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Permit 4 14 CITY OF TIGARD rOrb PERM T# PERMIT MT 000 -00043 _ ' , DEVELOPMENT SERVICES DATE ISSUED: 2/24/00 't 13125 SW Hall Blvd., Tigard, OR 97223 (5'.. 3 1 • SITE ADDRESS: 10466 SW LADY MARION DR PARCEL: 2S111CB -04400 SUBDIVISION: MARION ESTATES ZONING: R -3.5 BLOCK: LOT: 017 JURISDICTION: TIG REMARKS: Construction of 500 square foot addition to existing single family residence. BUILDING REISSUE: STORIES: 1 FLOOR AREAS REQUIRED SETBACKS REQUIRED CLASS OF WORK: ADD HEIGHT: 25 FIRST: 500 sf BASEMENT: sf LEFT: 5 SMOKE DETECTORS: Y TYPE OF USE: SF FLOOR LOAD: . 40 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : TYPE OF CONST: 5N DWELLING UNITS: 1 FINBSMENT: sf RIGHT: 5 VALUE: $ 35,485.00 OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: sf REAR: 56 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: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER: GAS FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: 1 MAX INP: btu FLOOR FURNANCES: VENTS: 1 WOODSTOVES: GAS OUTLETS: 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: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS: Owner: Contractor: TOTAL FEES: $ 777.29 NORGART, RANDALL E + STACEY L OWNER This permit is subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and 10466 SW LADY MARION DR 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 844 -8444 Post/Beam Mechanical Electrical Service Electrical Final n Underfloor insulation Gas Line lnsp Mechanical Final Footing Insp Crawl Drain /Backwater Gas Fireplace Plumb Final Foundation lnsp Footing /Foundation Dn Insulation Insp Final inspection Pos eeanrStructural Mechanical lnsp Rain drain lnsp • • - - / i / ,r Iss ' Permittee Signature : u ed By : � �/ ! ��i.�_ _ 9 rx �.-- Call (503) .39-4175 by 7:00 p.m: for an inspection needed the next business day � - Check # � CIT` - O� IGARD Residential Building Permit Application Recd Plan Ch h # \ 13125 SW HALL BLVD. Additions or Alterations Date Recd —� O • • TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. A -/l V 503 - 639 -4171 ��oo Date to DST ": - 5/1 -(id F 503 - 684 -7297 fi " 1' Permit # / f 5 To`taif5 - thee 5 Print or Type Called aR - 0 7 3 - Incomplete or illegible applications will not be accepted 35 e-Gpr lfP7 , Name of Project Name Job VOA-pe/A7 � �� Address Site Address Architect Mailing Address /O 4 S f " J LAD`i .f-i '10; 04. City /State Zip Phone N , a �� e ,jj Ogi iU ►G �I 1 " Name Owner Mailing Address )Dylaly Sw L TAid- O. City /State Zip e Engineer Mailing Address fil G Al i ad-- G!? 2Z�/ i��� n -4cal City /State Zip Phone General Name w ho P-tiC° l 2 Cc 0 Contractor � Nc'� Describe work New 0 Addition Alteration 0 Repair 0 Mailing Address _ to be done: Prior to permit Additional Description of Work: issuance, a copy City /State Zip Phone of all licenses are required if Oregon Const. Cont. Board Exp. Date PROJECT expired in COT Lic.# VALUATION $ 3 5, Lifer database Mechanical Name NEW CONSTRUCTION ONLY: Sub- Ocynict t.— Sq. Ft. House: Sq. Ft. Garage Contractor Mailing Address dicate the restricted energy installation by the electrical . Prior to permit issuance, a copy City /State Zip Phone su tractor in the following areas of all licenses Restricts Audio /Stereo are required if Oregon Const. Cont. Board Exp. Date Energy System ` arms expired in COT Lic.# Installations Mi - Irrigation • database ` ' System Plumbing Name (check all that - Oth` .Sub- ()&,-,&/ `L i apply) Contractor Mailing Address Corner Lot ENO k of YES NO (check one) (check on-- Has the Subdivi Plat recorded? N/A - YES NO Prior to permit City /State Zip Phone issuance, a copy of all licenses are Oregon Const. Cont. Board Exp. Date required if Lic.# I hearby acknowledge that I have read this application, that the expired in COT database Plumbing Lic. # Exp. Date information given is correct, that I am the owner or authorized agent of the owner, and that plans submitted are in compliance with • Ore.. - State laws. Name `• n- re of Owner /An,en Date �� �� ,P-4 ,P-4 O0 Electrical / Address Con t Pert n Name Phone # Mailing g - .Vp / i1 4 - acts - asp Contractor • City /State Zip Phone Prior to permit O QrO,0 E Th T3 /-0 7 issuance, a copy FOR OFFICE USE ONLY of all licenses are Oregon Const. Cont. Board Exp. Date Plat #: Map/TL #; required if Lic.# a 51//e6 -6 W e3 expired in COT database Electrical Lic. # Exp. Date Setbacks: Zone.:_. 