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Permit
CITY OF TIGARD MASTER PERMIT _ 1 i PERMIT #: MST2000 -00221 r DEVELOPMENT SERVICES DATE ISSUED: 7/11/00 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 SITE)ADDRESS: 15029 SW KENTON DR PARCEL: 2S112CB -08200 S�UfBDIVISION: ASHFORD OAKS NO. 2 ZONING: R -7 BLOCK: LOT: 096 JURISDICTION: TIG REMARKS: Construction of fireplace enclosure, to include installation of gas fireplace and associated gas piping, and one branch circuit. BUILDING REISSUE: STORIES: FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: OTR HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: TYPE OF USE: SF FLOOR LOAD: SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: FINBSMENT: sf RIGHT: VALUE: $ 2,000 00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0.00 sf REAR: PLUMBING SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS: LAVATORIES: ' DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS: TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS: OTHER FIXTURES: MECHANICAL FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER: FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS: 1 ELECTRICAL RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS 1000 SF OR LESS: 0 - 200 amp: 0 - 200 amp: W /SVC OR FDR: 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: . DATAITELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 86.50 This permit is subject to the regulations contained in the SMITH, PHILIP D AND VICKY A MARTIN L. CONLEY Tigard Municipal Code, State of OR. Specialty Codes and '15029 SW KENTON DR 4334 NE HANNAH CT all other applicable laws. All work will be done in TIGARD, OR 97223 HILLSBORO, OR 97124 -6871 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 #: LIC 63161 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 Mechanical Insp Mechanical Final Electrical Rough In Building Final � A HFrramiming g Insp 09\G Gas Line Insp Electrical Final Issued y : , ,'. ,∎ _` _i_. /' • - Permittee Signature : � Call (503) 639 -4175 by 7:00 p.m. for an inspection needed the next business day CITY OF TIGARD Residential Building Permit Application Plan -- # 1 i _ C - - 13,12-MW Rec • By ,_ s HALL BLVD. Additions or Alterations Date Recd 7 H -00 • TILARD,''OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. V 503 - 639 -4171 Date to DST F 503 - 684 -7297 Permit # NSA GYJ2 Print or Type Called Incomplete or illegible applications will not be accepted / Name of Project Name / Job Architect Mailing Address Address S ite Address 1 � � /6a�9 ,w �ND� City /State Zip Phone Owner % Na mu P' S�� (� Name ai!�r� res Sl/ 4 a2,61,,e_ Main. • ddress Ci y /Sta �c� /Phoon Engineer � I (CJtJ7�Sf.S? • ity /State Zip Phone General Na e Contractor Ma, ,',. 64 ( 351 -9 22) ! Describe work ew 0 Addition 0 Alteration 0 Repair 0 g �4 to be done: Prior to permit 5 l� Additional Description of Work: issuance, a copy � (/� �7 7 � of all licenses ! J� ©U are required if Oregon Const. Cont. Board Exp. Date / PROJECT po expired in COT Lic.# 63 t ( /. - ��->1 VALUATION database Mechanical Name NEW CONSTRUCTION ONLY: Sub- C ),) /v -.Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address / -k,,,_ Prior to permit , --Ca/14 4 €-- - as Gam'✓ lAz-- Indicate�the restricted energy installation by the electrical f.. issuance, a copy City /State Zip Phone subcontracforon the following areas of all licenses Restricted N. Audio /Stereo are required if Oregon Const. Cont. Board Exp. Date Energy System Alarms expired in COT Lic.# Installations Vacuum Irrigation database ystem System Plumbing Name . (check all that 0 -r: -- Sub- -- - apply) Contractor Mailing Address Corner Lot YES Flag Lot YES NO (check one) ( check one) Has the Subdivision PI. ecorded? /A YES NO Prior to permit City /State Z• Phone issuance, a copy , of all licenses are Oregon Cons ont. Board Exp. Date required if Lic.# expired in COT I hearby a• nowledge that I have read this application, tha the database tubing Lic. # Exp. Date inform- ''on given is correct, that I am the owner or authorized' agent oft ° owner, and that plans submitted are in compliance with • �• State laws. Name t Da Electrical / 7 ' ' / /OD Sub- Mailing Address /� Contact Name Phone # X Contractor .'///'''' SS "" / � / City /State Zip Phone C(G'U Q -( S (" ?) Prior to permit issuance, a copy FOR OFFICE USE ONLY: of all licenses are Oregon Const. C., t. Board Exp. Date Plat #: Map/TL #: required if Lic.# o,SI /.C6 - 610-6o expired in COT database Elec • al Lic. # Exp. Date Setback Zone: /2,... & Solar: Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF: ..------ . is \dsts \forms\sfaddalt.doc 11/20/98 Permit #: ,{ an - � : Address: 15O 4 Z 9 6to E.,/ I D 1/3 m;. vt v ') :: \ Issued C Date: 71/ 18�� 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 3 or 3B: e .S . 1. I own, reside in, or will reside in the completed structure. e S' 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. n 3A. My general contractor is -ei N Co/ 6 3 4 Na Contractor regis. ) is. # g I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR ri 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. (74 7////, (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) - ^ Itnformat Notice to Propery Owners About Construction Respons`b 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 exi i structure, you can prevent many problems by b aware of the following responsibilities and areas of concern. EMPLOYER RESPONISIMMES: 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 Raw: 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 ybur employees. For more information, cail 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. 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 done of your employees is injured untbo'ob. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. Dn&emmsUMmvmnnmService: 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. OTHEm RESPONSHilLilTUES AMID AREAS OF COHCERM: Code compliance: As the permit holder for this p jeci.ynumro:upooxihlefbccexo]viogooyfai]ucctnnucotoudco:guinorncots 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 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 uu – GwVZ- 24 -Hour Inspection Line: 639 -4175 • Business Line: 639 -4171 BUP , myt Date Requested AM PM BLD et"111W— Location (5 O 7 54/ /C- i-,v`vr^— Suite MEC Contact Person Ph 6.?(( PLM Contractor Ph SWR C BU,IL pJNG., 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 Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: PART FAIL P Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL ECHANI Vost & Beam Rough In Gas Line Smoke Dampers PART FAIL f rorzifiz Service Rough In UG /Slab Low Voltage Fire Alarm ., 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 7! / 0,v 0 Ins / 0 Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.