Permit CITY OF TIGARD MASTER PERMIT
i� �-� 1 , DEVELOPMENT SERVICES PERMIT # - MST97 -0277
• -..71'00,111 • ' I .. 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 07 17 97
PARCEL: 2S111AD -04700
SITE ADDRESS...:08990 SW PINEBROOK ST
SUBDIVISION - PINEBROOK TERRACE ZONING: R -4.5
BLOCK LOT -70 JURISDICTION: TIG
Remarks: Patio cover
— - -- BUILDING -- - - --
REISSUE: STORIES • 1 FLOOR AREAS -- BASEMENT...: 0 sf REQUIRED SETBACKS - -- REQUIRED-------------
CLASS OF WORK.:GTR HEIGHT : 10 FIRST • 432 sf GARAGE • 0 sf LEFT : 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 40 SECOND...: 0 sf FRONT • 0 PARKING SPACES: 0
TYPE OF CONST. :5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 10
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL : 432 sf VALUE..$: 5162 REAR • 30
- -- -- - PLUMBING - - ----
SINKS : 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
----- -- MECHANICAL -- - -- -
FUEL TYPES - - - -- FURN ( 100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 6AS OUTLETS...: 0
---- — ELECTRICAL — — --
- RESIDENTIAL UNIT— — SERVICE /FEEDER -- —TEMP SRVC /FEEDERS— -- BRANCH CIRCUITS -- -- MISCELLANEOUS -- - -ADD'L INSPECTIONS--
1m SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA RDD'L 500SF.: 0 201 - 400 amp..: 0 201 - 4'' amp..: 0 1st W/0 SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR : 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT : 0
MANF HN /SVC /FDR: 0 601 - 1000 amp.: 0 601+amps- 1m v: 0 MINOR LABEL -10: 0
1000+ amp /volt.: 0 - -- -- PLAN REVIEW SECTION - - -- - - - --
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC:
- - -- --------------------- ELECTRICAL - RESTRICTED ENERGY -- ____ - ___
A. SF RESIDENTIAL - -- B. COMMERCIAL - - -- — - — - - - --
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE MGM:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL OTHR: .•
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL 0 SYSTEMS: 0
Owner: -- -- -- Contractor: TOTAL FEES:$ 96.06
JACKSON, B F OWNER This permit is subject to the regulations contained in the
8990 SW PINEBROOK Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97224 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 0: 620 -7532 Phone 0: 639 -4171 X370 not started within 180 days of issuance, or if the work is
Reg 0..: •x••131 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 952-001-%10 through OAR 952- 001 -0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
----- - - - - -- -- -- REQUIRED INSPECTIONS ---- - - -- ------- - - - - --
Framing Insp
Rain drain Insp
Building Final
Issued By: (Vk " . -- -- Permittee Signat�_ire�`� --5• Mb � 4
+++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + ++ + + + ++
Call 639 -4175 by 6:00 p.m. for an inspection needed the n --. - - .ay
Plan Check # O �' i - 3(Z
l O F TIGARD R esidential Building Permit Application Redd By <;;;12—; 31 5 SW HALL. BLVD. New Construction Additions or Alterations Date Recd O 7 37 -
'GARD. 01 97223 Single Family Detached or Attached (Duplex) Date to P.E. - 7 -
503-636-411 Date to OST ?- / — 7
503 - 614-7297 Permit * 1- — 17
. Print or Type called 4'
Incomplete or illegible applications will not be accepted
Name of Pro Name / - •
Job / �� - 0 a � � Mailing Address
Address Site Address Architect ng .
Name B 9 �o�w ��'@zi� City /State Zip Phone
Z .1so4.)•
Name )
Owner Mailing �D� 772.10.414.04e
> ,-/\ . � / � / �j��7 ��
� / �l� �)x/ 14 ..
//Ya 2 �'/ ( J
Engmeer Zip Phone g meer Mailing Address
- 77 - P.&/&"0,41,. 97,22 G '� - - ie �' boy G 90 3 9
to Zip Phone
Nafne General 58 c p Describe work New (V Addition Alteration 0 Repair 0
Contractor Mailing Address to be done:
9 9) SJ.C/. i 1 2 e4 ? Additional Description of Work:
City/State Zip Phone
•
Orfton Const. Cont. Board Lic.r! Exp. Date
Attach Copy of / "2
Current COT Business Tax or Metro /t Exp. Date PROJECT /
Licenses VALUATION ( - / 7
Name
Mechanical , f /e_-- - -_ ._. _. , ' NEW CONSTRUCTION ONLY: , -
Sub - Mailing Address Sq. FL House: 44 S G 4 Sq. FL Garage
,Z9/)f /8 / C6vPiZ
Contractor Corner Lot YES NO Flag Lot YES NO
City/State Zip - Phone (check one) (check one)
Oregon Const. Cont. Board Lid* Exp. Date Restricted Audio /Stereo Burglar
Attach Copy of Energy System • - Alarm
Current COT Business Tax or Metro # Exp. Date Installation Garage Door HVAC
_icenses
Name Opener Systems
Plumbing /r °_ (check all that Other ' � ' e,/
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. Cont. Board Lic.# Exp. Date Reissue of MST* Solar Compliance
-ttach Copy of (Calculation Attached)
Current Ptumoing Lie # Exp. Date
Licenses I hearby acknowledge that I have read this application, that the
- •
COT Business Tax or Metro # Exp. Date information given is correct, that I am the owner or authorized
agent of the owner, and that plans submitted are in compliance
Name with Oregon State laws
Electrical e t e of 0 - /A& nt Date
Sub I Mailing Address Contactmo 4 - m - Phone #
Contractor .�� / /, ,c - • o; IZ6 - 's`32
City /State Zip Phone FOR OFFICE USE ONLY:
•
Plat
Oregon Const. Cont. Board Lie* Exp. Date K KN ZSI 1 1 X) - 1410
"tt Copy of Se�tb�ck • i Zo—:. `' S olar, .
