Permit r.
. - CITY OF TIGARD
MASTER PERMIT
� n d ,e DEVELOPMENT SERVICES PERMI TSUED: # MST2�36c.
t"N DATE 091W2197 97—
A- AL 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171
PARCEL: 2S103CB -020@0
SITE ADDRESS•••:12220 SW JAMES ST
SUBDIVISION ZONING: R -4.S
BLOCK LOT • JURISDICTION:
Remarks: 528 sq. ft. accessory building
- -- BUILDING -- -
REISSUIE: STORIES : 1 FLOOR AREAS — BASEMENT...: 0 sf REQUIRED SETBACKS ---- REQUIRED—
CLASS OF WORK.:RCS HEIGHT • 12 FIRST • 0 sf GARAGE • 528 sf LEFT • 5 SMOKE DETECTRS:
TYPE OF ULSE...:SF FLOOR LOAD : 50 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0
TYPE OF CONST. :5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT : 5
OCCUPANCY 6RP.:R3 BDRM: 0 BATH: 0 TOTAL - -: 0 sf VALUE..$: 9335 REAR • 15
- ---- ---- -- PLUMBING - ---
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH°.: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES : 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
- MECHANICAL
FUEL TYPES FURN (1'.'.1 ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN ) =1sa': ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
' MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 GAS OUTLETS...: 0
ELECTRICAL — - ---- --
- RESIDENTIAL UNIT— --- SERVICE /FEEDER— —TEMP SRVC /FEEDERS — — BRANCH CIRCUITS— -- MISCELLANEA --- - -ADD'L INSPECTIONS—
' 1' SF OR LESS: 0 0 - 200 alp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 . 201 - 400 amp..: 0 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HM /SVC/FDR: 0 601 - 1w amp.: 0 601 +amps- 1m v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 --- PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) V NOMINAL: CLS AREA /SPC OCC:
— -- ELECTRICAL - RESTRICTED ENERGY — — -
A. SF RESIDENTIAL B. COMMERCIAL ------------ ---- -- - - - -- ----
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL . • OTHR: •.
HVAC DATA /TELE COMM.: NURSE CALLS • TOTAL B SYSTEMS: 0
Owner: — Contractor: ---- TOTAL FEES:$ 136.86
CROUCH, FRED & KAREN OWNER This permit is subject to the regulations contained in the
12220 SW JAMES ST Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone I): 579 -7763 Phone R: not started within 180 days of issuance, or if the work is
Reg g..: 0w 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-%1 -0010 through OAR 952- 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
trest — -- - REQUIRED INSPECTIONS --------- — -----
Footing Insp
Framing Insp
Rain drain Insp
Final inspecti
Issued B : Permittee Si nature° /
9
C
+ + + + + + + ++ +++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + ++ + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day
Plan Check - #. ��72k
CITY OF T.IGARD Residential Building Permit Application Rec'd By G16.
°3125 SW HALL BLVD. New Construction Additions or Alterations Date Rec'd g P6-97
'i IGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. q 4 1
V 503- 639 -4171 Date to DST -.ZJ - r
F 503 - 684 -7297 Permit # �,T�7 - ® L
Print or Type Called C2 '!
Incomplete or illegible applications will not be accepted
Name of Project Name
j r-
Job 6-,- g rtf-g
Address Site Address Architect Mailing Address
t'22 SI w . S✓7�°e5 cS — ..
City/State Zip Phone
Nam -PIA Cr U C9 .► Name
Owner Mailing Address
1 0 £,v-. J fl-Mz -
5 S --
Engineer City /State � Phone • En i Mailing Address g /�
/v 0 42., , b - 2-23 s - 3
City /State / Zip Phone
Na
General S'9-4A � _..--.- Describe work New/It Addition 0 Alteration 0 Repair 0
Contractor Mailing Address to be done:
Additional Description of Work:
City/State Zip Phone
22- &A r A-- ,-
Oregon Const. Cont. Board Lic.# Exp. Date
Attach Copy of
Current COT Business Tax or Metro # Exp. Date PROJECT /GU
I Licenses VALUATION $ 3 3J,
Name
Mechanical /1/0/u/e .--J� •
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.# Exp. Date Restricted Audio /Stereo Burglar
Attach Copy of / \ Energy System Alarm
Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC
Licenses Opener Systems
Name
(check all that Other:
Plumbing ,/ apply)
Sub - Mailing Address Will the electrical subcontractor wire for all YES NO •
Contractor restricted energy installations?
City /State /ZIP Phone Has the Subdivision Plat recorded? N/A YES NO
Oregon Const. Con Board Lic.# Exp. Date Reissue of MST #: Solar Compliance
Attach Copy of
(Calculation Attached)
Current Plumbing Lic. # 1 : Exp. Date I hereby acknowledge that I have read this application, that the
Licenses _. information given is- correct, that I am the owner or authorized
COT Business Talc or Metro # Exp. Date agent of the owner, and. that plans submitted are in compliance
s Name
with Oregon State laws.