5 Solar Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: TIF: is \dsts \forms\sfaddalt.doc 11/20/98 FROM : CREATIVE ELECTRIC LLC FAX NO. : 503 982 0926 Apr. 06 2000 05:11AM P1 CITY Of TIGARD 13126 SAN, HALL BLVD. TIGARD. OR 97223 • o � IMPORTANT PERMIT NOTICE CREATIVE ELECTRIC INC 6 13220 BETHLEHEM DR NE GERVAIS, OR 97206 Electrical Signature Form Permit #: MST2000.00043 Date Issued: 02!2412000 POOR O1IA1 ORIGINAL Parcel: 28111CB -04400 BEST RE:PRODUtTIQN AVAILABLE Site Address: 10486 SW LADY MARION DR Subdivision: MARION ESTATES Block: Lot: 017 Jurisdiction: TIG Zoning: R.3.5 Remarks: Construction of 500 square foot addition to existing single family residence. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the . appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, A I 1 N: Building Dept. No electrical Inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: NORGART, RANDALL E + STACEY L CREATIVE ELECTRIC INC 10466 SW LADY MARION DR 13220 BETHLEHEM DR NE TIGARD, OR 97224 GERVAIS, OR 97206 • Phone #: Phone #: 503 -982 -0926 Rea #: 5UP 353385 a. 2a -3s4C AN INK SIGNATURE IS REQUIRED ON THIS FORM x 3 9 's S nature of Sup ising Electrician — If you have any questions, please call (503) 6394171, ext. # 310 Permit #: /yl Vr,g 000 — Dom` of O �'.. -�'P � : ' ���e � `� Address: SW GADS /�Ii9�b� ` :' z OO Issue ,by:� Date: �' 1859 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: f l i 1. I own, reside in, or will reside in the completed structure. rel 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 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 IN 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 Pro , • 'y Owners about Co 1 uction Responsibilities on the reverse side of this form. ref �■ L�_i _ 7-?-/ Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) Inlormgtion M© i© Propeny Ownerrs AbouA ©onarucUT_Dcrt ResponsrtMes • - 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 i,11. acting as your own contractor to construct A new home of make a substantial improvement to an existing structure, you car, prevent many problems by being aware of the following responsibilities and areas of concern. PLOY FO RESPONSEEPLIITES: 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 withlhold!riag tzsr ia As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable fo : 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 t..gxL As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For , riore information, call the Oregon Employment Division at the Department of Human Resources at 378-3524. Workers' cornpemnjalt i;195: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your ernpleyees. If you fail td obtain workers' compensation insurance, you may he subject to penalties and will liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. !Internal Revenue Sr.: As an employer, you must withhold federal income tax from employees' wages. You will be liable foi 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. OTMER RESPONSilEHLMES 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 punctures, fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Experdse: 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 W0 3 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP Date Requested �O f / J/OO AM l ° s PM BLD Location 1 a LI LO ( C1-9 ,r;Yl )(suite MEC Contact Person Ph Sig PLM Contractor Ph SWR gUILD110 � , - Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain Crawl Drain Inspection Notes: Slab O or 15 ill6A TN 4✓ Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall • Fire Sprinkler Fire Alarm Susp'd Ceiling Roof • • 4IPIP PASS PART FAIL i�� - ►[cam • Post & Beam Under Slab Top Out Water Service Sanitary Sewer V Rain Drains • - Vail. PART FAIL Post & Beam Rough In Gas Line . Smoke Dampers I -. PART FAIL E ICAL 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 - 7 1:) " Approach /Sidewalk Date l ( 5 ( u Inspector Ext Other Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. • CITY OF TIGARD BUILDING INSPECTION DIVISION MST 2•`0oo�3 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 BUP Date Requested (0/g/ © AM PM BLD Location I O f V4 ( eL9 yf {/]il Suite MEC Contact Person Ph S(9 cc' 8 / j PLM Contractor arCierv l Ph SWR BUILDING, ; . r `:y :,._ Tenant/Owner ELC Retaining Wall ELR Footing Access: Foundation j FPS Ftg Drain ! V W r ` l 3 ✓� G am}` d/���/1/e++/ SGN Crawl Drain Inspection Notes: C% � e n, j / Slab �f SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear S � Framing J / �� /' / ^ \I Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling r,4.7.4 Roof Misc: Final it c PASS PART FAIL PLUMBING Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS ART FAIL LECTRIC Service Rough In UG /Slab Low Voltage • Fire Alarm , SS 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 l Inspector r Other Date ? � I EXt _ Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.