Loading...
Permit /°E g,emoriet• '72) geriarnrr ia@ 3z) Sys CITY TI ARD • MASTER PERMIT s/ /off PERMIT #: MST97 -00308 . DEVELOPMENT SERVICES DATE ISSUED: 10/3/97 ° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 16030 SW 103RD AVE PARCEL: 2S114BB - 15500 SUBDIVISION: RIVERVIEW ESTATES ZONING: R - BLOCK: LOT: 001 JURISDICTION: TIG REMARKS: Garage addition. Proposed driveway must not encroach into the visual clearance triangle. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 20 FIRST: 0 sf BASEMENT: 0.00 sf LEFT: 12 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 200 sf GARAGE: 500 sf FRONT: 0 PARKING SPACES : 0 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT: 0 VALUE: $ 28,910.00 OCCUPANCY GRP: R3 BDRM: 0 BATH: 0 TOTAL: 200.00 sf REAR: 45 PLUMBING SINKS: 0 WATER CLOSETS: 0 WASHING MACH: 0 LAUNDRY TRAYS: 0 RAIN DRAIN: 0 TRAPS: 0 LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0 TUB /SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: 0 GREASE TRAPS: 0 OTHER FIXTURES: 0 MECHANICAL FUEL TYPES FURN < 100K: 0 BOIUCMP < 3HP: 0 VENT FANS: 1 CLOTHES DRYER: 0 GAS FURN > =100K: 0 UNIT HEATERS: 0 HOODS: 0 OTHER UNITS: 1 MAX INP: 0 btu FLOOR FURNANCES: 0 VENTS: 0 WOODSTOVES: 0 GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 0 • 200 amp: 1 0 - 200 amp: 0 W /SVC OR FDR: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF: 0 201 • 400 amp: 0 201 • 400 amp: 0 1st W/0 SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR: 0 LIMITED ENERGY: 0 401 • 600 amp: 0 401 - 600 amp: 0 EA ADDL BR CIR: 0 SIGNAUPANEL: 0 IN PLANT: 0 MANU HM /SVC /FDR: 0 601 - 1000 amp: 0 601 +amps- 1000v: 0 MINOR LABEL: 0 1000+ amp /volt : 0 PLAN REVIEW SECTION Reconnect only: 0 > =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: 0 Owner: Contractor: TOTAL FEES: $ 498.21 This permit is subject to the regulations contained in the ABELL, WARREN + DEBORAH OWNER Tigard Municipal Code, State of OR. Specialty Codes and 16030 SW 103RD AVE all other applicable laws. All work will be done in TIGARD, OR 97224 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 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 Control Insp 8' Electrical Rough In Insulation Insp Building Final Footing Insp Electrical Rough In Gyp Board Insp Foundation Insp Framing Insp Misc. Inspection Mechanical Insp Framing Insp Electrical Final Electrical Service Gas Line Insp Mechanical Final Issued By : fil A . - Permittee Signature , /; O Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day )• Y CITY OF TIGARD MASTER PERMIT „de, ,{ DEVELOPMENT SERVICES PERMIT # • MST97 -0308 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 0� DATE ISSUED: 10 / 03 / 97 �® PARCEL: 2S114BB -15500 SITE ADDRESS...:16030 SW 103RD AVE �� SUBDIVISION -RIVERVIEW ESTATES NING: R -7 PD BLOCK LOT •001 JURISDICTION: TIG Remarks: Garage addition. Proposed driveway must not encroach into the visual clearance triangle. -- ---- -- BUILDING — — -- REISSUE: STORIES • 2 FLOOR AREAS — BASEMENT...: 0 sf REQUIRED SETBACKS - -- REQUIRED - -- CLASS OF WORK.:ADD HEIGHT • 20 FIRST • 0 sf GARAGE • 500 sf LEFT • 12 SMOKE DETECTRS: Y TYPE OF USE...:SF FLOOR LOAD • 50 SECOND...: 200 sf FRONT • 0 PARKING SPACES: 0 TYPE OF CONST.:5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT • 0 OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL------: 200 sf VALUE..