448 00 Street System Dev Charge (SDC) 52-449 00 Parks System Dev Charge (PDC) 31-450 00 Storm Drainage Syst Dev Chrg (SSDC) - - • 10-230 06 Fire ., ' — smug it S° All A►If ,;` -,..ikld APPLI•i. SI r. • _ • _• ved. By: Date Rived: 9 - /7 9 .ef /3587P_WPF GRADING /EROSION CONTROL INFORMATION GENERAL CONTRACTOR NAME & ADDRESS: CASEFILE NO.: PERMIT NO.: APPLICANT NAME AND ADDRESS: EXCAVATION CONTRACTOR NAME & ADDRESS: OWNER NAME AND ADDRESS: TELEPHONE NUMBERS: APPLICANT: PROPERTY DESCRIPTION: OWNER: STREET ADDRESS AND CROSS STREET/LOCATED GENERAL CONTRACTOR: EXCAVATION CONTRACTOR: SITE/JOB: LEGAL DESCRIPTION: 24 HR/AFTER HOURS EMERGENCY TAX LOT NO.: CONTACT PERSON, TITLE, TELEPHONE: 1/4 SECTION: SITE SIZE, ACRES: DISTURBED/WORK AREA, ACRES: LOCATION & ADDRESS WHERE SPOILS LEAVING SITE WILL BE TAKEN SITE RUNOFF DRAINS TO: (CIRCLE ONE) (NOTE: PERMITS MAY BE REQUIRED) CATCH - BASIN DITCH PIPE CREEK (CIRCLE ONE) PRIVATE PROPERTY PUBLIC RIGHT OF WAY EROSION /SEDIMENTATION CONTROL (ESC) MEASURES MINIMUM ESC REQUIREMENTS MINIMUM ESC REQUIREMENTS DURING CONSTRUCTION: FOLLOWING CONSTRUCTION: SEDIMENTATION FACILITIES STABILIZE EXPOSED SURFACE STABILIZED CONSTRUCTION ENTRANCE REMOVE AND RESTORE TEMPORARY ESC PERIMETER RUNOFF CONTROL FACILITIES CLEARING AND GRADING RESTRICTIONS CLEAN AND REMOVE ALL SILT AND DEBRIS COVER PRACTICES ENSURE OPERATION OF PERMANT FACILITIES CONSTRUCTION SEQUENCE OTHER OTHER PLAN FOR EROSION CONTROL PREPARED AND SUBMITTED IN ACCORDANCE WITH 'TECHNICAL GUIDANCE HANDBOOK ". EROSION CONTROL PLAN DRAWING, AS REQUIRED. HAS PLAN CONSTRUCTION NOTES COMPLETE. INCLUDING EMERGENCY PHONE NUMBER, SCHEDULE /STAGING FOR INSTALLATION AND REMOVAL OF EROSION CONTROL MEASURES, AND APPLICABLE STANDARD NOTES. I HAVE READ AND WILL COMPLY WITH THE ABOVE AND WILL CONSTRUCT AND MAINTAIN ESC MEASURES AS NECESSARY TO CONTAIN SEDIMENT ON THE CONSTRUCTION SITE. OWNER SIGNATURE APPLICANT SIGNATURE OFFICIAL USE ONLY. RECEIPT DATE ACCEPTED FEE NUMBER RECEIVED BY CITY OF TIGARD 13 SW HALL BLVD. PLUMBING PERMIT - P. O. BOX 23397 Appf aunt hold Oregon Registration to conduct a plumbing TIGARD, OR 97223 busuncss of must be prope tyowncr /operator not hiring outside help_ (503) 63 9 —4175 Narts. of Development Plumbing Permit No_ Address pescnptron • ORS 814-21-810 OUAN. PRICE AMT_ Job Tax trot Map- No. _ Address • FIXTURES Lot Clod( Subs Sink 750 Lavatory 750 INS Name (ex torus of-business) ) 750 _ - - Tub ot7rbtStsoe�etCorrrb- 1111111 TAadinq JLddtess Shower Only 730 750 11.111 At - Water Closet 750 Owner CKy7Stale Dishwasher Phone Garbage Disposal 750 in Washing IAad'ine - _ - - -750 Name - Floor Drain 750 IIIA Phone Heater 750 �t Laundry Roam Tray 730 0001Pant Y iv - - Utiaal 7 30 OlLsetFodures(Speoily� 750 Narwe -ro 750 . MaiGg Address Phony 750 750 Contractor y e Zip MISCELLANEOUS _ City Bus_ Tax No_ Sewer 1st 100 - ' 30-00 15.00 sewet�a M�a 100' _ State � - Board No. State Plumbers Bus, >,c No. 2oAo - ar Wale -Semi:a 1st t Water Servioeea.Aa6a2�s - 1500 I hereby acknowledge that I have teed Ibis application_ that �� 3000 - given