Current E!ernpt Lie a # i Ex p Oate 0 t r L \ K L� tk`llJr�-
Licenses Enginesring Approval: l Plajt Approval: TIF: I ,
COT Business Tax or Metro # i Exp. Date K N
=REMDLDOC (DST) 3/97
ht 514 -627 ?MST. Permit (BUILD) (UBUILD$ ! 5 -6. 0 ,
Plumb. Permit (PLUMB) (UPLUMB)
t
Mech. Permit (MECH) (UMECH) V i
ELC/ELR Permit (ELPRMT) (UELPMT)
State Tax (TAX) (UTAX) 2,
BLDG: ,
PLUMB:
MECH:
ELC/ELR:
Plan Check
MST: (BUPPLN) (UBUPLN)
Plumb: (PLUMB) (UPLUMB)
Mech: -
(MECPLN) (UMEPLN) __V - -
COC 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) -V (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) -
Fire Life Safety (FLS) (UFLS) S 33
TOTALS:
%i t) ( , 3
•
I:SFREMDLDOC COST) 6197
Permit #: J ` 61' 62 :1 1
s • F
�, � ° q7/ ' P(Oo�.
v e Address:
•`. Issued by: 'JVll1L Date:
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.
/ Er
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
. Ei 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
il 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.
/--)
Sign; ture of pe ; .. . plicant) / (Date)
Whl e 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).
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 probiem6 by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement or 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 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 insurance tea! 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 information,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888.
U.S. internal Revenue Ser cc: 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 IN ithhold the tax. For more information, call the Internal Revenue Service
at 1- 800 - 829 -1040.
OTHER RESPONSIBILITIES 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.
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.p
1 /94
06/12/2000 Activities for Case . #: MST97 -00277 1 •
8:46:04 AM I
• Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes __ __ -
MSTA005 Application received 07/03/1997 JD RECD ;BON 07/10/1997
MSTA008 Permit Created 07/10/1997 B • PASS 'BON • 07/10/1997
MSTA010 Check for prcl. restrict. 07/10/1997 B PASS BON 07/10/1997
MSTA012 Plans routed to Plans Examiner 07/10/1997-- B PASS BON 07/10/1997
MSTA026 Plans approved by Pln Examiner • 07/11/1997 RT PASS BT2 07/11/1997
MSTA030 Reviewed plans routed to DSTS 07/11/1997 RT - PASS BT2 - 07/11/1997
MSTA032 DST Post - Review-Completed 07/16/1997 TT PASS TAT 07/16/1997
MSTA725 Framing Insp 08/19/1997 RC PASS ROC 08/20/1997
• MSTA755 Rain drain Insp 12/02/1997 MS PASS I J'H 12/09/1997 tied to existing
I
MSTA799 Building Final 06/05/2000 HAP PASS ;AKJ 06/05/2000 passed by review
MSTA080 (F) Ready to issue 07/16/1997 TAT PASS TAT 07/16/1997
MSTA092 (F) Issue combination permit 07/17/1997 B PASS ,DST 07/17/1997
MSTA970 Case Finaled 06/05/2000 HAP DONE No Hold AKJ 06/05/2000
•
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•
Page 1 of 1 -
CITY OF TIGARD BUILDING INSPECTION DIVISION MST g7- C6a77
24 -Hour Inspection Line: 639 -4175 Business Line: 639 - 4171
BUP
D ate Requested ' ^ AM PM BLD
Location b � L1 D PL Y\Q , IUI" b �. St Suite MEC
Contact Person Ph PLM
Contractor'&t)A.LY (> r (T4 CZ_ O' 1 Ph (D W-7S SWR
CMffa Tenant/Owner ELC
Retaining Wall ELR
Footing ss:
ACC
Foundation , � p � /�1.. f] �¢-, O c n' ,�� n FPS
Ftg Drain 1"` �f' Y W(' Civ1./ v C. SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing r
Insulation / / r
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm •
Susp'd Ceiling
Roof
Misc:
PART FAIL
• F MBING
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 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
Approach /Sidewalk D " I / Ext Other
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.