$: 28910 REAR • 45 PLUMBING SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0 LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 -- -- -- - MECHANICAL — FUEL TYPES--- ---- -- FURN (100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 1 CLOTHES DRYERS: 0 GAS FURN ) =1001( ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 1 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 • WOODSTOVES • 0 GAS OUTLETS...: 1 - -_ ----- - ELECTRICAL — - ----_— --- -- RESIDENTIAL UNIT— — SERVICE /FEEDER -- —TEMP SRVC /FEEDERS— -- BRANCH CIRCUITS — - -MISCELLANEOUS -- - -ADD'L INSPECTIONS - 1m SF OR LESS: 0 0 - 200 amp..: 1 0 - 200 amp..: 0 W /SVC OR FDR..: 2 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 4. amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR . 0 LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 2 SIGNAL /PANEL...: 0 IN PLANT • 0 MANF HM /SVC /FDR: 0 601 - 1 ,' amp.: 0 601 +amps -1w v: 0 MINOR LABEL -10: 0 1m+ amp /volt.: 0 ---- -- — PLAN REVIEW SECTION -- - -- - - - -- - Reconnect only.: 0 ) =4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC: --- - - ---- ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL - ----- ---- -- - -- -- AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: OTH: .. BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK..........: INSTRUMENTATION: MEDICAL OTHR: •• HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL B SYSTEMS: 0 Owner: ----- - -- --- Contractor: - - - -- - ---- TOTAL FEES:$ 430.71 ABELL, WARREN & DEBORAH OWNER This permit is subject to the regulations contained in the 16030 SW 103RD AVE Tigard Municipal Code, State of Ore. Specialty Codes and all TIGARD OR 97224 other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is Phone 0: 624 -8076 Phone B: not started within 180 days of issuance, or if the work is Reg B..: 0''• suspended for more than 180 days. ATTENTION: Oregon law - - - -- ---- requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 -001 -0080. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -1987. -- - -- -- REQUIRED INSPECTIONS Erosion Contol Electrical Rough Electrical Final Footing Insp Framing Insp Mechanical Final Foundation Insp Insulation Insp Building Final Mechanical Insp Gyp Board Insp Electrical Servi , 'ain drain sp Issued By: J. r ��L .,,. Permittee Si gnat ure + + + + + + + ++ + + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + + ++ ++ + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day CITY OF TIGARD OREGON PROPERTY OWNER/OPERATOR APPROVAL FORM I, , being the true legal owner of the (Please Print) property located at (Go 3o S Tigard, Oregon give my approval for the current tenant, , residing at the above mentioned property, my permission to operate a business at this location in accordance with the City of Tigard's home occupation permit ordinance. /40 Owner /Authorized Representative's Signature Owner /Authorized Representative's Phone Number to 1 3 W Date Signed H:\LOGIN \DSTS \HOPOWNER • 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772 • - . CITY OF TIGARD MASTER PERMIT e �� f� DEVELOPMENT SERVICES PERMIT `° ° ° ° ° ° ° ° t1ST97- 2zr308 IflI DATE ISSUED; 0 tr 11/37 + L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 tt p PARCEL; a 2S1415 00 SITE r DDf ESS, .. 