is correct that I am regisieredIvah the State Build•ses Board. and also - Stasss a Rein Drain 1st 100 have a State Pkarrbtng %cease that the raurrbacc given are correct that ail - 15.00 _ plumbing work veil bs bottom; in a000cdsnos with applicable p� d res gon O - Sloan &Prt OtainAdcfit 100" Revised Statutes Chapters K7 and 693 and applicebto codes and that IAoba. Home Space will be employed unless loomed unsdet ORS 603- (U exempt from Back sow Prevention below). Oer,ioe 7.50 • no help Stat. nooestra6oh. please give HOMEOWNERS — «'� h malty I am the varier of the property do DO~O°otMG ion sorbed above_ atwtidsbcallorsf propose b make aPkwmbtr'QInstallation Sor Any TmPotwastsNot /clown 7.50 yown use a this property la 'dittoing constructed for safe. tease orient. Connected so a Facture Catch Bas4s 750 asp_ of Ede- insp. Plumbing 40_00 Per H 5pecxaIt r- - y Requested V'cd0fa _ 4000 Per Hr. Rain Drain, 1500 . m . . single rata- Ovlq_ Date . AUTHORIZED SIGNATURE a lterntinnon 0 CI - _ Describe vrork new 0 ed6rtiorr 0 I IQ be done residential f 3 �l n_ II - MINIMUM PERMIT FEE 25. edstSna use of SUB —TOTAL c --ti 5% SURCHARGE MB or m ope 25% PLAN REVIEW bu�°rpipsRY NOTICE TOTAL 57) 'Ms peont beoor nee riAl end void If tacit or oohs niction ag.dx tied la not Dom- - TrWnoed within 1t0daya ,erroonetriXowsor work +s.baper dedocabandoned foc a period of 180 days .i any time .2 .r`work is aor minosd- tct'ECinl_ OOHOfl1OK3 by - -__ -- OeRe issued INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 972 Inspection Line (Rec- O- Phone): 639 -4175 Business Phone. 639 -4171 Inspection: �ugh-i �\ Footing Plbg. Underslab (Mech. Ro Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing -Bldg. Post /Beam Mech. Rain Drain Insulation - Plumb. Plbg. Underfloor Water Line Gyp. Bd. -Mech. lI l Date Requested: II I IC D Time: AM PM Address: .701 1 �� D l / TYNE Permi / # CW - f 1 2- 7 41 Builder: - 76" , f7" -44 V D tt ■r 2-q ? 6 LP THE FOLLOWING CORRECTIONS ARE REQUIRED: Inspector: Date: 'r/ 'Cr C/ O ---V\ APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department 13125 SW Hall Blvd. Tigard, Oregon 97223 Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: _ Footing Plbg. Underelab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing Post /Beam Mech. Rain Drain Insulation - Plumb. Plbg. Underfloor Water Line Gyp. Bd. Date Requested: 7 fd Time: AM 1( PM Address: /393 O /On v.- Permit #: 9 c)/ a3 Builder: THE FOLLOWING CORRECTIONS ARE REQUIRED: �5�N Cc ,e T/c c, 1"cG Inspector: 1 I — `( - 1 Date:/2- V APPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinap. INSPECTION NOTICE City of Tigard Building Department 1 13125 SW Ball Blvd. Tigard, Oregon 97223 Inspection Line (Rec- O- Phone): 639 -4175 Business Phone: 639 -4171 Inspection: _ Footing Plbg. Underslab Mech. Rough -in Appr /Sdwlk Found. Plbg. Top Out Gas Line FINAL: Post /Beam Struct. San. Sewer Framing -Bldg. Post /Beam Mech. Rain Drain Insulation Plbg. Underfloor Water Line Gyp. Bd. -Mech. Date Requested: //-11f / ' ' Time: � AM PM Address: 1-3950 Itl) ) di