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Permit CITY OF TIGARD MASTER PERMIT ', �� DEVELOPMENT SERVICES PERMIT # • MST97 -0327 �' DATE ISSUED: 08/13/97 :_.. 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639.4171 PARCEL: 2S111BD -01100 SITE ADDRESS...: 09685 SW SATTLER ST SUBDIVISION •DARMEL ZONING: R -3.5 BLOCK LOT •12 JURISDICTION: TIG Remarks: Addition BUILDING REISSUE: STORIES • 1 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS— REQUIRED CLASS OF WORK.:ADD HEIGHT • 14 FIRST • 275 sf GARAGE • 0 sf LEFT • 8 SMOKE DETECTRS: TYPE OF USE...:SF FLOOR LOAD : 40 SECOND...: 0 sf FRONT : 0 PARKING SPACES: 0 TYPE OF CCNST.:SN DWELLING UNITS: 0 FINBSNENT: 0 sf RIGHT • 0 OCCUPANCY GRP.:R3 BORN: 0 BATH: 0 TOTAL------: 275 sf VALUE..$: 18398 REAR • 0 PLUMBING SINKS : 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0 LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 0 CATCH BASINS..: 0 TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0 OTHER FIXTURES: 0 MECHANICAL FUEL TYPES FURN (1Y.1 ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0 FURN ) =109K ..: 0 UNIT HEATERS..: 0 HOODS : 0 OTHER UNITS...: 0 MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOUDSTOVES : 0 GAS OUTLETS...: 0 ELECTRICAL — RESIDENTIAL UNIT— — SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS -- —MISCELLANEOUS— — ADD'L INSPECTIONS- 1'.''. SF OR LESS: 1 0 - 209 alp..: 0 0 - 280 alp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0 EA ADD'L 500SF.: 0 201 - 409 alp..: 0 281 - 4'.'. alp..: 0 1st W/O SVC /FDR: 0 SIGN /OUT LIN LT: 0 PER HOUR • 0 LIMITED ENERGY.: 0 401 - 600 alp..: 0 401 - 600 alp..: 0 EA ADDL BR CIR: 0 SIGNAL /PANEL...: 0 IN PLANT • 8 MANF HM/SVC /FDR: 0 601 - 1' amp.: 0 601 +amps- 1' v: 0 MINOR LABEL -10: 0 1090+ amp /volt.: 0 PLAN REVIEW SECTION Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 609 V NOMINAL: CLS AREA /SPC OCC: ELECTRICAL - RESTRICTED ENERGY A. SF RESIDENTIAL B. COMMERCIAL AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT: BURGLAR ALARM..: 0TH: :: BOILER HVAC • LANDSCAPE /IRRIG: PROTECTIVE SIGNL: GARAGE OPENER..: CLOCK • INSTRUMENTATION: MEDICAL • OTHR: .. HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL 0 SYSTEMS: 0 Owner: Contractor: TOTAL FEES:$ 344.16 RODNEY FURLOTT & ELIZABETH FURLOTT OWNER This permit is subject to the regulations contained in the 9685 SW SATTLER 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: Phone 0: not started within 180 days of issuance, or if the work is Reg 9..: ww 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 952-091 -0010 through OAR 952-081 -0988. You may obtain copies of these rules or direct questions to SIC by calling (583)246 -1987. REQUIRED INSPECTIONS Footing Insp Electrical Final Electrical Rough Building Final Framing Insp Insulation Insp Gyp Board Insp _—� Issued By: ��= Permittee Signature: + + + + + + + + + + + + + + + + + ++ .+ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++ + + + + ++ + + + + + + + + + + + ++ Call 639 -4175 by 6:00 p.m. for an inspection needed the next business day 7 144 Plan Ch e /" /1`7 ITY OF TIGARD Residential Building Permit Application Recd B .4. i;;5 SW HALL BLVD. New Construction Additions or Alterations . Oate 7- -9 7 IGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. 503- 639 -4171 Date to DST Q l V( 503-684-72:7 - Permit* ST - 43 - 12- Print or Type called b---( ` _) Lo Incomplete or illegible applications will not be accepted ' Name of Protect _ Name, Job o.Lt ,CfCVZcd - Lt.2.ui-1--, Address Site Address Architect Mailing Address glofal) +1e2I.�t / iry/State i Phone ocl d Eft zak-/-1 F,��f f q I s -3 -A,42 Mailing Name Owner R63 S +' 1 . . Engineer M A ddre ss City/State p Phone Narfle 114 e ll s � 1-9Y39 City /State Zip . Phone . General 5 l.0 Describe wont New 0 Addition Alteration 0 Repair 0 Contractor Mailing Address _ - , to be done: Additional Description of Work: City/State Zip Phone . . i p W a 2 m Oregon Const Cont. Board tic.* Exp. Date Attach Copy of Current COT Business Tax or Metro # Exp. Date PROJECT `(6 t Licenses VALUATION Name Aechanical _.._ — _ _ .. _._._.. "NEW CONSTRUCTION ONLY: • = - Sub- Mailing Address : 2 '7.5 Sq. FL Garage Contractor -- - - - --- - - Corner Lot YES NO Flag Lot YES NO ✓ City/State Zip - Phone (check one) (check one) Oregon Const. Cont. Board tic.* Exp. Date Restricted Audio /Stereo Burglar .ttach Copy of - Energy.. ' - System , . Alarm Current COT Business Tax or Metro # Exp. Date Installation Garage Door ' HVAC Licenses - - Opener - . Systems Name - Qumbing (�, �� (check all that Other • Sub- _.