1G032? SW 102RD f'VE ® s ECTPTES �� ®.0N I hJ : R-7 PD JURISDICTION; TIC Redarks: Garage addition. Proposed dent: :ay oast not enc,-cach into the visual clearance triangle. --------------------- -- ------------- - -�- -- 9JILOIPIS REISOBEz STORIES.......: 2 FLOOR AREAS--- - - - --- 6ASE "£nT S sf REQUIRED SETBACKS -- REQUIRED CLASS OF HORK.:ACCD HEIGHT........: 20 FIRST....: 0 sf EARAGE • 580 sf LEFT..........: 12 S';Fii',E DETECTRS: Y TYPE OF USE...:SF FLOOR LOAD....: 50 SECOND...: 200 sf FRONT 0 ' PARKIN& SPACES: fi TYPE OF COI4ST. :5N DEELLINSS /TWITS: 1 FINBSHENT: 0 sf RIGHT . 4 OCCUPANCY SRP.:R3 BDRI:`: 0 BATH: 0 TOTAL- ---- -: 200 sf VALUE-S: 28910 REAR..........: 45 ---------------- -- - - -- ------ - ----- GLUNBING -------------- ---- -- ---- --- - -- SII�'1tS,,... °.,.: 0 EATER CLOSETS.: 0 WASHIt6 NACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS.........: 0 LAVATORIES..,.: 0 DISHNASSHERS...: 0 FLOOR DRAINS..: i SEHER LINE ft: 0 SF RAID! DRAINS: B CATCHY BASINS..: S TUB /SHOWERS... o G GARBAGE DISP..: 0 WATER HEATERS.: 0 EATER LIME ft: 0 BC1 {FU PREVNTR: 0 GREASE TRAPS..: 8 OTHER FIXTURES: 0 -- - - -- rECtuIyICAL -- _- ----__ _— _— __------ - - - - -- - -- FUEL TYPES----------- FURN ( 100( ..: 0 BOIL /CMA ( 3HP: 0 VENT FANS . 1 CLOTHES DRYERS: E GAS Fi RN ) =1 SX ..: 0 UNIT HEATERS-: : 0 MOODS... , .....: 0 DINER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS.........: 0 'NOCDSTOVES • 0 SAS CUTLETS...: B ________________ __-- __— .__..._ -- __— ._— __ - -_ -- ELECTRICAL -- RESIDENTIAL JNIT -- - -- SERVICE /FEEDER -- --TEA SRVC /FEEDERS— -- BRANCH CIRCUITS - -- --- MISCELLANEOUS - - -- —ADD'L INSPEC ?ICNS - 1000 SF OR LESS: 0 0 - 200 app..: 1 2 - 200 cop..: 0 E /SVC OR OR..: 2 P'UNA /IRRIGATION: 0 PER INSPECTION: 0 EA ABD'L 520SF.: . 201 - 4000 cop..: 0 201 - 428 cop..: 0 1st HID SVC /FDR: S SIGN/GUT LIN LT: 0 PER HOUR ° 0 LIMITED ENERGY.: 401 - 680 aop..: 0 401 - 628 cop..: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL..,; © IN PLANT..,...: 0 MANF HN /SVC /FDR: 0 681 - 1020 app.: 3 6001 +aaps -16,80 v: 0 MINOR LABEL -IS: 6 1000+ aop /volt.: 0 ------ ___--- .____.- _- .__._ —_— PLAN REVIEW SECTION - - -- - ______- Reconnect only.: 0 ) =4 RES EMITS..: SVC /FDR) =225 A,: ) 680 V NOMINAL: 0LS AREA /SRC OCC: --------------------------------------------------- ELECTRICAL - RESTRICTED ENEMY A. SF RESIDENTIAL ---------- - - - - -- B. CCNNERCIAL--____--------------------------------- AUDIO & STEREO.: JACUUM SYSTEM..: AUDIO 6 STEREO.: FIRE ALARN INTEROS l /PAGiNS: C' DSDR L ?DSC LT: BURGLAR ALARM..: 0TH: :: BOILER.,,.....,: HV'AC,,.......... LANDSCAPE /IRRJG: PROTECTIVE- SISdL: GARAGE OPENER..: CLOCK,.........: INSTRUNENTATIDN: KEEDICAL........: CTH'd: HVAC - DATA /TELE COMM.: NURSE CALLS--; TOTAL (# SYSTEMS: 2 Omer: ------------ ..— _----- ...