Permit #:`� � / d3 Builder: TBE FOLLOWING CORRECTIONS ARE REQUIRED: 41 Ii ` Inspector: Date: /AA , A PPROVED DISAPPROVED APPROVED SUBJECT TO ABOVE Call For Reinsp. INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639 -4175 Type of Inspection -/ Date Requested f'.30 �2 a� — �� Time A.M. J P.M. Address /3 /60 Pe / wit # / Owner Lot # Builder The following Building Code deficiencies are required to be corrected: Presented to / Approved Inspector ❑ Disapproved Date (v /Z / ( CALL FOR REINSPECTION ❑ YES ❑ NO INSPECTION NOTICE City of Tigard Building Department P.O. Box 23397 Tigard, Oregon 97223 Phone: 639 -4175 Type of Inspection Date Requested /D �y � Time A.M. Address / 3 3 0 /O G '' m P e Permit # 0 3 Owner Lot # Builder The following Building Code deficiencies are required to be corrected: 7 7 //m 4 " ov g el ° Presented to XI Approved Inspector ❑ Disapproved Date /7 L CALL FOR REINSPECTION Z C YES ❑ NO View comments for selected item UaMASTER PERMITaaaaaaaaaaa aaaa asaaaa aaaaaa aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa0 o :MST90 -0103: PROJECT:SHILO : STATUS:F : UPD:11 /15/90: :GES: ° • PERMITTEE:RONALD BROWN PRIM..:MST90 -0103: ° ° SITE ADDRESS:13930 SW 100TH ° Ua CASE HISTORY aaaaaaaaaaaaaaaaaaaaaaaaReq/ SentaSchd /DueaEnd /DoneaaByaStataaa o A007 Application received / / ° o A010 Plan check deposit paid 09/18/90 JLH PASS ° o A020 Plan check by / / 09/28/90 RT PASS ° o H A030 Check for prcl. restrict. 09/28/90 09/28/90 RT PASS ° o A092 (F) Issue combination permit 10/01/90 JLH PASS ° o A717 PLM /Underfloor 10/19/90 MS FAIL ° o A717 PLM /Underfloor / 10/24/90 MS PASS • A722 Plumb Top Out C Y 11/14/90 MS PASS ° o A740 Insulation Insp '1 10/29/90 TLP PASS ° • A745 Gyp Board nsp Q ' 10/30/90 TLP PASS ° ° A760 Water L' sp ` V / / ° o A795 Mectla • 1 Final 11/14/90 TLP PASS ° o A797 P1 i al ° A799 Bui ding Final 11/14/90 TLP PASS ° • A970 Case Finaled 11/14/90 TLP PASS ° aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaai HISTORY: VIEW UPDATE DELETE ESC View comments for selected item NMASTER PERMITaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaa0 o :MST90 -0103: PROJECT:SHILO : STATUS:F : UPD:11 /15/90: :GES: ° o PERMITTEE:RONALD BROWN PRIM..:MST90 -0103: ° o SITE ADDRESS:13930 SW 100TH ° Ua CASE HISTORY aaaaaaaaaaaaaaaaaaaaaaaaReq/ SentaSchd /DueaEnd /DoneaaByaStataaa4 ▪ A007 Application received / / ° • A010 Plan check deposit paid 09/18/90 JLH PASS ° o A020 Plan check by / / 09/28/90 RT PASS ° o H A030 Check for prcl. restrict. 09/28/90 09/28/90 RT PASS ° o A092 (F) Issue combination permit 10/01/90 JLH PASS ° o A717 PLM /Underfloor 10/19/90 MS FAIL ° o A717 PLM /Underfloor 10/24/90 MS PASS ° • A722 Plumb Top Out 11/14/90 MS PASS ° o A740 Insulation Insp 10/29/90 TLP PASS ° o A745 Gyp Board Insp 10/30/90 TLP PASS ° o A760 Water Line Insp / / ° o A795 Mechanical Final 11/14/90 TLP PASS ° o A797 Plumb Final / / ° o A799 Building Final 11/14/90 TLP PASS ° o A970 Case Finaled 11/14/90 TLP PASS ° asaaaaaaaaaaaaaaaaaaaaaasaa AAdAAaaaaaaaaaaaaaaaaaaaaaaaaa aaaaaaaaaaaaaaaaaaaai \e CY)