Permit \ ■ 613
�' r? MASTER PERMIT
CITY TI GARD PERMIT #: MST93 -00256
4 DEVELOPMENT SERVICES DATE ISSUED: 5/18/93
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
SITE ADDRESS: 13010 SW KATHERINE ST PARCEL: 2S104AA - 09900
SUBDIVISION: BELLWOOD NO. 3 ZONING: R -4.5
BLOCK: LOT: 119 JURISDICTION: TIG
REMARKS: PATH I
BUILDING
REISSUE: STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: 25 FIRST: 194 sf BASEMENT: 0 sf LEFT: 0 SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 40 SECOND: 806 sf GARAGE: 0 sf FRONT: 0 PARKING SPACES : 0
TYPE OF CONST: 5N DWELLING UNITS: 1 THIRD: 0 sf RIGHT: 0
VALUE: 46
OCCUPANCYGRP: R3 BDRM: 1 BATH: 1 TOTAL: 1,000 sf REAR: 0
PLUMBING
SINKS: 0 WATER CLOSETS: 1 WASHING MACH: 0 LAUNDRY TRAYS: 0 RAIN DRAIN: 0 TRAPS: 0
LAVATORIES: 1 DISHWASHERS: 0 FLOOR DRAINS: 0 SEWER LINES: 0 SF RAIN DRAINS: 0 CATCH BASINS: 0
TUB /SHOWERS: 2 GARBAGE DISP: 0 WATER HEATERS: 0 WATER LINES: 0 BCKFLW PREVNTR: 0 GREASE TRAPS: 0
OTHER FIXTURES: 0
MECHANICAL
FUEL TYPES FURN < 100K: 0 BOIL/CMP < 3HP: 0 VENT FANS: 1 CLOTHES DRYER: 0
/GA FURN > =100K: 0 UNIT HEATERS: 0 HOODS: 0 OTHER UNITS: 0
MAX INP: 0 btu FLOOR FURNANCES: 0 VENTS: 2 WOODSTOVES: 0 GAS OUTLETS: 0
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 0 - 200 amp: 0 0 - 200 amp: 0 W /SVC OR FDR: 00 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EAADD'L 500SF: 0 201 - 400 amp: 0 201 - 400 amp: 0 1st W/O SVC/FDR: 00 SIGN /OUT LIN LT: 0 PER HOUR: 0
LIMITED ENERGY: 0 401 - 600 amp: 0 401 - 600 amp: 0 EAADDL BR CIR: 0.00 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: $ 633.25
MARKOZAN LYNN TOAUS This permit is subject to the regulations contained in the
KIN
KIN M R KATHERINE ST. L LYNN CAMELOT Tigard Municipal Code, State of OR. Specialty Codes and
13010 S , OR KATHERINE COURT all other applicable laws. All work will be done in
PORTLAND, OR 97225 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:
Oregon law requires you to follow rules adopted by the
Phone: 503 - 524 - 7424 Phone: Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through 952 - 001 -0080. You
Reg #: may obtain copies of these rules or direct questions to
OUNC by calling (503) 246 -1987.
