Permit A , CITY OF TI GARD BUILDING PERMIT
PERMIT #: BUP2000 -00283
16, DEVELOPMENT SERVICES DATE ISSUED: 7/27/00
1
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1096A -06900
SITE ADDRESS: 13874 SW LEAH TERR
SUBDIVISION: HILLSHIRE SUMMIT NO. 2 ZONING: R -7
BLOCK: LOT: 055 JURISDICTION: TIG
REISSUE: FLOOR AREAS EXTERIOR WALL CONSTRUCTION
CLASS OF WORK: ACS FIRST: sf N: S: E: W:
TYPE OF USE: SF SECOND: sf PROJECT OPENINGS?
TYPE OF CONST: 5N sf N: S: E: W:
OCCUPANCY GRP: R3 TOTAL AREA: 0.00 sf ROOF CONST: FIRE RET?
OCCUPANCY LOAD: BASEMENT: sf AREA SEP. RATED:
STOR: HT: ft GARAGE: sf OCCU SEP. RATED:
BSMT ?: MEZZ ?: REQD SETBACKS REQUIRED
FLOOR LOAD: psf LEFT: ft RGHT: ft FIR SPKL: SMOK DET:
DWELLING UNITS: FRNT: ft REAR: ft FIR ALRM : HNDICP ACC:
BEDRMS: BATHS: IMP SURFACE: PRO CORR: PARKING:
VALUE: $ 3,556.00
Remarks: PATIO COVER 14 X20
Owner: Contractor:
JOHN F NAEGELI OWNER
DIANNA M SCHUMACHER
13874 SW LEAH �
TI konee'. qJ ui b Phone:
Reg #:
FEES REQUIRED INSPECTIONS
Type By Date Amount Receipt Footing Insp
PLCK BT2 7/7/00 $44.53 0003545 Framing Insp
Final Inspection
PRMT DEB 7/27/00 $68.50 0004034
5PCT DEB 7/27/00 $5.48 0004034
CDCB DEB 7/27/00 $20.00 0004034
Total $138.51
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -1987. You may obtain a copy of these rules or direct questions to OUNC by
calling (503) 246 -1987.
Pe rm itee
Signature: -,----- - I .
' t , /
Issued By: „� �
Call 639 -4175 by 7 p.m. for an inspection the next business day
C;T" - ^F TIGARD Residential Building Permit Application Plan Check# — 3 /4
Recd By
13125 SW HALL BLVD. Additions or Alterations Date Recd 7/7/eCO
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 7-- -00
V 503 - 639 -4171 Date to DST 7- Z Y — "' v
F 503 - 684 -7297 / 2
/(� Permit #,PMP, 00,
Print or Type Called
Incomplete or illegible applications will not be accepted
I/i l fsh ; .v , 94.1.44 • * L
Name of Project / /9 -E L - / Name
Job P A r 05 C `- t — Architect Mailing Address
� Address Site Address
L $7 `-( S 61._ V City /S to Zip Phone
Name
e■Cdv -' /1/4--t4, Name
Owner Mailing Address
i "" c', '7 `E S ` x.) ` - T Mailing Address
City /State Zip Phone Engineer
-- T' ( (i*-(Z 0 a k co ,2 -2_9_ .3 39 6 City /State Zip Phone
General Name
Contractor 6 f■M Describe work New ® Addition 0 Alter tion ,` Repair O
Mailing Address to be done: /y X A 6 r a.,f'O Aethd Cr1 /kA)
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 ' ort
database
Mechanical Name • NEW CONSTRUCTION ONLY:
Sub- q. Ft. House: Sq. Ft. Garage
Contractor Mailing ess
Indi the restricted energy installation by the electrical
Prior to permit subcontr- tor in the following areas
. issuance, a copy City /State Zip Phone Restricted Audio /Stereo
of all licenses
are required if Oregon Const. Cont. Board Exp. Date Energy System arms
expired in COT Lic.# Installations Vacuum Irrigation
database stem System
Plumbing Name _— _ (check all that Of
Sub- apply)
Contractor Mailing ddress Corner Lot YES NO -g Lot YES _ NO
(check one) (chec• one)
Has the Subdivision Plat re • ded? YES NO
Prior to permit City /State Zip Phone
issuance, a copy
of all licenses are Oregon Const. Co t. Board Exp. Date
required if Lic.# I hearby a owledge that I have read this application, that ` e
expired in COT
database Plumbing Lic. # Exp. Date inform =n given is correct, that I am the owner or authorized :.•ent
of the owner, and that plans submitted are in compliance with
Oregon State laws.