Sign of O ner /• .2: D t
Electrical Mailing .M 2 . % 7
S Ub- g Address • Cont t Perso {ate '' hone ° #
Contractor / �3zd ` .. k- 377 F-77
City /State / Zip Phone FOR OFFICE USE ONLY: !.i ;• : '- -9Q� �0a6 /dye / " Plat 0:1 •
Oregon Const. C�nt. Board Lic.# Exp. Date /Ut Z51 �.Jr�'"' Z�d
Attach Co , . i. Copy of : ° _ i ._. Setback on � Sol ar:
Current Electrical Lie.•# _ Exp. Date 2 N -1, � �
Licenses : ' '''' rn En in ring Approval: Planning Approval: TIF:
C, Tax or Metro # Exp. Date P M I t,3 ¶' — D� I / 1A
,.. _ sr
. f .�'. wl afrrolf
,
••
Permit # Acct. Descritpion COT C . WACO Amount Amt. Pd. Bal. Due
M5 /17- 03 (o Z MST. Permit (BUILD) ( UBUILD) �' c �. s ° w "�✓
Plumb. Permit (PLUMB) (UPLUMB)
Mech. Permit (MECH) - (UMECH) .
ELC /ELR Permit (ELPRMT) (UELPMT)
State Tax (TAX) (UTAX) * i 0_23._ _ , ——
BLDG: 4-03
PLUMB:
MECH:
ELC /ELR:
Plan Check
MST: (BUPPLN) ( UBUPLN) 2 3 '° 4 / t , 63 7s70
Plumb: (PLUMB) (UPLUMB)
Mech:
(MECPLN) (UMEPLN)
CDC Review (BUILD) (CDCBLD) (UCDC)
CDC Review (PLN) (CDCPLN) N/A
Sewer Connon (SWUSA) (USWUSA)
Reimbur. District ( ) ( )
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)
Erosion Planck/COT (EROSN) (UEROSN)
i „N.:
Fire Life Safety (FLS) (UFLS) ,_
TOTALS: � ,? 1
4
I:SFAPP.DOC (DST) 4/97
Permit #: /JSV'99 - 0 3 6 PZ
OF
� '= �'F��� .0' Address: f .R 54 �e_S
Issued by: ( t Date: r
1 859 �
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.
n 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
I 1 before or upon completion.
ri 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
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 Const • tion Responsibilities on the reverse side of this form.
---p _,_.,/Z-- l'2---77
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
A
RnVormation Nolace to Properity Owners
AbouR Conercactkpn ResponsitHNIes
-
Note: This infbrmation 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.
ERiPLOYER RESPCNISIBIUTQES:
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:
Ovegon's w iirg tar 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 :11 11 .1SartinCe ICZTLZ As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. 1 more information, call the Oregor Employment Division at the Department of Human Resources
at 378-3524.
Workers' carrEletntsaEom in5z.mrace: 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' CompensEeion Division at the Department of Consumer and Business Services at 945-7888.
U.S. w1i rievenve C2:1'.'12: 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.
' RE.SPONSOMTES AKIO AREAS OF COMCERNI:
Code complliamm, As the permit ho;der for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your a0.ention through inspections.
Liability and proirty 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
1194
N- 9' 7- co 36, 2
August 25, 1997 CITY OF TIGARD
OREGON
Fred and Karin Crouch
12220 SW James Street
Tigard, OR 97223
Re: MIS 97- 0015 /Accessory Structure
Dear Mr. and Mrs. Crouch:
This letter is in response to your request for approval of a 528 square foot, 13- foot -tall
Accessory Structure /Garage. The Director has approved this structure finding that it
meets the approval standards of Section 18.144 of the Tigard Community Development
Code.
The structure is on a parcel of land that is smaller than 2.5 acres and zoned R -4.5. The
structure, as proposed, does not encroach into the five (5) -foot side yard and rear yard
setbacks required for accessory structures in residential districts. The structure also
does not exceed 15 feet in height or 528 square feet in size. There are no identified
sensitive lands. Therefore, the structure meets the requirements of the applicable
development code sections for this type of use.
This Accessory Structure approval allows the structure in the location proposed,
however, you are required to obtain building permits prior to construction. Please
submit a copy of this letter of approval with your request for building permits.
Please feel free to contact me concerning this information if you have any questions.
Sincerely,
44/
Julia Powell Hajduk
Associate Planner
i:\curpin\julia\mis\crouch.acc
c: MIS 97 -0015 land use file
Development Services Technicians
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
.. :. -_ aS:1. , !K:�'v ....�.. ii3 °;. :..�::N .. :N. , $:3� . . , ., ^'ity{ti 'Ah�e.K'•s`tu ' � a._'L:., _ ....
5-21
2037
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4
Date Requested: q q S A.M. P.M. MST: ? 7-036<)--...
Location: [ A a n „R A BUP:.
Tenant: Suite: /� -7 Bldg: MEC:
Contractor: L /�,Q Phone: 5
7 — ! 7 7 3 PLM:
Owner: Phone: ELC:
i
at / .%. _ _L . . _ �! /.J . ... -- -. 1 _ ELR:
BUILDING - BLDG i n't) '' LUMBING ME ' • CAL ELECTRICAL SITE
Site • os i : eam Post/Beam Post/Beam Cover /Service Sewer /Storm
Footing Roof UndFl/Slab Rough -In Ceiling Water Line
Slab Framing Top Out Gas Line Rough -In UG Sprinkler
Foundation Insulation Sewer Hood/Duct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
is • • • : • Approved Approved Approved Approved
Appr /Sdwlk ": _ • ved Not Approved Not Approved Not Approved Not Approved
INAL FINAL FINAL FINAL FINAL
6Gt1 c C/4-'L /t1e.4L camL) 6 8
,7� J j e/7,_:: /7 4'Ai/J /' LL S & »74-.' --f --- 7 - 04.G -•:
•
•
•
0 Call for reinspec ' ' El Reinspection fee of $ required before next inspection El Unable to inspect
-- 2- 9--9 e
Inspector: Da Page of