REQUIRED INSPECTIONS
Foot/found Insp Mechanical Insp Framing <REINSP> Insulation Insp Misc. Inspection Plumb Final
Post/Beam Structural Plumb Top Out Gas Line Insp Insulation Insp Electrical Final Final inspection
Post/Beam Mechanical Plumb Top Out Insulation Insp Gyp Board Insp Electrical Final Final inspection
PLM /Underfloor Electrical Rough In Insulation Insp Gyp Board Insp Mechanical Final Final inspection
Mechanical Insp Framing Insp Insulation Insp Misc. Inspection Mechanical Final Final inspection
I --
Issued By :/ .i L `. l ` - x . _ _ ____.,,./.,%i/ Permittee Signature :
Call (503) 639 -417' •y 7:00 p.m. for an inspection needed the next business day
CITY OF TIGtll`D 13125 SW H Bl PLNCK /RECT # /
PERMIT # g'41, • 0 A2S
COMM UNITY D EVELOPM ENT DEPARTM ENT Tigard. °"8cn
(503)9 am DATE ISSUED
JOB ADDRES S: PO 1D S Koi ��- ` r ∎ TAX MAP /LOT -S/ a f t 4 14 —a ffe0a
SUB: gi'/ / /4/v4. LOT: / / 9 LAND USE:
VALUATION: 4t 00 0
OWNER �/ SPECIAL NOTES
/ NAME: 1�� REISSUE OF:
ADDRESS: 1,c SW LAST REISSUE:
/RC- l - 7 FLOOD PLAIN/
PHONE: ' Q3 1U SENSITIVE LAND:
CONTRACTOR APPROVALS REQUIRED
NAME: 56 PLANNING:
ADDRESS: ENGINEERING:
FIRE DEPT:
PHONE: - OTHER: NO 7 /F
CONTR. BOARD #: EXP DATE:
ITEMS REQUIRED
SUBCONTRACTORS: PLUMB: _5 Er
LIST /SUBCONTRACTORS:
MECH: BUS TAX:
ARCH /ENGINEER CALCULATIONS:
NAME :A- G eLl(-66 r TRUSS DETAILS:
ADDRESS: ` q S � S ' H
' `� ),', OT ER:
(AflorklgtArv\ Ot 70i (
PHONE: (03 /4-a -c-c6t.
PROPOSED BLDG. USE: Al' ` C,5t j O W,
COMMENTS: I f \ Co )c - \S °Ct I �Lki �✓ �C-
w v(k_ wti
APPLICANT SIGNATURE
Received By: Date Received: 3 93
PERMIT # ACCT # DESCRIPTION AMOUNT AMOUNT PD. BAL. DUE
10-432 00 Building Permit Fees 026s, &0 ,•�� " +l ? lr
10 -431 00 Plumbing Permit Fees ?O :
10 -431 01 Mechanical Permit Fees r2 a / i
10 -230 01 State Building Tax (5 %) / 4 /6
Building /3. 21
Plumbing /,r) /
Mechanical tot( /
10 -433 00 Plans Check Fee / 7 2. Z �� 15 j � 9 5
Building /72. 2, )4
Plumbing
Mechanical
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
(SSDC)
24- 445 -01 Water Quality (Fee in lieu of)
24- 445 -02 Water Quantity (Fee in lieu of)
TOTAL 50t. G/60 Doe•24
nm /3587P.WPF
•
•
o F o Permit No: 3^ U Z5�
. V \F 3 b t 4?%^ Address: l l U, ) � I�lirw
a ' z Issued by Date: 5 7 g - -3
5 g FOR OFFICE USE ONLY
STATEMENT:
• . 'INFORMATION NOTICE TO PROPERTY OWNERS
.. 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 .the following 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 I. own, reside in, or will .reside.in °the completed structure.
2 . I I•understand•that = 1 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, strut=
ture must be registered with the Construction Contractors V
OR •
3. B. I will be my own general contractor.
. , . If I hire subcontractors, I will hire only subcontractors registered with the Construe-
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, of this form.
-
Signature of Permit Appl Date
•
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91 '
WHITE COPY TO ISSUING AGENCY PERMIT FILE
. ' - PINK COPY TO APPLICANT •
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 in accordance 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 RESPOr SP = }ILITIES: •
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 vvill 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
•
. 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 RESPONSII3 LITIES 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 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 10/24/89 - .