Name Si ture of Owner /Agent Date
Electrical / `' `1' - O - Q_.' -/ C. to 0
ContAct Person Name ZS Phone #
Sub- Mailing Address / Z- G1�c -s �t g 0 -63 ry (o
Contractor
City /State Zip Phone `
Prior to permit
issuance, a copy FOR OFFICE USE ONLY:
of all licenses are Oregon Const. Cont. Boa Exp. Date Plat #: M ap , #: n
required if Lic.# ( (s � ! -(J�p G v
expired in COT °
database Electrical-Lic: 4- xp. Date- - Setbacks; Zone: SDlar:
- - R-7 -
Electrical Supervisor Lic. # Exp. Date Engineering Approval: Planning Approval: WIF.
_ i:\dsts \forms\sfaddalt.doc 11/20/9E
1 0 1 Ae i.// - 7 5_3
Date Rec'd:
CITY OF TIGARD Rec'd By:
SINGLE FAMILY ATTACHED OR DETACHED (New, Addition) Plan Check #:.
APPLICATION /PLANS SUBMITTAL REQUIREMENTS '
Applicants: Please complete
1. APPLICANT NAME: PHONE #:
2. SITE ADDRESS: FAX # ,.
N,
k
1. 5 SITE PLANS (Full d drawn to scale) labeled with:
❑ map & tax lot #, ❑ ubdivision name, ❑ subdivision lot #, ❑ Ate addr;ss,
❑ zoning, ❑ applicant name, ❑ phone number.
Size requirement: 8 -1/ " x 11" to a maximum 11" x 17" a d NOT attached • tiding plans.
A. North Arrow.
B. Scale (any standard, rchitectural or engineers only).
•
C. Street Names.
D. All building plans shall r flect actual build. g dimensions.
E. Finished floor elevations all levels, ac al topographical).
F. Garage finished floor elev tion (act .I topographical).
G. Corner lot elevations ( actua topo :2 raphical).
H. Driveway corner elevations.
I. Zoning setbacks (front, side ,d rear).
— - J. The location of all public and pri ate easements.
K . The location, terminati. , and all vert elevations of all drainage piping (sanitary
and storm) showing elevations necessary to show positive gravity flow to the
approved drainage ;evice (i.e.: pee holes, storm lateral, sanitary lateral).
L. Residential drivew =ys, sidewalks and heelchair ramps will be shown on site
plans and will be n accordance with th CITY OF TIGARD standards. Drive -way
cuts shall not be permitted within 30 feet f intersecting right -of -way lines nor
within 5 feet of oroperty lines. Weep holes/ rain pipes will be installed 5 feet from
adjoining prop: rty lines. Multiple driveways n individual parcels of land must
have 30' of se,•aration; joint use driveways re ire a formal agreement.
M. Show all proposed ero•;ion control devices osed for site; refer to UNIFIED SEWERAGE
p
AGENCY , A Technical Guidance Handbook ( evised 1994), or telephone
USA at 648 8621 for assistance.
N. Show loc ion of existing facilities and new or relocat d structures (mailboxes,
power poles, water meter, light pole, stop sign, etc...).
O. Indicate property slope directions.
P. Existing and finished contours when slope in any direction exceeds 20 %.
(ADDITIONAL REQUIREMENTS MAY APPLY, SEE GRADING POLICY).
Odsts\forms\sfreq.doc 4/20/99
i
1 Permit #: OL7O 60e9M
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_ :,mot,. 74 o
N. ' ._..r a:
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Issued bye ae ■rktri.A4 Date: 7 --- -
.r 59
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:
A � 1. I own, reside in, or will reside in the completed structure.
/R 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
I I (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
K 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 erty Owners about Construction Responsibilities on the reverse side of / this form.
s--)(_ s � �
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
•
IlnlormAton HoUce to Prroperty Ownerrs
11-r
About Coco ResponsH3iMes
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 RESPONSOMMES:
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 he 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.
Unemplloyment 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 if one of your employees is injured on the job. For more infonnatien,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
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 I -800-829-1040.
OTHER RESPONSEDLMES Al D 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
accident.; 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 1-4140; Salem, OR 97309-5052,
503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop-own .prn4
1 /94
CITY OF TIGARD BUILDING INSPECTION DIVISION
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
BUP Z - 00 293
Date Requested 1 Z' 2 - 7 AM PM BLD •
Locations /S 6 7 (( $ w 4,4 Suite MEC
V - r
Contact Person n /74 4 9 3'/1 Ph 390 -D f' PLM
Contractor Ph SWR
UILDIN Tenant/Owner a d4 >14( RI° 5i t - ELC •
Retaining Wall Tv ti 0 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
'ASS PART FAIL
PLUMBINGg$ , ` fy
Post & Beam •
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL `a er-
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final •
PASS 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
• Other- . Date /2 -27—oei Inspector • Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.