- -Contractor: - - - - -- TOTAL FEES :8 420.21 ABEL, WARREN & DEBORAH CENER This permit is subject to the regulations contained in tha 16030 SE 103RD AVE Tigard Municipal Code, State of Ore. Specialty Codes anal all TIGARD OR 97224 other applicable laws. All work will be done in accordance with approved plans. This p €roit will expire if work is Phone O: 624 -8076 Phone .LL: not started uithin 182 days of issuance, or if the work is Reg R..: 66024.0 suspended for pore than 18S days. ATTENTION: Oregon law ...— - - - -- _---- ____ -____ --- - - -___ reycires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0310 t>±rough OAR 952 - 881 -0083. You ❑ay .obtain copies of these rules or direct crestions to LLNC by calling (513)246 -1987. - - - - - -- --- - - - - -- - -- REQUIRED INSPECTIONS ----- - - - -_— — _------ - ----- - Erosio: Contol Electrical Rough Electrical Final Footing Insp Framing insp Mechanical Final Foundation Insp Insulation Insp Building Final Mechanical Ir: Syp Board Insp Electrical Servi vin drain Tnsp e • Issued By:__ •_ P'arfittee Signature: — J -_ a.-i +-S• 7 r '` - : -•i-+ - 1 {•-- +-:--t -••I- .-•9 -#- -d-- -- r - - 1._ . •- .�...1-± i- ^:^--0--}• ? -- -f + : --3 �7 + 4•±-,- - F :. ;. a �. -t 4 f $ - •- -t :- - 6 Call 639-4175 by 6:00 p.m. . f'or° an inspection needed the next business day • Plan Check # I`) f ITYYOF T - Residential Building P ermit Application Reed By :12 SW HALL,BLVD. New Construction Additions or Alterations Date Recd - 7Pc IGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 7� - `17 503- 639 -4171 Oate to OST g • 4 1 ---5 7 503 -684 -7297 Permit # 7 ��// _..__ Print or Type Called Nrey 4 S Incomplete or illegible applications will not be accepted _ Name of Project - Name - Job 61a Atte_ �� �I �C a, I) 4 . 3 0■1 E Address site Address t - Architect Mailing Address I. � � \rteq ��- .�p�yfitI Ate,., City /State - - -- Zip Phone I�kz ► �� [iti mean._ Name Owner �Ma 61 r ess 5 r.. t c03 ♦ ItC d .. - - - City/State Zip Phog4e Enginee - Mailing Address . 7 kO TX 4 1722.4 " -S01‘ City /State Zip Phone Name ` - ` General QW pVr•/� Describe work New 0 Addition 0 Alteration 0 Repair O Contractor Mailing Address to be done: _ - - Additional Description of Work: - - - -- City /State -- - - -- Zip - Phone - -• - Oregon Const Cont. Board Lie# Exp. Date • - • Attach Copy of .._ ' • Current COT Business Tax or Metro 4 Exp. Date PROJECT Licenses . •. . . - VALUATION $ V...2* 9 Name / • Mechanical --- - ION / NEW CONSTRUCTION ONLY: - .-•.. - Sub- Mailing Address Sq. Ft. House: Sq. Ft Garage Contractor - - " - - Corner Lot YES NO Flag Lot YES NO City/State Zip Phone _ (check one) (check one) . - -- Oregon Const Cont Board Lic.4 Exp. Date Restricted Audio /Stereo Burglar Attach Copy of Energy . - - System - - Alarm Cur COT Business Tax or Metro 4 Exp. Date Installation Garage Door HVAC _icerrses Name _ Opener Systems a check all that Other: Plumbing / pPly) - • - Sub - Mailing Address - • Will the electrical subcontractor wire for all YES NO Contractor / restricted energy installations? _ City/State Zip I Phone Has the Subdivision Plat recorded? N/A YES N • Oregon Const Cont. Board Lic.4 I Exp. Date Reissue of MST#: Solar Compliance StYach Copy of (Calculation Attached) Current Plumping Lic. 4 Exp. Date I Nearby acknowledge that I have read this application, that the • Licenses - - - -- - COT Business Tax or Metro I Exp. Date information given is correct. that I am the owner or authorized agent of the owner, and that plans submitted are in compliance Name with Oregon State laws. Sigture of Owney ent �Iectrical O u�j�Z esr .