- Mailing Address - Will the electrical subcontractor wire for all YES NO antractor 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 .loch Copy of (Calculation Attached) _ Current Plumbing Lic. Exp. Date I hearby acknowledge that I have read this application, that the • Licenses 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. � � Si to z �er/ lectrical '7i Date Sub- Mailing Address Cogtifact Person Name Phone # .ontractor • - `� S 9Q- 45cov City/State Zip Phone FOR OFFICE USE NLY: M / Oregon Const Cont Board tic.* Exp. Date (tlt l� #•2 2 /T S/ / / (f , - (j // Uttach Copy of Setbacks: s i Zone: /�J Solar. Current Electrical Lc. * I Exp. Date / - \ 7 Licenses no p Planning Approval: TIF: FA . COT Business Tax or Metro * Exp. Date I � � i �� 3EMDL.DOC (DST) 5/97 ( ' r4. 1 Permit ii Acct. Descritpion COT WACO Amount Amt. Pd. Bal. Due ; i l l , t ri A i MST. Permit (BUILD) (UBUILD1 / 3 ✓ a' s° � . 6 Plumb. Permit (PLUMB) (UPLUMB) Mech. Permit (MECH) (UMECH) ELC /ELR Permit • ( ELPRMT) - ( UELPMT) /10 ' /10 - State Tax " AX) . (UTAX) 12-9k 3 7 ' 0 BLDG: (,13v PLUMB: MECH: . ELC/ELR: -- 550 Plan Check - • - • / . MST: (BUPPLN) ( UBUPLN) .4i Af 113 .50 • Plumb: (PLUMB) - ( UPLUMB) - . _ _ _ Mech: • (MECPLN) (UMEPLN) - • -- - CDC Review (BUILD) (CDCBLD) (UCDC) CDC Review (PL•) - .(CDCPLN) • • . N/A Sewer Connon (SWUSA) (USWUSA) Reimbur. District ( ). _ ( . ) Sewer Inspection (SWINSP) (USWINS) . Parks Dev Charge (PKSDC) N/A .. Residential TIF - (TIF -R) - - - (UTIF -R) _ .• - -- • - - Mass Transit TIF — . f TIF -MT) : " - (UTIF -M) _ . _ _ 1 . 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) $,;* - TOTALS: 'AL/, lb /57 1 `1,/ ��d 10 I:SFREMDL.DOC (DST) 6197 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE OWNER ignature Form Permit # tg=01Z277 - Date Issued.: 08/13/97 Parcel 2S111BD -01100 Site Address: T1r - ST1 . Subdivision.: DARNEL Block Lot: 12 Jurisdiction: TIG Zoning R -3.5 ..Remarks : Addition 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 work. No electrical inspections will be authorized until this completed form is received. AN INK SIGNATURE IS REQUIRED ON THIS FORM OWNER: ELECTRICAL CONTRACTOR: RODNEY FURLOTT & ELIZABETH FURLOTT OWNER 9685 SW SATTLER TIGARD OR 97224 Phone #: 624 -9439 Phone #: Reg #..: 999999 • Sig ' ure of Su•ervising E`trician Please return this completed form to the address above. ATTN: Building Dept. If you have any questions, please call 639 -4171, ext. #310 • Permit #: MA- 5 / g Q 7 al b . ,� ,�, Address: c--7)(0% -- _ 7 e--K ;.-z Issued by: Date: (V ,F-5-0 Statement: Information Notice to Property Owners About Construction Responsibilities I 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: r i 1. I own, reside in, or will reside in the completed structure. 7/I 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 7 A 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. r - 8#3/9 7 Signature of permit applicant) (Date) (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 dei'eloped 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 RESPONSIBILITIES: 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, he 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. 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 he 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 Service: As an employer, you must withhold federal income tax from employees' wages. You will he liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Seim- ic.e 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 accident.; and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must he 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 Bo&fd (PO BOX t4140, 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 1 CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 6 - °a- r 0 000 /rU 1 / p)1.4,6 Date Requested: A.M. P.M. MST: / 6 3, 7 Location: ! & lJ BUP: Tenant: Suite: ( Bldg: MEC: Contractor: /p, M J i Phone: ' .4-1) 3 7 PLM: Owner: Phone: ELC: ELR: SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ETRICAL LEC SITE Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm Footing Roof UndFl/Slab Rough -In _ _ _ Water Line Slab Framing Top Out Gas Line ' o : - UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approv Approved Appr /Sdwlk Not Approved Not Approved Not Approved o pproved Not Approved FINAL FINAL FINAL FINAL FINAL r40v 