CITY OF TIGARD 24 -Hour (,
BUILDING Inspection Line: (503) 639 -4175 MST - ` ,'3 66°Z5 _
l"
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP
Received 2, Date Requested ' / v AM PM BUP
Location / ✓ ID Suite MEC
Contact Person �� Ph ( ) 3/ U ' - 2 7 PLM
Contr . �J Ph ( ) SWR
ILDING Tenant/Owner C a ELC
fi
Foote r ELC
Foundation Access:
)< Ftg Drain � "I /O � ELR 3 I
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam -
Shear Anchors � (l (()/1�
Ext Sheath/Shear / d J �/
Int Sheath/Shear
Framing
Insulation
Drywall Nailing �n V / /��,,,
Firewall 5 7» % �- mdi /� 7 fT f c7 7 !rte -rocs /frj 7 /
Fire Sprinkler
Fire Alarm t' dr /9 •
di Susp'd Ceiling �.
Roof dL C "de/T
fi r. " `
ART FAIL
BI
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
T FAIL
''L
Post & . earn
Rough -In
Gas Line
SII ._e Dampers
4174° RT FAIL
fRIc
Rough -In
UG /Slab
Low Voltage
Fire Alarm
�ii+±+�'� - ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
•', SS PART FAIL
❑ Please call for reinspection RE: ❑ Unable to inspect - no access
Fire Supply Line
ADA r� /0
Approach/Sidewalk
Date � '" Inspector Ext
PP
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY 7 TIGARD 24 -Hour
� s Q
BI" DING Inspection Line: (503) 639 -4175 MST G3 "6 6 c
INSPECN DIVISION Business Line: (503) 639 -4171
•
BUP
Received Date Requested _t ( AM PM EMP
Location / 3D ID da...14Az.::„..) Suite MEC
Contact Person Ph ( ) q-7 - `i' PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation Access: ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: -°-- SIT
Post & Beam
Anchors �^
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling Th
Roof
Other:
Othe
, '•
PART FAIL
Post & Beam
Under Slab
Rough -In n
Water Service I
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART 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 Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line - - -
ADA Date 2 105 Inspector 7 T!5 Ext
Approach /Sidewalk
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
Mcr9 3 - op 2 5 Co
CITY OF TIGARD BUILDING INSPECTION NOTICE
Inspection Line: 639 -4175 Business Phone: 639 -4171
Footing Rain Drain Cover /Service FINAL:
Foundation Water Line Ceiling - Plumb.
Post/Beam Mech. Shear /Sheath Framing -Mech.
PIbg.Und /FIr /Slab Plbg. Top Out Insulation - Elect.
Post/Beam Struct. Mech. Rough -in Gyp. Bd. -Bldg.
San. Sewer Gas Line Appr /Sdwlk Reins.
Other:
• Date: J "v A.M. P.M.' (�Cntry:
Address: V 4b.
Tenant: m.ae A(. ,v d s -C9Ste: MST:
BUP:
Con /Own: MEC:
PLM:
•
ELC:
THE FOLLOWING CORRECTIONS ARE REQUIRED: ELR:
eiz j r ,
.
- �
p f r h 9 / X ' LI 4 l 7
Ins ector: �, � Date:
X APPROVED _ DISAPPROVED /CALL FOR REINSP. 4110 CO
SEP -11 -1996 15:26 WRSH.CNTY.OR.LUT /BLDG 1 503 681 3993 P.01
Hermits Live OD La: ACFP150 Keyword: UACT User: BLDGTMP1 09/11/96
, Activity Maintenance - Inspection Processing Residential Electrical
Permit #: 05043875 Applicant: KENNEDY, MATT
Status: APPROVED Address: 13010 SW KATHERINE ST TI
Dept: Div:
Inspection Item: 00499 Description: Final Electrical
Inspection Times =Li =3=
Date Inspector Action Notation Begin End Elpsd Entry No
n08/24/93 DA RI AM 1
n08/24/93 WB APPR APPROVED 2
09/01/93 WB APPR APPROVED 3
Enter Option: A =Add an Entry F2 =Next Item F5 =First 12 Entries
C= Change an Entry F3= Previous Item ESC= Return to Item List
D=Delete an entry F4 =Next 12 Entries