„,c...— "ZS _�� Sub- Mailing Address on Name P one # Contractor - I t1/4l• C Lam-- gGO- t{,39g CityiState Zip Phone FOR OFFICE USE ONLY: Plat #: Map/TL# Oregcn Const Cont Board Lic.4 Exp. Date (— I 1 - 7--1 I q - iS - S6a -attach Copy of Setbacks: � I Zone: Current E!encal Lic. 4 I Exp. Date 0\k" ( t R - 7 l�- ct Licenses Engineering r y ng Approval: I Pla'nirpproval: TIF:� 1 .. COT Business Tax or Metro 4 I Exp. Date /\ I Ir�� )A` (v ° REMDL.DOC (DST) .3/97 Permit it Acct. Oescritpion COT WACO Amount Amt. Pd. Bal. Due - rr MST. Permit (BUILD) (UBUILD) j 8 �^ / � � : : { ft . Plumb. Permit (PLUMB) (UPLUMB) _ _ Mech. Permit (MECH) (UMECH) . 2,5 w - Z23 - ELC/ELR Permit -= ( ELPRMT) - ( UELPMT) la Gv . r.70, - - ` - " . - State Tax - . _.- --- : --- (-rte) < - (UTAX) -- 14:- lic • .._ . _ . _ _ _ • _ ,.- i BLDG:• _ q, _ _ —_ _ _ PLUMB: MECH: /. 2.,'' / .. . ._ . - -- ELC/ELR: - 2 _ -- - . ___ - . . _ . .- - Plan Check MST: _ _ (UBUPLN). - I 22,5 / Jt S -7 - ----- - E3°-- Plumb: (PLUMB) • ( UPLUMB) . Mech: - ___._._ ._. _.._.. _ . _.__ __ - --- (MECPLN) _ _- (UMEPLN) --- - • ... _. — ._ -_ _._.._— ..- �—_^ -__ • CDC Review (BUILD) (CDCBLD) _. (UCDC) - - CDC + Review (PLN) Y (COCPLN)_ ' t _ N/A : : 4 a - Sewer Cannon (SWUSA) (USWUSA) . S • , . _ Reimbur_ District - J_______ ) ( ) Sewer Inspection " (SWINSP) (USWINS) • . .�;( Parks Dev Charge . ' (PKSDC) N/A - - -- • • • - - - Residential TIF - - --,- (TIF -R) - -- - : - • (UTIF -R) _ _ _ . __ ____ _. _. • --- Mass Transit.TIF -- - : (TIF -MT) ---:. -- (UTIF -M) . - - .. • • - - . Water Quality (WQUAL) . (UWQUAL) - • Water Quantity - ( WQUANT) (UWQANT) Erosion Control Prmt (ERPRMT) (UERPMT) Erosion Planck/USA (ERPLN) (UERPLN) ? 7 e Erosion Planck/COT (EROSN) (UEROSN) " " Fire Life Safety -- (FLS) - (UFLS) r TOTALS: , �v. 2 L 42 S3 was 7. Lsr . ,�,ll I:SFREMDL.DOC (DST) 6/97 Permit #: k "ot I "( 7- 030 � y4 '6 103 A C. F ' Addres • 1O, • 4 Issue. sy: 1 _ CI, - : / Date: g-1/— .7 ..!...; 18 1 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. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. Ti 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 �1 /'� 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. J r"------ at i (17 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) TWormaMon Not5ct to Properly Owners About ConstrucUon ResponsfibElMes 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 RESPONSEOLCTES: 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. 1 Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and rrXist obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, yeti may he subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more inforrnatlon, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Enternal 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 MESPONSDSPLOTES 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 accident3 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 haAe aJdition'al questions, write or call the Construction Contractors Board. (PO Bo-X S-alei4QR 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 tf TII.ST GO 