5 4 / — P6' s' 0 Call for reinspec ' n Reinspection fee of $ l required re before next inspection 0 Unable to inspect ^ ^ L Inspector: Date: / Page of 1 CITY OF TIGARD BUILDING INSPECTION NG I SPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: / -- c- 3 — 9rf A.M. P.M. MST: q 7-4327 p Location: [ ' 5 A BUP: Tenant: n Suite: Bldg: MEC: Contractor. �/� Phone: 6 -q (137 PLM: Owner: Phone: ELC: ELR: SIT: BUILDING LDG n't) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm Footing �Roof UndFl/Slab Rough -In Ceiling Water Line Slab r' Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt pproved Approved Approved Approved Approved Appr /Sdwlk Yy , oved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL • O Call for - inspec N 0 O Reinspection fee of $ required before next inspection CI Unable to inspect Inspector: - Date: / -23- F U Page of CITY OF TIGARD BUILDING INSPECTION DIVISION 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171 Date Requested: " 7 7 A.M. P.M. MST: 9 7O 32i Location: 9 C S5 .�� BUP: Tenant: Suite: Bldg: MEC: Contractor: Phone: PLM: Owner: Phone: ELC: ELR: SIT: BUILDING BLDG (con't) PLUMBING MECHANICAL ELECTRICAL SITE Site Post/Beam Post/Beam Post/Beam Cover /Service Sewer /Storm oo 11 Roof UndFl/Slab Rough -In Ceiling Water Line Sla • Framing Top Out Gas Line Rough -In UG Sprinkler Foundation Insulation Sewer Hood/Duct Reconnect Vault Bsmt Damp Drywall Storm Furnace Temp Service MISC. Masonry Ceiling Rain Drain A/C UG Slab Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt Approved Approved Approved Approved Appr /Sdwlk o pproved Not Approved Not Approved Not Approved Not Approved FINAL FINAL FINAL FINAL FINAL . L ) /�-e._ /yt� p-1---1fr" ■l4-;fn-- ca✓ c. - cy O Call for reinspection O Reinspection fee of $ required before next inspection CI Unable to inspect Inspector: ,...7 Q Date: O '" 2- - 9 7 Page of CITY OF TIGARD MS BUILDING DIVISION PERMIT #: 9 � _ £03c.7 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 /�P+ r� Inspection Requests (24 Hrs.): (503) 639 -4175 ` _ �� INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: ES CLASS OF WORK: SUBDIVISION: 76, LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection) Request Scheduled For: Date: 7 -d-s- 6 k, Pour Tim .: P, (-- c M Code # Inspection Description Confirm # Contact # Message ?('N a91 (ea �{ -gy39 Corr ons /Comma syl tructions: - 5/ /, PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL F R INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /& 5 h (,,.... Phone #: (503) 718- 20/6 CITY OF TIGARD BUILDING INSPECTION DIVISION MST Q7 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 ((RI BUP e 1 < Date Requested AM Z PM BLD Location q C3c k) Suite MEC Contact Person O( (,�,� ( 0 Ph Go ? "Q`F 0 % � :` = C Contractor Ph BUILDING Tenant/Owner ELC Retaining Wall ELR Foundation ACCeSS:� GG �� , ' 1, FPS Ftg Drain �� t c-G ��� / ./ ( SGN Crawl Drain InspeF ig N P,s: w L C am / _ j , Slab I IJ w� 'mac C(�T x.tR� 7�•C UU SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Fra d _ 623 � �� �i . i ! � nsulatio 2 a Nailing c�k!J . �r e Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof • Mis a ART FAIL BING 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 ADA Approach /Sidewalk ( /'�/� l Other Date ! r a �� / 1 C Inspector � ' Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site. CITY OF TIGARD BUILDING INSPECTION DIVISION M- 9 60 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 i2 BU • e �► Date Requested AM PM BLD Location 6 /(00S <Sedi Suite MEC 1g99-00 ,M0 C-/ gl1tieYlratAti p ,h ContractorAu tae , /r j/i' yU } /[q Ph (Ogg Zip/() SWR UILDI Tenant/Owner J ELC Retaining Wall ELR Footing Access: Foundation „ f � � , ^ �r, ^ 4 - a Cc FPS Ftg Drain �/ (/U I Y �.. SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath/Shear N ► l M C ff lnt Sheath /Shear Framing Insulation Drywall Nailing /f� Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: • 6,-mertiA , S PART FAIL a L �jJ � J43 ��" �- PLUMBING Post & Beam Under Slab / Top Out Water Service ` ►f`L / / /� � / � , '� 01' Sanitary Sewer Rain Drains Final PASS PART FAIL ICA 7 Post & Beam Rough In Gas Line Smoke Dampers ( •ART FAIL CTRIC i Service Rough In UG /Slab Low Voltage ( Warm 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 [ ] Please call for reinspection RE: [ ] Unable to inspect - no access Fire Supply Line ADA Otheoach /Sidewalk Date l 973 Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.