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested 6• Z AM d PM BLD Location /403() .5 3 K/ Suite MEC Contact Person Ph OlgO -371c( PLM Contractor Ph SWR BUILDING Tenant/Owner 7/PG jC Ca _04417 1.0v //•0-1 ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain 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 j Water Service Sanitary Sewer Rain Drains Final / PASS PART FAIL MECHANICAL . Post & Beam Rough In — Gas Line - Smoke Dampers Final PASS PART FAIL Service Rough In UG /Slab Low Voltage Fire Alarm 460 ART FAIL 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 Appro Z -- A6= - Z)( Appro Date J Other Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION MST cr',CD�..�g 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 4 �- „ / , 9 / C� - M �� 1 BLD BUP Date Requested fj(� `� ! AM !" PM Location 1(0 10 Suite MEC Contact Person Ph NO-3 I' PLM Contractor Ph SWR BUILDING Tenant/Owner ELC Retaining Wall ELR Footing Access: . Foundation / 6 FPS Ftg Drain ( 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 Final PASS PART FAIL Post & Beam Rough In Gas Line Smoke Dampers •Q' PART FAIL E CTRICAL 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 r Inspector . Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • 5� CITY OF TIGARD BUILDING INSPECTION DIVISIO 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST .G aS) BUP Date Requested 7'' 2 Z-- AM PM BLD Location / egos 5 ' /6 3r( Suite MEC Contact Person Ph O 37)' PLM Contractor Ph SWR �IILIIING -� Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing )q. / Co tVe Va Firewall .. Fire Sprinkler (( Fire Alarm Susp'd Ceiling /• e:3Z ' A r e Tr,'r ce / / .t.24.-- Roof Misc: °ASS PART FAI / BING r/ Post & Beam ` eG / �,rn . n ti/ x/7,74 fr r Under Slab 4 /�c�Y/ Crt / F /yi4. yec•/ G -A & -iD / /g4P Top Out Water Service /IVO 0.7 R 155 "e- S Sanitary Sewer Rain Drains Final PASS PART FAIL • (21/14. Post & Beam Rough In Gas Line Smoke Dampers ' Fi �' ' AS 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 I C 22 - / - - Other Date G Inspector i' Ext J4 2 Final ' PASS PART FAIL DO NOT REMOVE this inspection record from the job site. BUP - Building Permit ELC - Electrical Permit ' J Inspection Description Date Passed By -4 Inspection Description Date Passed By Footing /Setback Underground cover Foundation walls Wall cover _ Footing drain Ceiling cover Waterproof bsmt walls Electrical rough-in Slab Electrical service _ Crawl drain _ ,43- Electrical final (p PL 5 1 -&, Underfloor insulation Post /beam structural Shear walls /anchors ELR - Restricted Energy Permit Roof nailing 4 Inspection Description Date Passed By Firewall Low voltage Tilt -up panel Electrical final Masonry /Reinforcement Framing MFG - Structure set -up MEC - Mechanical Permit Insulation 4 Inspection Description Date Passed By Drywall nailing Post /beam mechanical Suspended ceiling Engineered soils Gas line Welding Lab Final Mechanical rough -in Concrete Lab Final Fire damper Bolting Lab Final Duct work Structural observation Smoke detector Fireproofing Lab Final x Mechanical final 2Z -o/ Final inspection PLM - Plumbing Permit I3UP — Fire Protection System Permit Inspection Description Date Passed By Plumbing underslab 4 Inspection Description Date Passed >�y Crawl drain Sprinkler underfloor /slab Post/beam plumbing Sprinkler rough in Plumbing top -out Sprinkler final RP /backflow preventer Fire alarm final Rain drain Storm drain Water service SIT - Site Permit Sanitary sewer J Inspection Description Date Passed By Culvert/catch basin Footings Pump /fill septic tank Foundation walls Plumbing final Sprinkler supply lines Sprinkler underfloor /slab _ _ Catch basin /Manhole SWR - Sewer Permit Engineered soils 4 Inspection Description Date Passed By Engineering acceptance Sanitary sewer Final inspection Final inspection Inspection Record - BUP, PLM, SWR, ELC, ELR, MEC, SIT Permits is \dsts \ forms \InspRecordBUP.doc 04/17/01 /06;e1 0 �4 iemly 73 /eRNS7 7e- is4 3o / yS . T os 1 :$5 1 • MASTER PERMIT A lli. CITY ® 1 AR® • �' /, / ® 1 PERMIT #: MST97 -00308 of DEVELOPMENT SERVICES DATE ISSUED: 10/3/97 �''�' I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE ADDRESS: 16030 SW 103RD AVE PARCEL: 2S114BB -15500 SUBDIVISION: RIVERVIEW ESTATES ZONING: R -7 BLOCK: LOT: 001 JURISDICTION: TIG REMARKS: Garage addition. Proposed driveway must not encroach into the visual clearance triangle. BUILDING REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 20 FIRST: 0 sf BASEMENT: 0.00 sf LEFT: 12 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: 50 SECOND: 200 sf GARAGE: 500 sf FRONT: 0 PARKING SPACES : 0 TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: 0 sf RIGHT: 0 VALUE: $ 28,910.00 OCCUPANCY GRP: R3 BDRM: 0 BATH: 0 TOTAL: 200.00 sf REAR: 45 PLUMBING SINKS: 0 WATER CLOSETS: 0 WASHING MACH: 0 LAUNDRY TRAYS: 0 RAIN DRAIN: 0 TRAPS: 0 LAVATORIES: 0 DISHWASHERS: 0 FLOOR DRAINS: 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0 TUB /SHOWERS: 0 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: 0 GREASE TRAPS: 0 OTHER FIXTURES: 0 MECHANICAL FUEL TYPES FURN < 100K: 0 BOIUCMP < 3HP: 0 VENT FANS: 1 CLOTHES DRYER: 0 GAS FURN > =100K: 0 UNIT HEATERS: 0 HOODS: 0 OTHER UNITS: 1 MAX INP: 0 btu FLOOR FURNANCES: 0 VENTS: 0 WOODSTOVES: 0 GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 0 • 200 amp: 1 0 • 200 amp: 0 W /SVC OR FDR: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF: 0 201 - 400 amp: 0 201 - 400 amp: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR: 0 LIMITED ENERGY: 0 401 - 600 amp: 0 401 - 600 amp: 0 EA ADDL BR CIR: 0 SIGNAL/PANEL: 0 IN PLANT: 0 MANU HM /SVC /FDR: 0 601 - 1000 amp: 0 601 +amps- 1000v: 0 MINOR LABEL: 0 1000+ amp /volt : 0 PLAN REVIEW SECTION Reconnect only: 0 > =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: 0 Owner: Contractor: TOTAL FEES: $ 498.21 This permit is subject to the regulations contained in the ABELL, WARREN + DEBORAH OWNER Tigard Municipal Code, State of OR. Specialty Codes and 4 1 16030 SW 103RD AVE all other applicable laws. All work will be done in TIGARD, OR 97224 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 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 CO Erosion Control Insp 84 Electrical Rough In Insulation Insp Building Final Footing Insp Electrical Rough In Gyp Board Insp Foundation Insp Framing Insp Misc. Inspection Mechanical Insp Framing Insp Electrical Final Electrical Service Gas Line Insp Mechanical Final 0 Issued By : r 40 Permittee Signature ) .-1146(2.(12 OA Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day 6/6/00 Activities for Case #: MST97 -00308 EXpi� 2:10:27 PM Er) Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA005 Application received 7/25/97 JD RECD BON 7/30/97 MSTA008 Permit Created 7/30/97 B PASS BON 7/30/97 MSTA010 Check for prcl. restrict. 7/30/97 B PASS BON 7/30/97 MSTA012 Plans routed to Plans Examiner 7/30/97 B PASS BON 7/30/97 MSTA026 Plans approved by Pln Examiner 8/4/97 RT PASS BT2 8/4/97 MSTA030 Reviewed plans routed to DSTS 8/4/97 RT PASS BT2 8/4/97 MSTA032 DST Post- Review Completed 8/7/97 DRA PASS DRA 8/7/97 MSTA700 Erosion Control lnsp 844 -8444 BON 7/30/97 • MSTA705 Footing Insp 9/9/97 RB PASS J *H 9/14/97 1. Stubout for continuous . footing at wing walls of garage. 2. Install UFER ground rod. Extend to a height of 12- inches above mud sill. Lap hook 12- inches and tie with 3 -ties, 20 -ft. total length required. Tie all joints together. (Illustration . on insp. report). Call for . reinspection. MSTA706 Foundation Insp 9/9/97 RB PASS J *H 9/14/97 MSTA723 Electrical Service • 11/5/97 MJR PASS MJR 11/5/97 MSTA724 Electrical Rough In 10/6/97 MJR PASS J *H 10/9/97 Physical protection required for storage area light. Protect lights in soffit from insulation. Electrical rough in approved. Good work! MSTA725 Framing Insp 10/7/97 TLP PASS J *H 10/7/97 9/12/97 - Dwg 3 has been revised over the phone with Bob P - the 2 X 6 Girder truss , 2 X 6 common trusses, and ridge have been changed on the office plans to reflect the following; 2 X 10 ridge, the Girder Truss will become a header 2- 2 x 12 lamenated, the • rafters will be 2 x 8's. This change will aloow the roof line to match existing. All loads have been checked, and this revision will comply. Bob Poskin MSTA740 Insulation Insp 12/31/97 TLP PASS VLN 7/13/98 MSTA745 Gyp Board lnsp 1/30/98 KS PASS J *H 1/30/98 MSTA755 Rain drain Insp 1/4/99 TLP PASS TLP 1/4/99 MSTA790 Electrical Final BON 7/30/97 MSTA795 Mechanical Final 6/24/99 MS PASS AKJ 6/24/99 Page 1 of 2 2. 6/6/00 Activities for Case #: MST97 -00308 • 2:10:27 PM Assigned Hold Updated Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes MSTA799 Building F J *H 10/7/97 100797, see framing inspection • report in file (stairs to be • completed in the future.) MSTA720 Mechanical Insp BT2 8/4/97 MSTA080 (F) Ready to issue 8/7/97 DRA PASS DRA 8/7/97 Have owner sign Owner Responsibilty Form prior to issuance. MSTA092 (F) Issue combination permit • 8/11/97 DRA PASS CTR 8/11/97 need electrical signature form MSTA092 (F) Issue combination permit 10/3/97 GEO PASS DST 10/3/97 MSTA735 Gas Line Insp 10/10/97 KS PASS VLN 7/13/98 Moving gas line: 1. Extension of gas piping, PT = 20 psi, for 15 mins. 2. Support piping at six -ft. intervals and at each change of direction. MSTA724 Electrical Rough In 12/31/97 BRP PASS J *H 12/31/97 Stairwell work approved MSTA725 Framing Insp 12/31/97 TLP PASS J *H 1/1/98 Approved as noted: correct stairwell height to minimum of 6•-8" at finish. MSTA770 Misc. Inspection 2/22/00 2/22/00 2/22/00 JMT DONE No Hold JMT 2/22/00 research inspection request MSTA153 Expired by limitation 6/5/00 HAP DONE No Hold AKJ 6/5/00 • • • • Page 2 of 2 • • •